MARCELO BELLESSO
Índice h a partir de 2011
5
Projetos de Pesquisa
Unidades Organizacionais
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina
18 resultados
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conferenceObject Risk Factors for Early Mortality in Fragile Patients with Non-Hodgkin Lymphoma at Diagnosis Who Need Hospitalization in a Developing Country(2016) BARBOSA, Ivan de Carvalho Valente; BELLESSO, Marcelo; LEVY, Debora; PEREIRA, Juliana; ROCHA, Vanderson- Less Intensive Regimens May Still Be Suitable for the Initial Treatment of Primary Mediastinal B-Cell Lymphoma in Resource-Limited Settings(2022) VELASQUES, Rodrigo Dolphini; SILVA, Wellington F. da; BELLESSO, Marcelo; ROCHA, Vanderson; PEREIRA, JulianaPrimary mediastinal B-cell lymphoma (PMBCL) is an uncommon disease, consisting of 2-4% of non-Hodgkin lymphomas. Radiotherapy-free DA-EPOCH-R and R-CHOP plus radiotherapy (RT) have been the upfront standard regimens worldwide. However, performing DA-EPOCH-R in resource-constrained settings can be burdensome, especially in low/middle-income countries, where data on PMBCL are still largely unknown. We retrospectively analyzed 93 patients with PMBCL diagnosed between 2008 and 2018 with the intention of comparing the characteristics of the patients and the results obtained with each protocol and to verify if the use of less intensive chemotherapy is still possible to be used. The median age was 28 years, 59.1% were female, 42.3% were in advanced stages, and 92.1% were with bulky disease. DA-EPOCH-R (41.9%), R-CHOP (35.5%), and R-CHOEP (22.6%) were the regimens used, and no difference was observed in the characteristics of the patients. After four cycles of chemotherapy, complete response (CR), partial response (PR), and progressive disease (PD) rates were 40%, 55.7%, and 4.5%, respectively. At the end of treatment, metabolic CR and PD rates were 56.8% and 11.1%. RT was performed in 42.1% of DA-EPOCH-R, 75% of R-CHOP, and 83% of R-CHOEP, and switched PR to CR in 73.7%. Estimated 5-year PFS and OS were 77.2% and 77.4%, respectively. Only LDH levels remained independently associated with PFS, and type of treatment was not associated with OS, PFS, or relapse rate. Therefore, we conclude that in a resource-constrained setting, R-CHOP or R-CHOEP could be still safely adopted in upfront treatment for PMBCL.
- Is it feasible to use granulocyte-colony stimulating factor alone to mobilize progenitor cells in multiple myeloma patients induced with a cyclophosphamide, thalidomide and dexamethasone regimen?(2016) CRUSOE, Edvan de Queiroz; HIGASHI, Fabiana; MARTINEZ, Gracia Aparecida; BARROS, José Carlos; BELLESSO, Marcelo; ROSSATO, Marina; MARRET, Ana Cinira F.; CHIATTONE, Carlos Sérgio; HUNGRIA, Vania Tietsch de MoraesABSTRACT Background: Cyclophosphamide plus thalidomide as induction for multiple myeloma patients eligible for autologous stem cell transplantation may be a limiting factor for cell mobilization. The minimum acceptable mobilized peripheral blood stem cell count to prevent deleterious effects during transplantation is 2.0 × 106 CD34+ cells/kg. Combining other treatments to granulocyte-colony stimulating factor, such as cyclophosphamide, could overcome the mobilization limitation. The objective of this study was to assess the number of CD34+ cells mobilized using granulocyte-colony stimulating factor with and without cyclophosphamide after induction with cyclophosphamide, thalidomide and dexamethasone. Methods: A retrospective study was performed of a cohort of multiple myeloma patients submitted to autologous stem cell transplantations at two Brazilian centers between May 2009 and July 2013. The oral cyclophosphamide and thalidomide induction doses used were 1500 mg/month and 100-200 mg/day, respectively. Mobilization doses were 10-15 mcg/kg granulocyte-colony stimulating factor with 2-4 g/m2 cyclophosphamide, or 15-20 mcg/kg granulocyte-colony stimulating factor alone for 5 days. Collection of >2.0 × 106 CD34+ cells/kg was considered sufficient. Results: Eighty-eight patients were analyzed; only 18 received cyclophosphamide. The median age was 58 years old (range: 51-62) for the granulocyte-colony stimulating factor group and 56.5 years old (range: 54-60) for granulocyte-colony stimulating factor plus cyclophosphamide group. Fifty-two patients were male. Eighty cases (90.9%) were Durie-Salmon Staging System III-A/B and 38 (44.7%) and 20 cases (23.5%) were International Staging System 2 and 3, respectively. The group that received cyclophosphamide collected a higher median number of progenitor cells [3.8 (range: 3.1-4.4) vs. 3.2 (range: 2.3-3.8)] (p-value = 0.008). No correlation was observed between better responses or number of induction cycles and the number of cells collected. Conclusion: The number of cells mobilized with granulocyte-colony stimulating factor plus cyclophosphamide was higher. However, in both groups, the median number of CD34+ cells was sufficient to perform a single autologous stem cell transplantation; no deleterious effects were reported during harvesting.
