ELVIRA DEOLINDA RODRIGUES PEREIRA VELLOSO
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
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- Flow cytometry ""Ogata score"" for the diagnosis of myelodysplastic syndromes in a real-life setting. A Latin American experience(2019) MONTAUBAN, Sofia Grille; HERNANDEZ-PEREZ, Carlos R.; VELLOSO, Elvira D. R. P.; NOVOA, Viviana; LORAND-METZE, Irene; GONZALEZ, Jaqueline; SOLARI, Liliana; CISMONDI, Valeria; SERRANO, Juan Carlos; BURGNINI, Andreina; RABELO-CARRASCO, Laura J.; BACAL, Nydia; TRIAS, Natalia; GUEVARA, Romina; VIDO, Joyce Rico; CRISP, Renee; ENRICO, Alicia; BOADA, Matilde; CUNHA, Fernanda G. Pereira; FANESSI, Viviana; VENEGAS, Maria Belen; ISSOURIBEHERE, Diego; NOVOA, Andrea; LENS, DanielaIntroduction Flow cytometry (FC) is a helpful tool for the diagnosis of myelodysplastic syndrome (MDS). Different FC score systems have been developed. The ""Ogata score"" is a simple diagnostic score that has been validated having a sensitivity of 69% and a specificity of 92% in low-risk MDS. We aimed to study the feasibility and the utility of the ""Ogata score"" for the diagnosis of MDS among Latin America (LA) Laboratories. Methods This is a case and control study conducted in LA institutions members of Grupo Latinoamericano de Mielodisplasia (GLAM). A total of 146 MDS patients and 57 control patients were included. ""Ogata score"" was calculated. Results The sensitivity of ""Ogata score"" was 75.6% (95% CI, 66.8-81.3), specificity was 91.2% (95% CI, 79.7-96.7), PPV was 95.6% (95% CI, 88.5-98.3), and NPV was 65.4% (95% CI, 49.1-71.9). In low/intermediate-1 IPSS patients group, the sensitivity was 70.1% (95% CI, 60.2-78.2), specificity was 91.2% (CI-95%, 79.7-96.7), PPV was 94.2% (95% CI, 86.4-97.8), and NPV was 62.1% (95% CI, 53.0-78.7). In the group of patients ""without MDS specific markers"" (patients without ring sideroblasts, blast excess, or chromosomal abnormalities), the sensitivity was 66.7% (CI-95%, 55.8-76.0), specificity was 91.2% (95% CI, 79.7-96.7), PPV was 92.3% (95% CI, 82.2-97.1), and NPV was 63.5% (95% CI, 51.9-73.5). Conclusions The diagnostic power found in this study was similar to the reported by Della-Porta et al. Also in LA, the analysis was made in modern equipment with acquisition of at least 100 000 events which permits a good reproducibility of the results.
- 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.
conferenceObject Patient Clonal Chromosomal Alterations During Human Multipotent Mesenchymal Stromal Cell Culture(2019) GODOY, Juliana Aparecida Preto; NASCIMENTO, Sabrina; OLIVEIRA, Denise Cristine de; ALVES-PAIVA, Raquel Melo; KISHIMOTO, Renata Kiyomi; VELOSO, Elvira Deolinda Rodrigues Pereira; LUCON, Danielle Ribeiro; BORTOLINI, Maria Augusta Tezelli; CASTRO, Rodrigo Aquino; OKAMOTO, Oswaldo Keith; KUTNER, Jose Mauro- 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.
- Pre-analytical parameters associated with unsuccessful karyotyping in myeloid neoplasm: a study of 421 samples(2019) SANTOS, M. F. M.; OLIVEIRA, F. C. A. C.; KISHIMOTO, R. K.; BORRI, D.; SANTOS, F. P. S.; V, P. Campregher; SILVEIRA, P. A. A.; HAMERSCHLAK, N.; MANGUEIRA, C. L. P.; DUARTE, F. B.; CREPALDI, A. H.; SALVINO, M. A.; VELLOSO, E. D. R. P.Cytogenetics is essential in myeloid neoplasms (MN) and pre-analytical variables are important for karyotyping. We assessed the relationship between pre-analytical variables (time from collection to sample processing, material type, sample cellularity, and diagnosis) and failures of karyotyping. Bone marrow (BM, n=352) and peripheral blood (PB, n=69) samples were analyzed from acute myeloid leukemia (n=113), myelodysplastic syndromes (n=73), myelodysplastic syndromes/myeloproliferative neoplasms (n=17), myeloproliferative neoplasms (n=137), and other with conclusive diagnosis (n=6), and reactive disorders/no conclusive diagnosis (n=75). The rate of unsuccessful karyotyping was 18.5% and was associated with the use of PB and a low number of nucleated cells (<= 7 x 10(3)/mu L) in the sample. High and low cellularity in BM and high and low cellularity in PB samples showed no metaphases in 3.9, 39.7, 41.9, and 84.6% of cases, respectively. Collecting a good BM sample is the key for the success of karyotyping in MN and avoids the use of expensive molecular techniques.
