VANDERSON GERALDO ROCHA

(Fonte: Lattes)
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Departamento de Clínica Médica, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina - Líder

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  • article 168 Citação(ões) na Scopus
    Effect of donor-recipient HLA matching at HLA A, B, C, and DRB1 on outcomes after umbilical-cord blood transplantation for leukaemia and myelodysplastic syndrome: a retrospective analysis
    (2011) EAPEN, Mary; KLEIN, John P.; SANZ, Guillermo F.; SPELLMAN, Stephen; RUGGERI, Annalisa; ANASETTI, Claudio; BROWN, Maria; CHAMPLIN, Richard E.; GARCIA-LOPEZ, Joan; HATTERSELY, Gareth; KOEGLER, Gesine; LAUGHLIN, Mary J.; MICHEL, Gerard; NABHAN, Samir K.; SMITH, Franklin O.; HOROWITZ, Mary M.; GLUCKMAN, Eliane; ROCHA, Vanderson
    Background The importance of matching at the HLA C locus has not been well defined for unrelated umbilical-cord blood transplantation. The selection algorithm for umbilical-cord blood units generally considers intermediate resolution HLA typing at A and B and allele-level typing at DRB1. We aimed to establish the relative importance of additional matching at HLA C. Methods We used Cox regression to assess retrospectively the effect of donor-recipient HLA matching on outcomes of single umbilical-cord blood transplantations for leukaemia and myelodysplastic syndrome. Our primary endpoint was transplant-related mortality. HLA typing was done with molecular techniques with a minimum of intermediate resolution for HLA A, B, and C, and at the allele-level for DRB1. Findings The median age of our study population was 10 years (range <1-62) and 552 (69%) of 803 patients were aged 16 years or younger at transplantation. Compared with transplantations matched at HLA A, B, C, and DRB1 (n=69), transplant-related mortality risk was higher after transplantations matched at HLA A, B, and DRB1 and mismatched at HLA C (n=23; HR 3.97, 95% CI 1.27-12.40; p=0.018). Transplant-related mortality risk was also higher after transplantations with a single mismatch at HLA A, B, or DRB1 and mismatched at HLA C (n=234; 1.70, 1.06-2.74; p=0.029) compared with transplantations matched at HLA C with a single mismatch at HLA A, B, or DRB1 (n=127). Assessing the overall effect of HLA disparity on transplant-related mortality, risks were higher with units mismatched at two (n=259; 3.27, 1.42-7.54; p=0.006), three (n=253; 3.34, 1.45-7.71; p=0.005), or four (n=75; 3.51, 1.44-8.58; p=0.006) loci compared with matched units (n=69). Interpretation Our data suggest that the present strategy for umbilical-cord blood unit selection should be reassessed; matching at HLA C for units that are matched at HLA A, B, or DRB1 or in the presence of a single locus mismatch at HLA A, B, or DRB1 should be included to minimise mortality risks.
  • article 22 Citação(ões) na Scopus
    Risk Factors and Options to Improve Engraftment in Unrelated Cord Blood Transplantation
    (2011) PETROPOULOU, Anna D.; ROCHA, Vanderson
    Use of umbilical unrelated cord-blood (UCB) cells as an alternative source of hematopoietic cell transplantation has been widely used mainly for patients lacking an HLA-matched donor. UCB present many advantages over bone marrow or mobilized peripheral blood from volunteer donors, such as rapid availability, absence of risk for the donor, and decreased incidence of acute graft-versus-host disease. However, a significant clinical problem is delayed engraftment that is directly correlated with the number of hematopoietic stem cells in a cord-blood unit. The identification of prognostic factors associated with engraftment that can be easily modified (e. g., strategies for donor choice) and the development of new approaches including use of multiple donors, intrabone injection of UCB, ex vivo expansion, and cotransplantation with accessory cells are of crucial importance in order to circumvent the problem of delayed engraftment after UCB transplantation. Those approaches may increase the quality and availability of UCB for transplantation.