VANDERSON GERALDO ROCHA

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Departamento de Clínica Médica, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina - Líder

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Agora exibindo 1 - 10 de 22
  • conferenceObject
    Clinical, Laboratory, and Genetic Features of Erdheim-Chester Disease Patients from Two Reference Centers in a Developing Country
    (2020) BRANDAO, Antonio Adolfo Guerra Soares; FATOBENE, Giancarlo; ABDO, Andre; LAGE, Luis Alberto De Padua Covas; BENDIT, Israel; NARDINELLI, Luciana; SIQUEIRA, Sheila Aparecida Coelho De; LEVY, Debora; PEREIRA, Juliana; REGO, Eduardo M.; ROCHA, Vanderson
  • article 6 Citação(ões) na Scopus
    MR 4log and low levels of NK cells are associated with higher molecular relapse after imatinib discontinuation: Results of a prospective trial
    (2021) SEGURO, Fernanda S.; MACIEL, Felipe V. R.; SANTOS, Fernanda M.; ABDO, Andre N. R.; PEREIRA, Thales D. M.; NARDINELLI, Luciana; ROCHA, Vanderson; BENDIT, Israel
    Background: Treatment-free survival (TFS) in chronic myeloid leukemia (CML) is a new goal. This prospective study aims to evaluate imatinib discontinuation's feasibility and safety in patients with deep molecular response MR4 (BCR-ABL1 < 0.01 % IS). Methods: Study was approved by the ethical committee and registered at Clinicaltrials.gov (NCT03239886). Incluision criteria were: age >= 18y, chronic phase, first-line imatinib for 36 months, MR4 for 12 months, no previous transplant or resistance. Imatinib was resumed when two samples confirmed the loss of MMR. The primary endpoint was molecular recurrence-free survival (MRFS) at 24 months. Lymphocyte subpopulations were counted in peripheral blood before discontinuation. Results: 31 patients were included from Dec/2016 until Oct/2017. Median age was 54years, 58 % male, 58 % low Sokal, 65 % b3a2 transcripts, and 61 % were in MR4.5. Imatinib therapy's median time was 9.7y (3-14.9 y), median time of MR4 was 6.9y (1.6-10.3y). MRFS at 24 months was 55 % (95 % CI 39-75). Thirteen patients relapsed, 46 % after six months of discontinuation, and all patients recovered MMR. Median time to recover MMR was one month. MR4.5 was the only factor associated with MRFS. NK cells proportion at baseline was lower in patients with only MR4 who relapsed after discontinuation. Conclusion: With a median duration of sustained MR4 above five years, as recommended by most TKI discontinuation guidelines, the TFS was similar to previous studies. Only MR4.5 was associated with lower risk of relapse. Further studies are needed to evaluate whether patients with only MR4 and low NK cell levels are suitable for discontinuation.
  • conferenceObject
    WHO-2016 Classification in ALL By Cytogenetics, FISH and Molecular Biology - Experience of Two Reference Centers in Brazil
    (2018) VELLOSO, Elvira D. R. P.; CORDEIRO, Maria Gabriella; LUCON, Danielle; KISHIMOTO, Renata; LEAL, Aline Medeiros; MAIA, Ana Carolina Arrais; BUCCHERI, Valeria; BENDIT, Israel; SILVA JR., Wellington Fernandes; MANGUEIRA, Cristovao; REGO, Eduardo Magalhaes; ROCHA, Vanderson
  • conferenceObject
    Treatment-Free Response in Chronic Myeloid Leukemia Using Brazilian Imatinib Copies As First Line - Results from Two Prospective Clinical Trials
    (2022) CENTRONE, Renato Torrescasana; SEGURO, Fernanda S.; BELLESSO, Marcelo; NARDINELLI, Luciana; BENDIT, Israel; ROCHA, Vanderson; ALVES, Adelson
  • article 12 Citação(ões) na Scopus
    Risk factors and incidence of thrombosis in a Brazilian cohort of patients with Philadelphia-negative myeloproliferative neoplasms
    (2020) SEGURO, Fernanda Salles; TEIXEIRA, Larissa Lane Cardoso; ROSA, Lidiane Ines da; SILVA, Wellington Fernandes da; NARDINELLI, Luciana; BENDIT, Israel; ROCHA, Vanderson
