JULIANA FOLLONI FERNANDES
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina
10 resultados
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conferenceObject NON-MYELOABLATIVE HAPLOIDENTICAL BMT WITH PTCY FOR CHILDREN AND ADULTS WITH SICKLE CELL DISEASES: THE BRAZILIAN EXPERIENCE(2023) BONFIM, Carmem; SIMOES, Belinda; GOUVEIA, Roseane V.; SILVA, Roberto Luiz; LEITE, Lauro Augusto C.; FERNANDES, Juliana Folloni; GARCIA, Julia Lopes; ZECCHIN, Victor Gottardello; LEE, Maria Lucia; KUWAHARA, Cilmara; GOMES, Alessandra Araujo; RODRIGUES, Celso Arrais; NICHELE, Samantha; LOTH, Gisele; GINANI, Valeria Cortze; FELICIANO, Joao Vitor; LIMA, Alberto Cardoso Martins; DARRIGO JR., Luiz Guilherme; FUENTE, Josu De La; KASSIM, Adetola; SEBER, AdrianaconferenceObject The Brazilian Experience with Haploidentical Hematopoietic Cell Transplants (Haplo-HCT) with Post-Transplant Cyclophosphamide (PTCy) in Pediatric Patients with Hematological Malignancies(2020) BONFIM, Carmem; ARCURI, Leonardo J.; COLTURATO, Vergilio; ZECCHIN, Victor G.; KUWAHARA, Cilmara C.; RIBEIRO, Lisandro L.; GOUVEIA, Roseane; FERNANDES, Juliana F.; TAVARES, Rita; DAUDT, Liane E.; DARRIGO JR., Luiz G.; SOUZA, Mair P. de; ROCHA, Vanderson; VILLELA, Neysimelia C.; MARIANO, Livia C. B.; GINANI, Valeria C.; LOTH, Gisele; GOMES, Alessandra A.; ZANETTE, Antonella; HAMERSCHLAK, Nelson; FLOWERS, Mary E.conferenceObject Allogeneic bone marrow transplantation for children and adolescents with severe aplastic anemia in Brazil: A multicenter study on behalf of the Brazil-Seattle Consortium Study Group(2018) DARRIGO JR., Luiz; COULTURATO, Vergilio; SOUZA, Mair; MATTOS, Ederson; LOTH, Gisele; CALIXTO, Rodolfo; SEBER, Adriana; ZECCHIN, Victor; DAUDT, Liane; PAZ, Alessandra; TAVARES, Rita Barbosa; ARCURI, Leonardo; MACEDO, Antonio; VIEIRA, Ana Karine; KUWAHARA, Cilmara; GOUVEIA, Roseane; RIBEIRO, Lisandro; FERNANDES, Juliana; FLOWERS, Mary; PASQUINI, Ricardo; BONFIM, CarmemconferenceObject Outcomes and Immune Reconstitution After T-Cell Replete Haploidentical Stem Cell Transplantation With Post-Transplantation Cyclophosphamide (PTCY) for Pediatric Patients with Primary Immunodeficiencies(2020) FERNANDES, Juliana Folloni; NICHELE, Samantha; ARCURI, Leonardo Javier; RIBEIRO, Lisandro; NETTO, Gabriele Zamperlini; LOTH, Gisele; RODRIGUES, Ana Luiza Melo; KUWAHARA, Cilmara; KOLISKI, Adriana; GARCIA, Julia Lopes; DAUDT, Liane Esteves; SEBER, Adriana; GOMES, Alessandra Araujo; HAMERSCHLAK, Nelson; BONFIM, Carmem- Haploidentical bone marrow transplantation with post transplant cyclophosphamide for patients with X-linked adrenoleukodystrophy: a suitable choice in an urgent situation(2018) FERNANDES, Juliana Folloni; BONFIM, Carmem; KERBAUY, Fabio Rodrigues; RODRIGUES, Morgani; ESTEVES, Iracema; SILVA, Nathalia Halley; AZAMBUJA, Alessandra Prandini; MANTOVANI, Luiz Fernando; KUTNER, Jose Mauro; LOTH, Gisele; KUWAHARA, Cilmara Cristina; BUENO, Clarissa; KONDO, Andrea Tiemi; RIBEIRO, Andreza Alice Feitosa; KOK, Fernando; HAMERSCHLAK, NelsonAllogeneic hematopoietic stem cell transplantation (HSCT) is the only treatment that enhances survival and stabilizes neurologic symptoms in X-linked adrenoleukodystrophy (X-ALD) with cerebral involvement, a severe demyelinating disease of childhood. Patients with X-ALD who lack a well-matched HLA donor need a rapid alternative. Haploidentical HSCT using post transplant cyclophosphamide (PT/Cy) has been performed in patients with malignant and nonmalignant diseases showing similar outcomes compared to other alternative sources. We describe the outcomes of transplants performed for nine X-ALD patients using haploidentical donors and PT/Cy. Patients received conditioning regimen with fludarabine 150 mg/m(2) , cyclophosphamide 29 mg/kg and 2 Gy total body irradiation (TBI) with or without antithymocyte globulin. Graft-vs.-host disease prophylaxis consisted of cyclophosphamide 50 mg/kg/day on days +3 and +4, tacrolimus or cyclosporine A and mycophenolate mofetil. One patient had a primary graft failure and was not eligible for a second transplant. Three patients had secondary graft failure and were successfully rescued with second haploidentical transplants. Trying to improve engraftment, conditioning regimen was changed, substituting 2 Gy TBI for 4 Gy total lymphoid irradiation. Eight patients are alive and engrafted (17-37 months after transplant). Haploidentical HSCT with PT/Cy is a feasible alternative for X-ALD patients lacking a suitable matched donor. Graft failure has to be addressed in further studies.
