JULIANA PEREIRA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina - Líder
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- Bortezomib-Based Therapy for Newly Diagnosed Mantle-Cell Lymphoma(2015) ROBAK, Tadeusz; HUANG, Huiqiang; JIN, Jie; ZHU, Jun; LIU, Ting; SAMOILOVA, Olga; PYLYPENKO, Halyna; VERHOEF, Gregor; SIRITANARATKUL, Noppadol; OSMANOV, Evgenii; ALEXEEVA, Julia; PEREIRA, Juliana; DRACH, Johannes; MAYER, Jiri; HONG, Xiaonan; OKAMOTO, Rumiko; PEI, Lixia; ROONEY, Brendan; VELDE, Helgi van de; CAVALLI, FrancoBACKGROUND The proteasome inhibitor bortezomib was initially approved for the treatment of relapsed mantle-cell lymphoma. We investigated whether substituting bortezomib for vincristine in frontline therapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) could improve outcomes in patients with newly diagnosed mantle-cell lymphoma. METHODS In this phase 3 trial, we randomly assigned 487 adults with newly diagnosed mantle-cell lymphoma who were ineligible or not considered for stem-cell transplantation to receive six to eight 21-day cycles of R-CHOP intravenously on day 1 (with prednisone administered orally on days 1 to 5) or VR-CAP (R-CHOP regimen, but replacing vincristine with bortezomib at a dose of 1.3 mg per square meter of body-surface area on days 1, 4, 8, and 11). The primary end point was progression-free survival. RESULTS After a median follow-up of 40 months, median progression-free survival (according to independent radiologic review) was 14.4 months in the R-CHOP group versus 24.7 months in the VR-CAP group (hazard ratio favoring the VR-CAP group, 0.63; P<0.001), a relative improvement of 59%. On the basis of investigator assessment, the median durations of progression-free survival were 16.1 months and 30.7 months, respectively (hazard ratio, 0.51; P<0.001), a relative improvement of 96%. Secondary end points were consistently improved in the VR-CAP group, including the complete response rate (42% vs. 53%), the median duration of complete response (18.0 months vs. 42.1 months), the median treatment-free interval (20.5 months vs. 40.6 months), and the 4-year overall survival rate (54% vs. 64%). Rates of neutropenia and thrombocytopenia were higher in the VR-CAP group. CONCLUSIONS VR-CAP was more effective than R-CHOP in patients with newly diagnosed mantle-cell lymphoma but at the cost of increased hematologic toxicity. (Funded by Janssen Research and Development and Millennium Pharmaceuticals; LYM-3002 ClinicalTrials.gov number, NCT00722137.)
- Primary nodal peripheral T-cell lymphomas: diagnosis and therapeutic considerations(2015) LAGE, Luis Alberto de Pádua Covas; CABRAL, Tamara Carvalho dos Santos; COSTA, Renata de Oliveira; GONÇALVES, Marianne de Castro; LEVY, Debora; ZERBINI, Maria Cláudia Nogueira; PEREIRA, JulianaNodal peripheral T-cell lymphomas are a rare group of neoplasms derived from post-thymic and activated T lymphocytes. A review of scientific articles listed in PubMed, Lilacs, and the Cochrane Library databases was performed using the term ""peripheral T-cell lymphomas"". According to the World Health Organization classification of hematopoietic tissue tumors, this group of neoplasms consists of peripheral T-cell lymphoma not otherwise specified (PTCL-NOS), angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma-anaplastic lymphoma kinase positive (ALCL-ALK+), and a provisional entity called anaplastic large cell lymphoma-anaplastic lymphoma kinase negative (ALCL-ALK-). Because the treatment and prognoses of these neoplasms involve different principles, it is essential to distinguish each one by its clinical, immunophenotypic, genetic, and molecular features. Except for anaplastic large cell lymphoma-anaplastic lymphoma kinase positive, which has no adverse international prognostic index, the prognosis of nodal peripheral T-cell lymphomas is worse than that of aggressive B-cell lymphomas. Chemotherapy based on anthracyclines provides poor outcomes because these neoplasms frequently have multidrug-resistant phenotypes. Based on this, the current tendency is to use intensified cyclophosphamide, doxorubicin, vincristine, prednisolone (CHOP) regimens with the addition of new drugs, and autologous hematopoietic stem cell transplantation. This paper describes the clinical features and diagnostic methods, and proposes a therapeutic algorithm for nodal peripheral T-cell lymphoma patients.
- Circulating endothelial cells are increased in chronic myeloid leukemia blast crisis(2015) GODOY, C.R.T.; LEVY, D.; GIAMPAOLI, V.; CHAMONE, D.A.F.; BYDLOWSKI, S.P.; PEREIRA, J.We measured circulating endothelial precursor cells (EPCs), activated circulating endothelial cells (aCECs), and mature circulating endothelial cells (mCECs) using four-color multiparametric flow cytometry in the peripheral blood of 84 chronic myeloid leukemia (CML) patients and 65 healthy controls; and vascular endothelial growth factor (VEGF) by quantitative real-time PCR in 50 CML patients and 32 healthy controls. Because of an increase in mCECs, the median percentage of CECs in CML blast crisis (0.0146%) was significantly higher than in healthy subjects (0.0059%, P<0.01) and in the accelerated phase (0.0059%, P=0.01). There were no significant differences in the percentages of CECs in chronic- or active-phase patients and healthy subjects (P>0.05). In addition, VEGF gene expression was significantly higher in all phases of CML: 0.245 in blast crisis, 0.320 in the active phase, and 0.330 in chronic phase patients than it was in healthy subjects (0.145). In conclusion, CML in blast crisis had increased levels of CECs and VEGF gene expression, which may serve as markers of disease progression and may become targets for the management of CML.