    Few data are available regarding epidemiology and outcomes of Philadelphia-negative chronic myeloproliferative neoplasms (MPN) in Latin America. Therefore, current models for MPN treatment are based in large cohorts of patients from Europe and North America. In this paper, we conducted a retrospective study to evaluate thrombotic and bleeding events in a cohort of patients with MPN from a reference center in Brazil. A total of 334 patients were included, being essential thrombocythemia the most common diagnosis. Here, we found that 41% of the MPN patients had a thrombotic event prior to the diagnosis. Thrombosis was more frequent in patients under 60 years-old. In a multivariable model, only JAK2 V617F mutation (OR 2.57 95% CI 1.58-4.18, p < 0.001) and presence of two cardiovascular risk factors (OR 1.90 95% CI 1.21-2.98, p < 0.005) were significant for thrombosis. The risk of thrombosis was similar among all subtypes of MPN. Cumulative incidence of thromboembolic event at 5 years from diagnosis was 5.8% (95% CI 3.5-8.9), which is similar to previous studies. The high incidence of thromboembolic events in younger patients suggests that socioeconomic disparities might have a role in the outcomes of MPN
  • article 6 Citação(ões) na Scopus
    Salvage treatment for refractory or relapsed acute myeloid leukemia: a 10-year single-center experience
    (2020) SILVA, Wellington Fernandes da; ROSA, Lidiane Ines da; SEGURO, Fernanda Salles; SILVEIRA, Douglas Rafaele Almeida; BENDIT, Israel; BUCCHERI, Valeria; VELLOSO, Elvira Deolinda Rodrigues Pereira; ROCHA, Vanderson; REGO, Eduardo M.
    OBJECTIVES: The outcomes of refractory and relapsed acute myeloid leukemia (AML) patients in developing countries are underreported, even though the similar classic regimens are widely used. METHODS: We conducted a retrospective comparison of ""MEC"" (mitoxantrone, etoposide, and cytarabine) and ""FLAG-IDA"" (fludarabine, cytarabine, idarubicin, and filgrastim) in adults with first relapse or refractory AML. RESULTS: In total, 60 patients were included, of which 28 patients received MEC and 32 received FLAG-IDA. A complete response (CR) rate of 48.3% was observed. Of the included patients, 16 (27%) died before undergoing bone marrow assessment. No statiscally significant difference in CR rate was found between the two protocols (p=0.447). The median survival in the total cohort was 4 months, with a 3-year overall survival (OS) rate of 9.7%. In a multivariable model including age, fms-like tyrosine kinase 3 (FLT3) status, and stem-cell transplantation (SCT), only the last two indicators remained significant: FLT3-ITD mutation (hazard ratio [HR] =4.6, p< 0.001) and SCT (HR=0.43, p=0.01). CONCLUSION: In our analysis, there were no significant differences between the chosen regimens. High rates of early toxicity were found, emphasizing the role of supportive care and judicious selection of patients who are eligible for intensive salvage therapy in this setting. The FLT3-ITD mutation and SCT remained significant factors for survival in our study, in line with the results of previous studies.
  • conferenceObject
    Chronic Myeloid Leukemia: Comparison of Survival between Pregnant and Non-Pregnant Women
    (2020) GHELFOND, Giovanna Iantevi; SANTOS, Fernanda; SEGURO, Fernanda S.; ABDO, Andre; PEREIRA, Thales; MACIEL, Felipe V. R.; ALVES, Lucas B. O.; BENDIT, Israel; ROCHA, Vanderson; REGO, Eduardo M.
  • article 22 Citação(ões) na Scopus
    Combining gene mutation with gene expression analysis improves outcome prediction in acute promyelocytic leukemia
    (2019) LUCENA-ARAUJO, Antonio R.; COELHO-SILVA, Juan L.; PEREIRA-MARTINS, Diego A.; SILVEIRA, Douglas R.; KOURY, Luisa C.; MELO, Raul A. M.; BITTENCOURT, Rosane; PAGNANO, Katia; PASQUINI, Ricardo; NUNES, Elenaide C.; FAGUNDES, Evandro M.; GLORIA, Ana B.; KERBAUY, Fabio; CHAUFFAILLE, Maria de Lourdes; BENDIT, Israel; ROCHA, Vanderson; KEATING, Armand; TALLMAN, Martin S.; RIBEIRO, Raul C.; DILLON, Richard; GANSER, Arnold; LOWENBERG, Bob; VALK, P. J. M.; LO-COCO, Francesco; SANZ, Miguel A.; BERLINER, Nancy; REGO, Eduardo M.
