VALERIA BUCCHERI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- Current role of interferon in hairy cell leukemia therapy: a timely decision(2019) SILVA JUNIOR, Wellington Fernandes da; TEIXEIRA, Larissa Lane Cardoso; ROCHA, Vanderson; BUCCHERI, Valeria
- WHO-2016 Classification in ALL By Cytogenetics, FISH and Molecular Biology - Experience of Two Reference Centers in Brazil(2018) VELLOSO, Elvira D. R. P.; CORDEIRO, Maria Gabriella; LUCON, Danielle; KISHIMOTO, Renata; LEAL, Aline Medeiros; MAIA, Ana Carolina Arrais; BUCCHERI, Valeria; BENDIT, Israel; SILVA JR., Wellington Fernandes; MANGUEIRA, Cristovao; REGO, Eduardo Magalhaes; ROCHA, Vanderson
- Retrospective Comparison between MEC and FLAG-Ida Regimens for Refractory or Relapsed Acute Myeloid Leukemia in Adults(2019) SILVA, Wellington F.; ROSA, Lidiane Ines Da; SEGURO, Fernanda S.; SILVEIRA, Douglas R. A.; NARDINELLI, Luciana; BUCCHERI, Valeria; VELLOSO, Elvira D. R. P.; ROCHA, Vanderson; REGO, Eduardo M.
- Treating Adult Acute Lymphoblastic Leukemia in Brazil-Increased Early Mortality Using a German Multicenter Acute Lymphoblastic Leukemia-based regimen(2018) SILVA JUNIOR, Wellington Fernandes da; MEDINA, Andrezza Bertolaci; YAMAKAWA, Patricia Eiko; BUCCHERI, Valeria; VELLOSO, Elvira D. R. P.; ROCHA, VandersonStudying adult acute lymphoblastic leukemia (ALL) in developing countries is essential, because few reports are available. We performed a retrospective medical record review of the adapted German Multicenter ALL regimen encompassing 59 patients treated in Brazil. A disappointing long-term survival rate of 15.3% was found, demonstrating that every regimen must be adjusted to a given population to avoid unacceptable toxicity. Background: Acute lymphoblastic leukemia (ALL) in adults is an invariably aggressive and rare disease. Its treatment is based on the use of multidrug regimens, which have been improved since the 1970s. Few published data are available on the results of adult ALL treatment in Latin America. Materials and Methods: We retrospectively analyzed the data from 59 patients with ALL treated from 2009 to 2015 at Hospital of Clinics of University of Sao Paulo, using an adapted German Multicenter ALL (GMALL) protocol (07/2003). Results: The median patient age was 35 years (range, 16-71 years), with 76% of new cases of B-cell lineage. Central nervous system involvement was present in 29%. Most patients were in the high-risk group, using the original GMALL criteria (68%). The early death rate was 17%, preventing early evaluation of the response in these patients. Despite a reasonable complete remission rate (76%), most patients eventually died of sepsis, especially during the induction phase and salvage regimens. The median overall survival was 17 months. Conclusion: Intensified chemotherapy protocols for adult ALL have succeeded in achieving better survival rates in adults, especially younger adults. The low overall survival found with GMALL in Brazil's public hospital denotes the importance of optimizing the adaptations of international protocols for treatment of ALL in nondeveloped countries and, in parallel, improving supportive care in public services.
- Salvage treatment for refractory or relapsed acute myeloid leukemia: a 10-year single-center experience(2020) SILVA, Wellington Fernandes da; ROSA, Lidiane Ines da; SEGURO, Fernanda Salles; SILVEIRA, Douglas Rafaele Almeida; BENDIT, Israel; BUCCHERI, Valeria; VELLOSO, Elvira Deolinda Rodrigues Pereira; ROCHA, Vanderson; REGO, Eduardo M.OBJECTIVES: The outcomes of refractory and relapsed acute myeloid leukemia (AML) patients in developing countries are underreported, even though the similar classic regimens are widely used. METHODS: We conducted a retrospective comparison of ""MEC"" (mitoxantrone, etoposide, and cytarabine) and ""FLAG-IDA"" (fludarabine, cytarabine, idarubicin, and filgrastim) in adults with first relapse or refractory AML. RESULTS: In total, 60 patients were included, of which 28 patients received MEC and 32 received FLAG-IDA. A complete response (CR) rate of 48.3% was observed. Of the included patients, 16 (27%) died before undergoing bone marrow assessment. No statiscally significant difference in CR rate was found between the two protocols (p=0.447). The median survival in the total cohort was 4 months, with a 3-year overall survival (OS) rate of 9.7%. In a multivariable model including age, fms-like tyrosine kinase 3 (FLT3) status, and stem-cell transplantation (SCT), only the last two indicators remained significant: FLT3-ITD mutation (hazard ratio [HR] =4.6, p< 0.001) and SCT (HR=0.43, p=0.01). CONCLUSION: In our analysis, there were no significant differences between the chosen regimens. High rates of early toxicity were found, emphasizing the role of supportive care and judicious selection of patients who are eligible for intensive salvage therapy in this setting. The FLT3-ITD mutation and SCT remained significant factors for survival in our study, in line with the results of previous studies.