- COVID-19 in HSCT recipients: a collaborative study of the Brazilian Society of Marrow Transplantation (SBTMO)(2022) DAUDT, Liane Esteves; CORSO, Mariana Cristina Moraes; KERBAUY, Mariana Nassif; ASSIS, Luiz Henrique dos Santos de; RECHENMACHER, Ciliana; COLTURATO, Iago; BARBIERI, Fernanda Rodrigues; ROCHA, Vanderson; MARIANO, Livia; GARCIA, Julia Lopes; DANTAS, Vanessa Esther Cavalcanti Barreto; LOTH, Gisele; FUNKE, Vaneuza Araujo Moreira; PELEGRINA, Polliany Roberta Dorini; DUARTE, Fernando Barroso; SILVA, Roberto Luiz da; ARAUJO, Marco Aurelio Salvino; CARLESSE, Fabianne Altruda de Moraes Costa; SOUSA, Ana Virginia Lopes de; MAIA, Luana Azevedo; FERNANDES, Juliana Folloni; RODRIGUES, Celso Arrais; BONFIM, Carmem; MARTINS, Leticia Navarro Gordan Ferreira; CIPOLOTTI, Rosana; XAVIER, Erick Menezes; GOMES, Alessandra Araujo; MORALES, Hugo Manuel Paz; SIMIONI, Anderson J.; SOARES, Victor Jablonski; MICHALOWSKI, Mariana Bohns; HAMERSCHLAK, Nelson; MACHADO, Clarisse MartinsIn the COVID-19 scenario, patients undergoing hematopoietic stem cell transplantation (HSCT) infected with SARS-CoV-2 may have an increased risk of death. Through a national multicenter study, we aimed to describe the impact of COVID-19 on the survival of HSCT recipients in Brazil. Eighty-six patients with a confirmed diagnosis of SARS-CoV-2 (92% by RT-PCR) were included. There were 24 children and 62 adults receiving an autologous (n = 25) and allogeneic (n = 61) HSCT for malignant (n = 72) and non-malignant (n = 14) disorders. Twenty-six patients died, (10 on autologous (38%) and 16 patients (62%) on allogeneic group). The estimated overall survival (OS) at day 40 was 69%. Adults had decreased OS compared to children (66% vs 79%, p = 0.03). The severity of symptoms at the time of diagnosis, ECOG score, laboratory tests (C-reactive protein, urea values) were higher in patients who died (p < 0.05). In conclusion, HSCT recipients infected with SARS-CoV-2 have a high mortality rate mainly in adults and patients with critical initial COVID-19 presentation. These findings show the fragility of HSCT recipients with SARS-CoV-2 infection. Therefore, the importance of adherence to preventive measures is evident, in addition to prioritizing the vaccination of family members and the HSCT team.
