CRISTINA AIKO KUMEDA

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 9 de 9
  • conferenceObject
    Morphological, Immunohistochemical and Cytogenetic Bone Marrow Characterization of 12 Patients with Acquired Aplastic Anemia (AAA) That Progressed to Myelodysplastic Syndromes (MDS)
    (2017) MARCHESI, Raquel; VELLOSO, Elvira; GARANITO, Marlene; SIQUEIRA, Sheila; NETO, Raymundo Azevedo; KUMEDA, Cristina; ZERBINI, Maria Claudia
  • article 1 Citação(ões) na Scopus
    Secondary myeloid neoplasms: bone marrow cytogenetic and histological features may be relevant to prognosis
    (2017) TANIZAWA, Roberta Sandra da Silva; ZERBINI, Maria Claudia Nogueira; ROSENFELD, Ricardo; KUMEDA, Cristina Aiko; AZEVEDO, Raymundo Soares; SIQUEIRA, Sheila Aparecida Coelho; VELLOSO, Elvira Deolinda Rodrigues Pereira
    Abstract Background: Secondary myeloid neoplasms comprise a group of diseases arising after chemotherapy, radiation, immunosuppressive therapy or from aplastic anemia. Few studies have addressed prognostic factors in these neoplasms. Method: Forty-two patients diagnosed from 1987 to 2008 with secondary myeloid neoplasms were retrospectively evaluated concerning clinical, biochemical, peripheral blood, bone marrow aspirate, biopsy, and immunohistochemistry and cytogenetic features at diagnosis as prognostic factors. The International Prognostic Scoring System was applied. Statistical analysis employed the Kaplan–Meier method, log-rank and Fisher's exact test. Results: Twenty-three patients (54.8%) were male and the median age was 53.5 years (range: 4–88 years) at diagnosis of secondary myeloid neoplasms. Previous diseases included hematologic malignancies, solid tumors, aplastic anemia, autoimmune diseases and conditions requiring solid organ transplantations. One third of patients (33%) were submitted to chemotherapy alone, 2% to radiotherapy, 26% to both modalities and 28% to immunosuppressive agents. Five patients (11.9%) had undergone autologous hematopoietic stem cell transplantation. The median latency between the primary disease and secondary myeloid neoplasms was 85 months (range: 23–221 months). Eight patients were submitted to allogeneic hematopoietic stem cell transplantation to treat secondary myeloid neoplasms. Important changes in bone marrow were detected mainly by biopsy, immunohistochemistry and cytogenetics. The presence of clusters of CD117+ cells and p53+ cells were associated with low survival. p53 was associated to a higher risk according to the International Prognostic Scoring System. High prevalence of clonal abnormalities (84.3%) and thrombocytopenia (78.6%) were independent factors for poor survival. Conclusion: This study demonstrated that cytogenetics, bone marrow biopsy and immunohistochemistry are very important prognostic tools in secondary myeloid neoplasms.
  • conferenceObject
    Cytogenetic abnormalities in primary MDS: Incidence and classification according to cytogenetic risk groups defined by the IPSS and IPSS-R
    (2013) SILVA, M.; AZEVEDO NETO, R.; LEAL, A.; FERREIRA, P.; KUMEDA, C.; TANIZAWA, R.; MASCARENHAS, A.; LIMA, W.; BUCCHERI, V.; VELLOSO, E.
  • conferenceObject
    High Proliferative Index in Acquired Aplastic Anemia (AAA) Bone Marrow Does Not Predict Progression to Myelodysplastic Syndromes (MDS)
    (2017) MARCHESI, Raquel; VELLOSO, Elvira; GARANITO, Marlene; SIQUEIRA, Sheila; NETO, Raymundo Azevedo; KUMEDA, Cristina; ZERBINI, Maria Claudia
  • conferenceObject
    High Proliferative Index in Acquired Aplastic Anemia (AAA) Bone Marrow Does Not Predict Progression to Myelodysplastic Syndromes (MDS)
    (2017) MARCHESI, Raquel; VELLOSO, Elvira; GARANITO, Marlene; SIQUEIRA, Sheila; NETO, Raymundo Azevedo; KUMEDA, Cristina; ZERBINI, Maria Claudia
  • conferenceObject
    Morphological, Immunohistochemical and Cytogenetic Bone Marrow Characterization of 12 Patients with Acquired Aplastic Anemia (AAA) That Progressed to Myelodysplastic Syndromes (MDS)
    (2017) MARCHESI, Raquel; VELLOSO, Elvira; GARANITO, Marlene; SIQUEIRA, Sheila; NETO, Raymundo Azevedo; KUMEDA, Cristina; ZERBINI, Maria Claudia
  • article 4 Citação(ões) na Scopus
    Evaluation of chromosomal abnormalities by cIg-FISH and association with proliferative and apoptotic indexes in multiple myeloma
    (2012) LINARDI, C. C. G.; MARTINEZ, G.; VELLOSO, E. D. R. P.; LEAL, A. M.; KUMEDA, C. A.; BUCCHERI, V.; AZEVEDO, R. S.; PELICARIO, L. M.; DORLHIAC-LLACER, P.