- Infection with Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae in cancer patients(2015) FREIRE, M. P.; PIERROTTI, L. C.; FILHO, H. H. C.; IBRAHIM, K. Y.; MAGRI, A. S. G. K.; BONAZZI, P. R.; HAJAR, L.; DIZ, M. P. E.; PEREIRA, J.; HOFF, P. M.; ABDALA, E.Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-Kp) is an emergent pathogen in healthcare-associated infections (HAIs). The aim of this study was to describe HAIs due to KPC-Kp, as well as identify mortality risk factors in cancer patients. In patients diagnosed with HAIs due to KPC-Kp between January 2009 and July 2013, we evaluated only the first infection episode of each patient, analyzing mortality separately for patients treated for a parts per thousand yen48 h with at least one antimicrobial agent proven to display in vitro activity against KPC-Kp. We evaluated variables related to the malignancy, the severity and characteristics of the HAI, and the antimicrobial therapy. We identified 83 HAIs due to KPC-Kp. The 30-day mortality was 57.8 % for all infections and 72.7 % for bacteremic infections. Of the 83 patients, 60 patients received a parts per thousand yen48 h of appropriate treatment and 44 (53 %) developed bacteremia. Ten patients (12 %) were neutropenic at HAI diagnosis and 33 (39.8 %) had infection at the tumor site. The most common HAI was urinary tract infection, seen in 26 patients (31.3 %), followed by primary bloodstream infection, seen in 24 patients (28.9 %). Forty-four patients (73.3 %) received combination antimicrobial therapy, most often including polymyxin (68.3 %). Risk factors for 30-day mortality are high sequential organ failure assessment (SOFA) score, need for intensive care stay at diagnosis of infection, and acute kidney injury; the removal of invasive devices related to infection and treatment with effective antibiotics for KPC-Kp are protective factors. In cancer patients, high mortality is associated with HAI due to KPC-Kp and mortality risk factors are more often related to acute infection than to the underlying disease.
conferenceObject Diffuse Large B-Cell Lymphoma, NOS: Prognostic Significance of Immunohistochemical Algorithms and Biomarkers in Newly Diagnosed Patients Treated With Rituximab Plus a CHOP-Like Regimen(2015) PAULA, Henrique de; SIQUEIRA, Sheila; PEREIRA, Juliana; LAGE, Luis Alberto; XAVIER, Flavia; COSTA, Renata; ZERBINI, Maria ClaudiaconferenceObject Adult T-Cell Leukemia/Lymphoma: A Clinical and Epidemiological Analysis at the Medicine School of Sao Paulo University(2015) CORDEIRO, Ana Costa; LAGE, Luis Alberto de Padua Covas; COSTA, Renata Oliveira; LEVY, Debora; PEREIRA, JulianaconferenceObject First Multicenter, Randomized Phase 3 Study in Patients (Pts) with Relapsed/Refractory (R/R) Peripheral T-Cell Lymphoma (PTCL): Alisertib (MLN8237) Versus Investigator's Choice (Lumiere trial; NCT01482962)(2015) O'CONNOR, Owen A.; OZCAN, Muhit; JACOBSEN, Eric D.; VIDAL, Josep Maria Roncero; TROTMAN, Judith; DEMETER, Judit; MASSZI, Tamas; PEREIRA, Juliana; RAMCHANDREN, Radhakrishnan; D'AMORE, Francesco A.; FOSS, Francine; KIM, Won-Seog; LEONARD, John P.; CHIATTONE, Carlos Sergio; ZINZANI, Pier Luigi; LIU, Hua; JUNG, JungAh; ZHOU, Xiaofei; LEONARD, E. Jane; ULLMANN, Claudio Dansky; SHUSTOV, Andrei R.conferenceObject Diffuse Large B-Cell Lymphoma, NOS: Prognostic Significance of Immunohistochemical Algorithms and Biomarkers in Newly Diagnosed Patients Treated With Rituximab Plus a CHOP-Like Regimen(2015) PAULA, Henrique de; SIQUEIRA, Sheila; PEREIRA, Juliana; LAGE, Luis Alberto; XAVIER, Flavia; COSTA, Renata; ZERBINI, Maria ClaudiaconferenceObject Anti-CCR4 monoclonal antibody KW-0761 (mogamulizumab) or investigator's choice in subjects with relapsed or refractory adult T-cell leukemia-lymphoma (ATL)(2015) PHILLIPS, Adrienne; FIELDS, Paul; HERMINE, Olivier; TAYLOR, Graham P.; DELIOUKINA, Maria; HORWITZ, Steven; RAMOS, Juan C.; MENIANE, Jean-Come; BARTA, Stefan K.; BRITES, Carlos; PERERIA, Juliana; BELTRAN, Brady; CASANOVA, Luis; WANDROO, Farooq; FELDMAN, Tatyana; DWYER, Karen; KURMAN, Michael; CONLON, Kevin