    By combining the analysis of mutations with aberrant expression of genes previously related to poorer prognosis in both acute promyelocytic leukemia (APL) and acute myeloid leukemia, we arrived at an integrative score in APL (ISAPL) and demonstrated its relationship with clinical outcomes of patients treated with all-trans retinoic acid (ATRA) in combination with anthracycline-based chemotherapy. Based on fms-like tyrosine kinase-3-internal tandem duplication mutational status; the Delta Np73/TAp73 expression ratio; and ID1, BAALC, ERG, and KMT2E gene expression levels, we modeled ISAPL in 159 patients (median ISAPL score, 3; range, 0-10). ISAPL modeling identified 2 distinct groups of patients, with significant differences in early mortality (P <.001), remission (P = .004), overall survival (P < .001), cumulative incidence of relapse (P = .028), disease-free survival (P = .03), and event-free survival (P < .001). These data were internally validated by using a bootstrap resampling procedure. At least for patients treated with ATRA and anthracycline-based chemotherapy, ISAPL modeling may identify those who need to be treated differently to maximize their chances for a cure.
  • conferenceObject
    Rhoa Mutation Is a Potential Biomarker Associated with Adverse Prognosis and High- Tumor Burden in Patients with Nodal Peripheral Lymphomas with T-Helper Follicular Phenotype (nPTCL-Thf): Data from a Brazilian Retrospective Cohort of Nodal PTCL
    (2021) LAGE, Luis Alberto de Padua Covas; BARRETO, Guilherme Carneiro; CULLER, Hebert Fabricio; CAVALCANTI, Jessica Billar; ALVES, Lucas de Oliveira; NARDINELLI, Luciana; BENDIT, Israel; ROCHA, Vanderson; PEREIRA, Juliana
  • article 17 Citação(ões) na Scopus
    Real-life Outcomes on Acute Promyelocytic Leukemia in Brazil - Early Deaths Are Still a Problem
    (2019) JR, Wellington F. da Silva; ROSA, Lidiane Ines da; MARQUEZ, Gabriel Lacerda; BASSOLLI, Lucas; TUCUNDUVA, Luciana; SILVEIRA, Douglas Rafaele Almeida; BUCCHERI, Valeria; BENDIT, Israel; REGO, Eduardo Magalhaes; ROCHA, Vanderson; VELLOSO, Elvira D. R. P.
    Real-life outcomes in acute promyelocytic leukemia are apparently worse than those reported by prospective studies. Retrospective data on 61 adult patients were reviewed. An early death rate of 20% was found, with a 5-year overall survival estimated at 59%. The results of real-life studies differ from prospective trials. Early actions and supportive care are needed, aiming to decrease toxicity, especially in developing countries. Introduction: Although a considerable improvement in survival of patients with acute promyelocytic leukemia (APL) has been seen over the past decades, real-life outcomes seem to be worse than those reported by prospective studies. We aim to describe clinical characteristics and outcomes of adult patients diagnosed with APL in an academic hospital from the University of Sao Paulo. Patients and Methods: We retrospectively reviewed the medical charts of 61 patients with APL diagnosed between January 2007 and May 2017. Baseline clinical features and follow-up data were collected, focusing on early toxicity variables such as infection, bleeding, and thrombosis in the first 30 days from diagnosis. Results: Among the 61 patients with APL, 54 received any chemotherapy. All patients also received alltrans retinoic acid (ATRA). Bleeding events were the main cause of death before receiving chemotherapy. Most patients belonged to the intermediate (43%) and high-risk (41%) groups, according to Sanz score. The '7 + 3 + ATRA' regimen was the most used regimen (n = 38). An early death rate of 20% was found, predominantly owing to sepsis. After a median follow-up of 5 years, only 1 relapse was diagnosed. The overall survival at 5 years was 59%. Discussion: In comparison with prospective trials with ATRA-based regimens, we found an inferior overall survival, mostly on account of a high early-death rate. Our results are in line with other real-life retrospective reports published in the past decades. Conclusion: Results of real-life studies differ from those found by prospective trials. Accordingly, early actions and supportive care are still needed, aiming to decrease toxicity, especially in developing countries.