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
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- 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.
- Febrile neutropenia studies in Brazil: treatment and cost management based on analyses of cases(2013) BELLESSO, Marcelo
- T-cell large granular lymphocytic leukemia: treatment experience with fludarabine(2012) COSTA, Renata Oliveira; BELLESSO, Marcelo; CHAMONE, Dalton Alencar Fischer; RUIZ, Milton Artur; HALLACK NETO, Abrahao Elias; ALDRED, Vera Lucia; PEREIRA, JulianaOBJECTIVES: The aim of this retrospective study was to investigate the results of T-cell large granular lymphocytic leukemia treatment with fludarabine by assessing the complete hematologic response, the complete molecular response, progression-free survival, and overall survival. METHODS: We evaluated the records of six patients with T-cell large granular lymphocytic leukemia who were treated with fludarabine as a first-, second-, or third-line therapy, at a dose of 40 mg/m(2), for three to five days per month and 6 to 8 cycles. RESULTS: Of the six patients investigated with T-cell large granular lymphocytic leukemia who were treated with fludarabine, five (83.3%) were female, and their median age was 36.5 years (range 18 to 73). The median lymphocyte level was 3.4x10(9)/L (0.5 to 8.9). All patients exhibited a monoclonal T-cell receptor gamma gene rearrangement at diagnosis. Two (33.3%) patients received fludarabine as first-line treatment, two (33.3%) for refractory disease, one (16.6%) for relapsed disease after the suspension of methotrexate treatment due to liver toxicity, and one (16.6%) due to dyspesia. A complete hematologic response was achieved in all cases, and a complete molecular response was achieved in five out six cases (83.3%). During a mean follow-up period of 12 months, both the progression-free survival and overall survival rates were 100%. CONCLUSION: T-cell large granular lymphocytic leukemia demonstrated a high rate of complete hematologic and molecular response to fludarabine, with excellent compliance and tolerability rates. To confirm our results in this rare disease, we believe that fludarabine should be tested in clinical trials as a first-line treatment for T-cell large granular lymphocytic leukemia.
- The H/R Fc gamma RIIA-131 polymorphism and survival in patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP: a study in a genetically mixed population(2011) LEVY, Debora; BELLESSO, Marcelo; OLIVEIRA-SOUZA, Pamela; MACIEL, Felipe V.; PEREIRA, Juliana; BYDLOWSKI, Sergio P.