    Eighty-six newly diagnosed multiple myeloma (MM) patients from a public hospital of Sao Paulo (Brazil) were evaluated by cIg-FISH for the presence of del(13)(q14), t(4;14)(p16.3;q32) and del(17)(p13). These abnormalities were observed in 46.5, 9.3, and 7.0% of the patients, respectively. In order to identify the possible role of del(13)(q14) in the physiopathology of MM, we investigated the association between this abnormality and the proliferative and apoptotic indexes of plasma cells. When cases demonstrating t(4;14)(p16.3;q32) and del(17)(p13) were excluded from the analysis, we observed a trend towards a positive correlation between the proportion of cells carrying del(13)(q14) and plasma cell proliferation, determined by Ki-67 expression (r = 0.23, P = 0.06). On the other hand, no correlation between the proportion of cells carrying del(13)(q14) and apoptosis, determined by annexin-V staining, was detected (r = 0.05, P = 0.69). In general, patients carrying del(13)(q14) did not have lower survival than patients without del(13)(q14) (P = 0.15), but patients with more than 80% of cells carrying del(13)(q14) showed a lower overall survival (P = 0.033). These results suggest that, when del(13)(q14) is observed in a high proportion of malignant cells, it may have a role in determining MM prognosis. Another finding was a statistically significant lower overall survival of patients with t(4;14)(p16.3;q32) (P = 0.026). In the present study, almost half the patients with t(4;14)(p16.3;q32) died just after diagnosis, before starting treatment. This fact suggests that, in Sao Paulo, there may be even more patients with this chromosomal abnormality, but they probably die before being diagnosed due to unfavorable socioeconomic conditions. This could explain the low prevalence of this chromosomal abnormality observed in the present study.
  • conferenceObject
    Dysplastic Changes and Proliferation Index in Acquired Aplastic Anemia Are Not Associated with Progression to MDS/AML - a Study of Bone Marrow in Children and Adults Blood
    (2016) MARCHESI, Raquel Ferrari; VELLOSO, Elvira Deolinda Rodrigues Pereira; GARANITO, Marlene Pereira; KUMEDA, Cristina Aiko; SIQUEIRA, Sheila Aparecida Coelho; AZEVEDO NETO, Raymundo Soares; ZERBINI, Maria Claudia Nogueira
  • article 1 Citação(ões) na Scopus
    Simultaneous Occurrence of Biphenotypic T Cell/Myeloid Lesions Involving t(12;13)(p13;q14) in a Pediatric Patient
    (2012) BORBA, Claudio Carneiro; CHAUFFAILLE, Maria de Lourdes; SANABNAI, Sabri Saeed; FERNANDES, Juliana Folloni; KUMEDA, Cristina Aiko; VELLOSO, Elvira Deolinda Rodrigues Pereira; SANTOS, Katia Jarandilha dos; PUPIM, Marcia Puato Vieira; HAMERSCHLAK, Nelson; ODONE FILHO, Vicente; BENDIT, Israel
    This paper chronicles a 2-year-old girl who presented with acute leukemia/lymphoma syndrome of the T cell immuno-phenotype. At this time, the cytogenetic analysis of her bone marrow cells showed a reciprocal translocation between the short arm of chromosome 12 and the long arm of chromosome 13, t(12;13)(p13;q14). The immunophenotyping of bone marrow blast cells by flow cytometry revealed a population of cells positive for CD56, CD117, CD45, partial CD33, partial HLA-DR, CD13, CD7, CD2 and CD5. Therefore, a diagnosis of acute leukemia with a mixed T cell/myeloid phenotype was made. The patient had a poor response to classic T cell acute lymphocytic leukemia/lymphoma therapy; thus, her treatment was changed to a myeloid leukemia protocol, which produced a good response. She underwent a successful cord blood transplantation from an unrelated HLA partially matched donor. The coexistence of these two phenotypes prompts questions about the existence of clonal instability, which might influence the choice of therapy. The rarity of the t(12;13)(p13;q14) and the coexistence of T cell/myeloid markers suggest a nonrandom association. To the best of our knowledge, this is the first reported case in which a cell clone bearing a t(12;13)(p13;q14) translocation in a mixed T cell/myeloid lesion was detected.