- Combining Clinical Features with Genetic Factors Improves Survival Prediction for Adults with Acute Myeloid Leukemia: Validation of a New Score System in 3 Cohorts(2019) SILVEIRA, Douglas R. A.; QUEK, Lynn; CORBY, Anna; COELHO-SILVA, Juan L.; PEREIRA-MARTINS, Diego A.; VALLANCE, Grant; BROWN, Benjamin; NARDINELLI, Luciana; SILVA, Wellington F.; VELLOSO, Elvira Drp; TRAINA, Fabiola; PENIKET, Andy; VYAS, Paresh; REGO, Eduardo M.; BENDIT, Israel; ROCHA, Vanderson
- Hepatic and cardiac and iron overload detected by T2*magnetic resonance (MRI) in patients with myelodisplastic syndrome: A cross-sectional study(2019) MANTOVANI, L. F.; SANTOS, F. P. S.; PERINI, G. F.; NASCIMENTO, C. M. B.; SILVA, L. P.; WROCLAWSKI, C. K.; ESPOSITO, B. P.; RIBEIRO, M. S. S.; VELLOSO, E. D. R. P.; NOMURA, C. H.; KAY, F. U.; BARONI, R. H.; HAMERSCHLAK, N.; SCHUSTER, S.Introduction: Transfusion-dependent anemia and iron overload are associatedwith reduced survival in myelodysplastic syndrome (MDS). This cross-sectional study aimed to evaluate the prevalence of hepatic and cardiac overload in patients with MDS as measured by T2* magnetic resonance imaging (MRI), and its correlation with survival. Methods: MDS or chronic myelomonocytic leukemia patients had iron overload evaluated by T2* MRI. HIO was considered when hepatic iron concentration >= 2 g/mg. Cardiac iron overload was considered with a T2*value< 20 ms. Results: Among 71 patients analyzed, median hepatic iron concentration was 3.9 g/mg (range 0.9-16 g/mg), and 68% of patients had hepatic iron overload. Patients with hepatic iron overload had higher mean ferritin levels (1182 ng/mL versus 185 ng/mL, p < 0.0001), transferrin saturation (76% versus 34%, p < 0.0001) and lower survival rates. Median cardiac T2* value was 42 ms (range 19.7-70.1 ms), and only one patienthad a T2* value indicative of cardiac iron overload. Conclusions: Hepatic iron overload is found in two thirds of patients, even in cases without laboratory signs of iron overload. Hepatic iron overload by T2* MRI is associated with a decreased risk of survival in patients with MDS.
- Outcomes and second neoplasms in hairy cell leukemia: A retrospective cohort(2019) SILVA, Wellington F. da; COSTA NETO, Abel; ROSA, Lidiane Ines da; SIQUEIRA, Isabela Assis de; AMARANTE, Guilherme Duffles; VELLOSO, Elvira D. R. P.; REGO, Eduardo Magalhaes; ROCHA, Vanderson; BUCCHERI, ValeriaHairy cell leukemia (HCL) is a rare chronic B-cell lymphoproliferative disease which is treated on the basis of small studies, making the literature still scarce of reports, especially of those conducted in Latin America. Here we intend to describe clinical characteristics, rates of response, survival and second neoplasms in HCL patients treated in a reference center in Brazil. All patients diagnosed with HCL between July/1987 and Jun/2018 were included in this analysis. Fifty-four patients were included in this analysis. Median age at diagnosis was 55 years (range, 26-88), with 37% being above 60 years-old. Most patients were treated with cladribine in our cohort (n = 36; 68%), administered through intravenous continuous infusion. Remaining patients were firstly managed with splenectomy (n = 7; 13%), IFN (n = 6; 11%) and rituximab (n = 2; 4%). In a univariate analysis, platelet count and B2M level at diagnosis were statistically associated with CR achievement (p = 0.004 and p = 0.024, respectively). A median follow-up time of 9 years was calculated. Estimated 10-year overall survival was 91.1% (95% confidence interval, 77-97). In this cohort, 10 patients had any second neoplasm, diagnosed before or after HCL. Regarding the sites of cancer, 69% were of skin -8/16 carcinoma-type and 3/16 melanoma-type. Our response and survival data are similar to those reported by literature, which reaffirms the role of purine analogs in current HCL management. With a very long follow-up we also have observed a high incidence of second neoplasm.