MARCELA CAVALCANTE DE ANDRADE SILVA

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  • article 15 Citação(ões) na Scopus
    Myelodysplastic syndromes in South America: A multinational study of 1080 patients
    (2015) BELLI, Carolina B.; PINHEIRO, Ronald Feitosa; BESTACH, Yesica; LARRIPA, Irene B.; TANIZAWA, Roberta Sandra da Silva; ALFONSO, Graciela; GONZALEZ, Jacqueline; ROSENHAIN, Mariana; WATMAN, Nora; SILVA, Marcela Cavalcante de Andrade; ARANGUREN, Pedro Negri; RIVELLO, Hernan Garcia; MAGALHAES, Silvia M. M.; VALLADARES, Ximena; UNDURRAGA, Maria S.; VELLOSO, Elvira R. P.
    There are previously reported data describing differences between Asian and European patients with Myelodysplastic Syndromes (MDS), few direct comparisons based on cancer registration characteristics or using cohorts to validate scoring systems. This is the first study from South-America, which attempts to describe demographic, clinical features, and outcome of MDS patients. We retrospectively analyzed 1,080 patients with de novo MDS from Argentina (635), Brazil (345), and Chile (100). Chilean patients were younger (P = 0.001) with female preponderance (P = 0.071). Brazilian series showed a higher predominance of RARS subtype regarding FAB and WHO classifications (P < 0.001). Hemoglobin levels were significantly lower in Brazilian and Chilean series (P < 0.001), and Chilean series also showed a lower platelet count (P = 0.028), with no differences concerning the neutrophil count, % BM blast, and the distribution of cytogenetic risk groups (P > 0.05). Chilean series depicted a lower overall survival (OS; 35 months vs. 56 months-Argentine; 55 months-Brazil, P = 0.030), which was consistent with a higher predominance of the high-risk group according both to the IPSS and IPSS-R (P = 0.046 and P < 0.001). The IPSS-R system and its variables showed a good reproducibility to predict clinical outcome for the whole South-American population. Epidemiological and clinical characteristics, distribution among prognostic subgroups, the OS, and the access to disease modifying therapies were more similar between Argentinean and Brazilian compared with Chilean MDS series. This will need further analysis in a larger group of patients. Descriptive and comparative studies are necessary to establish epidemiological features useful for public health attitudes to generate suitable therapeutic schemes. (C) 2015 Wiley Periodicals, Inc.
  • article 2 Citação(ões) na Scopus
    Prognostic assessment for chronic myelomonocytic leukemia in the context of the World Health Organization 2016 proposal: a multicenter study of 280 patients
    (2021) GONZALEZ, Jacqueline S.; PERUSINI, Maria Agustina; BASQUIERA, Ana L.; ALFONSO, Graciela; FANTL, Dorotea; LIMA, Walter Macedo; NUCIFORA, Elsa; LAZZARINO, Carolina; NOVOA, Viviana; SILVA, Marcela Cavalcanti de Andrade; LARRIPA, Irene B.; ROCHA, Vanderson; ARBELBIDE, Jorge; VELLOSO, Elvira D. R. P.; BELLI, Carolina B.
    Knowledge on chronic myelomonocytic leukemia (CMML) patients from Argentina and Brazil is limited. Our series of 280 patients depicted an older age at diagnosis (median 72 years old), 26% of aberrant karyotypes, and a prevalence of myelodysplastic (60%) and CMML-0 subtypes (56%). The median overall survival (OS) was 48.2 months for patients in CMML-0 (Ref.), 24.7 months for those in CMML-1 (HR = 2.0, p = 0.001), and 8.8 months for patients in CMML-2 (HR = 4.6, p < 0.001). In the CMML-0 category, median OS were different between myelodysplastic and myeloproliferative subtypes (63.7 vs 21.2 months, p < 0.001); however, no differences were observed within CMML-1 and CMML-2 subtypes (24.7 vs 23.7 months, p = 0.540, and 9.1 vs 8.2 months, p = 0.160). The prognostic impact of 24 variables and 7 prognostic systems was adjusted to the WHO 2016 after validating their usefulness. Multivariate analysis were performed, and the final model revealed Hb >= 8 -< 10g/dL (HR 1.7), Hb < 8g/dL (HR 2.8), poor karyotypes (HR 2.1), WHO 2016-CMML-1 (HR 2.1), and CMML-2 (HR 3.5) as independent adverse clinical parameters in our cohort with a borderline influence of platelets count < 50 x 10(9)/L (HR 1.4). We could validate several scoring systems, the WHO 2016 proposal and its prognostic capability, along with accessible covariates, on predicting the outcome in our series of CMML patients from Latin America.