- Real-life Outcomes on Acute Promyelocytic Leukemia in Brazil - Early Deaths Are Still a Problem(2019) JR, Wellington F. da Silva; ROSA, Lidiane Ines da; MARQUEZ, Gabriel Lacerda; BASSOLLI, Lucas; TUCUNDUVA, Luciana; SILVEIRA, Douglas Rafaele Almeida; BUCCHERI, Valeria; BENDIT, Israel; REGO, Eduardo Magalhaes; ROCHA, Vanderson; VELLOSO, Elvira D. R. P.Real-life outcomes in acute promyelocytic leukemia are apparently worse than those reported by prospective studies. Retrospective data on 61 adult patients were reviewed. An early death rate of 20% was found, with a 5-year overall survival estimated at 59%. The results of real-life studies differ from prospective trials. Early actions and supportive care are needed, aiming to decrease toxicity, especially in developing countries. Introduction: Although a considerable improvement in survival of patients with acute promyelocytic leukemia (APL) has been seen over the past decades, real-life outcomes seem to be worse than those reported by prospective studies. We aim to describe clinical characteristics and outcomes of adult patients diagnosed with APL in an academic hospital from the University of Sao Paulo. Patients and Methods: We retrospectively reviewed the medical charts of 61 patients with APL diagnosed between January 2007 and May 2017. Baseline clinical features and follow-up data were collected, focusing on early toxicity variables such as infection, bleeding, and thrombosis in the first 30 days from diagnosis. Results: Among the 61 patients with APL, 54 received any chemotherapy. All patients also received alltrans retinoic acid (ATRA). Bleeding events were the main cause of death before receiving chemotherapy. Most patients belonged to the intermediate (43%) and high-risk (41%) groups, according to Sanz score. The '7 + 3 + ATRA' regimen was the most used regimen (n = 38). An early death rate of 20% was found, predominantly owing to sepsis. After a median follow-up of 5 years, only 1 relapse was diagnosed. The overall survival at 5 years was 59%. Discussion: In comparison with prospective trials with ATRA-based regimens, we found an inferior overall survival, mostly on account of a high early-death rate. Our results are in line with other real-life retrospective reports published in the past decades. Conclusion: Results of real-life studies differ from those found by prospective trials. Accordingly, early actions and supportive care are still needed, aiming to decrease toxicity, especially in developing countries.
- Reassessment of risk factors and long-term results of autologous stem cell transplantation in relapsed and refractory classical Hodgkin lymphoma(2019) FATOBENE, Giancarlo; LINARDI, Camila da Cruz Gouveia; MOREIRA, Frederico; TARGUETA, Gabriela Matos Falcao; SANTOS, Fernanda Maria; VELASQUES, Rodrigo Dolphini; ROCHA, Vanderson; BUCCHERI, Valeria
- Concerns about Prognostic Meaning of Quantitative PET Analysis in Classical Hodgkin Lymphoma(2022) SANTOS, Fernanda Maria Maria; MARIN, Jose Flavio Gomes; LIMA, Marcos Santos; SILVA, Wellington F.; VELASQUES, Rodrigo D.; MAIA, Ana Carolina Arrais; ATANAZIO, Marcelo Junqueira; ALVES, Lucas Bassolli de Oliveira; MOREIRA, Frederico Rafael; BUCHPIGUEL, Carlos Alberto; BUCCHERI, Valeria; ROCHA, Vanderson
- Rescue of chemorefractory classical Hodgkin lymphoma with nivolumab and autologous stem-cell transplantation: Real-life experience(2021) BUCCHERI, Valeria; FATOBENE, Giancarlo; SANTOS, Fernanda M.; VELASQUES, Rodrigo D.; BELLESSO, Marcelo; ATANAZIO, Marcelo J.; ROCHA, Vanderson
- Prognostic and therapeutic stratification in CLL: focus on 17p deletion and p53 mutation(2018) BUCCHERI, Valeria; BARRETO, Wolney Gois; FOGLIATTO, Laura Maria; CAPRA, Marcelo; MARCHIANI, Mariana; ROCHA, VandersonChronic lymphocytic leukemia (CLL), a disorder for which B cell heterogeneity and increased cellular proliferation play central pathogenic roles, displays several genetic abnormalities that are associated with poor prognosis and have therapeutic implications. In this review, we discuss the prognostic role and therapeutic implications of chromosome 17p deletions and TP53 mutations in CLL. Unlike other recurrent genetic abnormalities, the frequency of TP53 alterations is relatively low in newly diagnosed patients, but increases sharply with disease progression, which suggests that these alterations represent an evolutionary mechanism of resistance. In comparison with patients without such abnormalities, those with 17p deletions and TP53 mutations have lower response rates and more aggressive disease. One important consequence of the diverse molecular mechanisms that affect the TP53 pathway is the need to assess both the presence of 17p deletion and TP53 mutations before treatment initiation. Several authors have attempted to incorporate TP53 abnormalities in different prognostic models for CLL, and the recent International Prognostic Index for Chronic Lymphocytic Leukemia formally considers patients with TP53 abnormalities (deletion 17p or TP53 mutation or both) as high-risk. Several novel agents may improve results in patients with CLL, including in those with TP53 mutations. Ibrutinib, idelalisib, and venetoclax have been approved in various settings and countries for treatment of CLL. Further progress in targeted therapy and judicious use of chemotherapy, monoclonal antibodies, and reduced-intensity allogeneic transplantation will provide patients with CLL in general, and those with TP53 abnormalities in particular, with a better prognosis.