article Bcl-2 protein in diffuse large B-cell lymphoma Response(2011) HALLACK NETO, Abrahao Elias; SIQUEIRA, Sheila Aparecida Coelho; DULLEY, Frederico Luiz; CHAUOBAH, Alfredo; BELESSO, Marcelo; SABOIA, Rosaura; RUIZ, Milton Artur; CHAMONE, Dalton Alencar Fischer; PEREIRA, Juliana- How to manage lymphoid malignancies during novel 2019 coronavirus (CoVid-19) outbreak: a Brazilian task force recommendation(2020) PERINI, Guilherme Fleury; FISCHER, Thais; GAIOLLA, Rafael Dezen; ROCHA, Talita Bueno; BELLESSO, Marcelo; TEIXEIRA, Larissa Lane Cardoso; DELAMAIN, Marcia Torresan; SCHELIGA, Adriana Alves de Souza; RIBEIRO, Glaciano Nogueira; NETO, Jorge Vaz; BAIOCCHI, Otavio Cesar Carvalho Guimaraes; ABDO, Andre Neder Ramires; ARRAIS-RODRIGUES, Celso; FOGLIATTO, Laura M.; BIGNI, Ricardo de Sa; SCHAFFEL, Rony; BIASOLI, Irene; PEREIRA, Juliana; NABHAN, Samir Kanaan; SOUZA, Carmino Antonio de; CHIATTONE, Carlos SergioThe novel Coronavirus (CoVid-19) outbreak is now consider a world pandemic, affecting more than 1,300,000 people worldwide. Cancer patients are in risk for severe disease, including a higher risk of intensive care unit (ICU) admission, need for invasive ventilation or death. Management of patients with lymphoid malignancies can be challenging during the outbreak, due to need of multiple hospital visits and admissions, immunosuppression and need for chemotherapy, radiotherapy and stem cell transplantation. In this article, we will focus on the practical management of patients with lymphoid malignancies during the COVID-19 pandemic, focusing on minimizing the risk for patients. (C) 2020 Published by Elsevier Editora Ltda. on behalf of Associacao Brasileira de Hematologia, Hemoterapia e Terapia Celular.
