JULIANA FOLLONI FERNANDES

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Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina

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Assunto: Oncology ×

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Agora exibindo 1 - 10 de 17
  • 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, Adriana
  • conferenceObject
    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
    RELAPSE AFTER ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION FOR PEDIATRIC PATIENTS WITH ACUTE MYELOID LEUKEMIA OR MYELODYSPLASTIC SYNDROME: SINGLE INSTITUTION RETROSPECTIVE STUDY
    (2022) MACHADO, Ana Rahal Guaragna; FLORES, Angelica Hidalgo; SILVA, Aline Rodrigues Da; ZAMPERLINI-NETTO, Gabriele; BECHARAMAFRA, Ana; BARBUTO, Tomas Marzagao; CRISTOFANI, Lilian; ODONE FILHO, Vicente; GARCIA, Julia Lopes; FERNANDES, Juliana Folloni
  • 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, Carmem
  • conferenceObject
    Relapsed Acute Lymphoblastic Leukemia and Blinatumomab: Results From a Single Institution in Brazil Universidade de Sao Paulo
    (2020) ZAMPERLINI-NETTO, G.; FONSECA, M.; ALMEIDA, M.; ODONE-FILHO, V.; TEIXEIRA, R.; FERNANDES, J.; AZAMBUJA, A.; DUTRA, A.; BREVIGLIERI, C.; CRISTOFANI, L.
  • conferenceObject
    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
  • article 13 Citação(ões) na Scopus
    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, Nelson
    Allogeneic 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.
  • article 8 Citação(ões) na Scopus
    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 Martins
    In 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.
  • article 4 Citação(ões) na Scopus
    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.
  • article 6 Citação(ões) na Scopus
    Targeted-dose of busulfan: Higher risk of sinusoidal obstructive syndrome observed with systemic exposure dose above 5000 mu Mol min. A historically controlled clinical trial
    (2020) ESTEVES, Iracema; SANTOS, Fabio Pires Souza; RIBEIRO, Andreza Alice Feitosa; SEBER, Adriana; SUGAWARA, Eduardo Kinio; SOBRINHO, Jairo Jose do Nascimento; BARROS, Jose Carlos; OLIVEIRA, Jose Salvador Rodrigues; FERNANDES, Juliana Folloni; HAMERSCHLAK, Nelson; ANDERSSON, Borje S.; LIMA, Marcos de; KERBAUY, Fabio Rodrigues
    Busulfan is given in the conditioning regimens preceding hematopoietic stem cell transplantation (HSCT), and plasma levels can be monitored. A targeted, individualized systemic exposure (SE) dose can be achieved by calculating the area under the plasma concentration versus time curve (AUC). The objective of this study was to determine a cutoff value for safety for the AUC for busulfan plasma levels in patients undergoing HSCT. A total of 149 consecutive HSCT patients were studied. After an oral test dose of busulfan, we set target doses of 4000, 5000, or 6000 mu Mol min/day, and analyzed the AUC of oral or intravenous Bu. These patients were compared with 53 historical control subjects who had received myeloablative conditioning regimen without busulfan pharmacokinetic monitoring. Using a test dose and the administration route had no impact on the sinusoidal obstructive syndrome (SOS) incidence, transplant-related mortality or 1-year overall survival. However, patients receiving busulfan at doses set up at AUC > 5000 had an increased risk to develop SOS after HSCT (hazard ratio 3.39,p= 0.034, 95% CI 1.09-10.52). Adjusting the busulfan dose according to SE levels target dose during conditioning is associated with lower rates of oral severe mucositis and SOS. A cutoff of 5000 mu Mol min is safe and does not impair survival.