- Impact of mother donor, peripheral blood stem cells and measurable residual disease on outcomes after haploidentical hematopoietic cell transplantation with post-transplant cyclophosphamide in children with acute leukaemia(2021) ROCHA, V; ARCURI, L. J.; SEBER, A.; COLTURATO, V; ZECCHIN, V. G.; KUWAHARA, C.; NICHELE, S.; GOUVEIA, R.; FERNANDES, J. F.; V, A. Macedo; TAVARES, R.; DAUDT, L.; SOUZA, M. P. De; DARRIGO-JR, L. G.; VILLELA, N. C.; MARIANO, L. C. B.; GINANI, V. C.; ZANETTE, A.; LOTH, G.; GOMES, A. A.; HAMERSCHLAK, N.; FLOWERS, M. E.; BONFIM, C.Haploidentical hematopoietic-cell transplantation using post-transplant cyclophosphamide(Haplo-PTCy) is a feasible procedure in children with haematologic malignancies. However, data of a large series of children with acute leukaemia(AL) in this setting is missing. We analysed 144 AL Haplo-PTCy paediatric recipients; median age was 10 years. Patients had acute lymphoblastic(ALL; n = 86) or myeloblastic leukaemia(AML; n = 58) and were transplanted in remission(CR1: n = 40; CR2: n = 57; CR3+: n = 27) or relapse (n = 20). Bone marrow was the graft source in 57%; donors were father (54%), mother (35%), or sibling (11%). Myeloablative conditioning was used in 87%. Median follow-up was 31 months. At day +100, cumulative incidence (CI) of neutrophil recovery and acute GVHD (II-IV) were 94% and 40%, respectively. At 2-years, CI of chronic GVHD and relapse, were 31%, 40%, and estimated 2-year overall survival (OS), leukaemia-free survival (LFS) and graft-versus-host-relapse-free survival (GRFS) were 52%, 44% and 34% respectively. For patients transplanted in remission, positive measurable residual disease (MRD) prior to transplant was associated with decreased LFS (p = 0.05) and GRFS (p = 0.003) and increased risk of relapse (p = 0.02). Mother donor was associated with increased risk of chronic GVHD (p = 0.001), decreased OS (p = 0.03) and GRFS (p = 0.004). Use of PBSC was associated with increased risk of chronic GVHD (p = 0.04). In conclusion, achieving MRD negativity pre-transplant, avoiding use of mother donors and PBSC as graft source may improve outcomes of Haplo-PTCy in children with AL.
conferenceObject Salvage Haploidentical Stem Cell Transplantation with Post-Transplant Cyclophosphamide for graft failure in children with non-malignant diseases(2018) FERNANDES, Juliana Folloni; RIBEIRO, Andreza Alice Feitosa; KERBAUY, Fabio Rodrigues; MANTOVANI, Luiz Fernando; NETTO, Gabriele Zamperlini; VENANCIO, Angela Mandelli; SILVA, Cinthya Correa; KONDO, Andrea Tiemi; COLLASSANTI, Maria Dulce Silveira; ZANICHELLI, Maria Aparecida; VINCE, Carolina Sgarioni Camargo; BRUMATTI, Melina; ODONE FILHO, Vicente; HAMERSCHLAK, NelsonconferenceObject Haploidentical Stem Cell Transplantation with Post-Transplant Cyclophosphamide for Patients with X-linked Adrenoleukodystrophy: expanding the donor pool in an urgent situation(2016) FERNANDES, J.; BONFIM, C.; KERBAUY, F.; RODRIGUES, M.; ALMEIDA, A.; ESTEVES, I.; LOTH, G.; KUWAHARA, C.; BUENO, C.; KONDO, A.; KUTNER, J. M.; RIBEIRO, A.; KOK, F.; HAMERSCHLAK, N.- Pharmacokinetics analysis results are similar for oral compared to intravenous busulfan in patients undergoing hematopoietic stem cell transplantation, except for the earlier onset of mucositis. A controlled clinical study(2019) ESTEVES, Iracema; SANTOS, Fabio Pires Souza; FERNANDES, Juliana Folloni; SEBER, Adriana; OLIVEIRA, Jose Salvador Rodrigues; HAMERSCHLAK, Nelson; KERBAUY, Fabio Rodrigues; ANDERSSON, Borje S.; LIMA, Marcos deBusulfan is used in myeloablative schemes for hematopoietic stem cell transplantation (HSCT), with monitoring of dosage through the area under the curve (AUC) of the drug plasma concentration (mu Mol min). In this study, we compared the complete pharmacokinetics of busulfan administered orally (Bu-Oral) and intravenously (Bu-IV). We evaluated 40 patients who underwent HSCT with different types of conditioning regimens. After one dose, in the Bu-Oral group (n = 21), the median AUC was 1174 mu Mol min (799-4000), reaching a median of 4440 mu Mol min (3428-7181.5) during conditioning in 24 h. In the Bu-IV group (n = 19), it was 1244.8 mu Mol min (1001.2-2021), reaching 5598.0 mu Mol min (3102-8818) during conditioning in 24 h. Measuring plasma concentration of Bu in patients undergoing HSCT is important, regardless of the formulation, and the inclusion of a pre-HSCT test can predict the optimal dose during conditioning. Pharmacokinetics of the oral administration of busulfan, as well as clearance, are extremely variable, and this can potentially compromise the clinical results of the treatment since it makes it difficult to predict clinical results.