conferenceObject The Worth of Surveillance for Vancomycin-Resistant Enterococci in the Hematology-Oncology Unit(2014) BELLESSO, Marcelo; ABDALA, Edson; PEREIRA, Juliana; SANTUCCI, Rodrigo; IBRAHIM, Karim Yaqub; FREIRE, Maristela Pinheiro; FRATELLI, Lumena Vaz Carvalho; MARQUES, Patricia Andrea Crippa- Would Be Cyclophosphamide, Thalidomide and Dexamethasone (CTD) a Possible Treatment For Multiple Myeloma Where Is Not Possible New Drugs?(2013) BELLESSO, Marcelo; SILVA, Marcela Cavalcante de Andrade; VELASQUES, Rodrigo Dolphini; VISNADI, Helena; SHCOLNIK, Roberta; SEGURO, Fernanda Salles; LEVY, Debora; ABDO, Andre Neder Ramires; SANTUCCI, Rodrigo; PEREIRA, Juliana; MARTINEZ, Gracia Aparecida
- Febrile neutropenia studies in Brazil: treatment and cost management based on analyses of cases(2013) BELLESSO, Marcelo
- Outcomes of HIV-associated Burkitt Lymphoma in Brazil: High treatment toxicity and refractoriness rates - A multicenter cohort study(2020) SILVA, Wellington F. da; GARIBALDI, Pedro Manoel Marques; ROSA, Lidiane Ines da; BELLESSO, Marcelo; CLE, Diego Villa; DELAMAIN, Marcia Torresan; REGO, Eduardo Magalhaes; PEREIRA, Juliana; ROCHA, VandersonBackground: Although the increased use of combined antiretroviral therapy (cART) has decreased the incidence of lymphomas HIV-associated, Burkitt lymphoma (BL) incidence remains stable. Reported outcomes on HIV-associated BL from developed countries seem to corroborate that the regimens do not need to be tailored to the HIV-positive population. Materials and methods: This is a retrospective multicenter cohort study from Brazil, including HIV-positive patients aged 15 years and above diagnosed with BL. Results: A total of 54 patients were included. Median age was 39 years (range, 15-64). At diagnosis, advanced disease was found in 86% and 52% had a CD4+ count lower than 200 cells/mm(3). Five patients died before starting any regimen. Among the remaining 49 patients, most were treated with Hyper-CVAD (53%) and CODOX-M IVAC (18%). Rituximab was used in frontline in only 16% of the patients. Primary refractory disease was found in 14%. A treatment-related mortality of 38.7% and a complete response rate of 44.9% were found. At 4 years, estimated overall survival (OS) was 39.8%. All relapsed and primary refractory patients eventually died. Remaining patients died from infections (24/34), despite antimicrobial prophylaxis and associated cART. Conclusion: Early mortality and toxicity were higher in our cohort than in developed countries. A faster diagnosis, better understanding of the biology of the disease, establishment of low toxicity regimens, inclusion of rituximab and improvement of supportive care may decrease the mortality of HIV-associated BL in developing countries.
- Rhizopus arrhizus and Fusarium solani Concomitant Infection in an Immunocompromised Host(2016) ALMEIDA JUNIOR, Joao N. de; IBRAHIM, Karim Y.; NEGRO, Gilda M. B. Del; BEZERRA, Evandro D.; DUARTE NETO, Amaro N.; BATISTA, Marjorie V.; SICILIANO, Rinaldo F.; GIUDICE, Mauro C.; MOTTA, Adriana L.; ROSSI, Flavia; PIERROTTI, Ligia C.; FREIRE, Maristela P.; BELLESSO, Marcelo; PEREIRA, Juliana; ABDALA, Edson; BENARD, GilNeutropenic patients are at risk of the development of hyalohyphomycosis and mucormycosis. Correct identification is essential for the initiation of the specific treatment, but concomitant mold infections are rarely reported. We report one unprecedented case of concomitant mucormycosis and fusariosis in a neutropenic patient with acute myeloid leukemia. The patient developed rhino-orbital infection by Rhizopus arrhizus and disseminated infection by Fusarium solani. The first culture from a sinus biopsy grew Rhizopus, which was consistent with the histopathology report of mucormycosis. A second sinus biopsy collected later during the patient's clinical deterioration was reported as hyalohyphomycosis, and the culture yielded F. solani. Due to the discordant reports, the second biopsy was reviewed and two hyphae types suggestive of both hyalohyphomycetes and mucormycetes were found. The dual mold infection was confirmed by PCR assays from paraffinized tissue sections. Increased awareness of the existence of dual mold infections in at-risk patients is necessary. PCR methods in tissue sections may increase the diagnosis of dual mold infections. In case of sequential biopsies showing discrepant results, mixed infections have to be suspected.