LUIS ALBERTO DE PADUA COVAS LAGE
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, 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
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bookPart Classsificação dos linfomas(2016) SIQUEIRA, Sheila Aparecida Coelho; MACIEL, Luis Alberto de Pádua Covas Lage; PEREIRA, Juliana- A difficult case of angioimmunoblastic T-cell lymphoma to diagnose(2016) SACHSIDA-COLOMBO, Elisabetta; MARIANO, Livia Caroline Barbosa; BASTOS, Fernanda Queiróz; RASSI, Amanda Bruder; LAGE, Luís Alberto de Pádua Covas; BARRETO, Ariel; SIQUEIRA, Sheila; PEREIRA, Juliana
- Bone marrow necrosis: literature review(2016) CABRAL, Tamara C. S.; FERNANDES, Carolina M.; LAGE, Luis Alberto C.; ZERBINI, Maria Claudia; PEREIRA, JulianaABSTRACT Introduction: Bone marrow necrosis (BMN) is a rare pathologic entity that is commonly undiagnosed, and often associated with hematologic diseases. Methodology: We conducted a literature review at PubMed using ""bone marrow necrosis"" as key words. Our search retrieved 25 articles written in English, and a further 65 case reports. Results and discussion: BMN pathophysiology is not well understood, but appears to be associated with vascular injuries that lead to oxygen and nutrient deprivation. Destructive tumor necrosis factor alpha (TNF-α) activity is also likely involved in the development of endothelial and bone marrow sinusoidal lesions. Diagnoses of BMN are commonly indicated by anemia, thrombocytopenia, high levels of lactic dehydrogenase and alkaline phosphatase, and the identification of leukoerythroblastic reactions. Bone marrow (BM) aspirate and biopsy, and magnetic nuclear resonance imaging are the main diagnostic options. The only available treatments are those directed against the primary cause, with associated supportive care for what is ordinarily a rapidly lethal state. Conclusion: The search for an underlying associated malignancy is important for the management of BMN.
- Interim fluorine-18 fluorodeoxyglucose PET-computed tomography and cell of origin by immunohistochemistry predicts progression-free and overall survival in diffuse large B-cell lymphoma patients in the rituximab era(2016) COSTA, Renata de Oliveira; HALLACK NETO, Abrahao; SIQUEIRA, Sheila; LAGE, Luis Alberto de Padua Covas; PAULA, Henrique M. de; COUTINHO, Arthur M.; PEREIRA, JulianaObjectiveThe aim of this study was to analyze the prognostic value of the interim PET (iPET)-computed tomography (CT) (iPET-CT) after two cycles of immunochemotherapy with the R-CHOP protocol in patients with diffuse large B-cell non-Hodgkin lymphoma (DLBCL) treated with a curative intent in combination with the neoplastic cell origin defined by Hans's immunohistochemstry algorithm followed in a reference center for cancer treatment in Brazil.Materials and methodsWe prospectively evaluated 147 DLBCL patients treated with R-CHOP-21 to assess the value of the International Prognostic Index, iPET-CT, and cell of origin by immunohistochemistry as prognostic markers in the rituximab era. Fluorine-18 fluorodeoxyglucose PET-CT was performed after two cycles (iPET-CT) and at the end of treatment in 111 patients. Lymphoma cases were categorized into germinal center (GC) and nongerminal center subtypes by immunohistochemistry according to Hans's algorithm.ResultsThe median age of GC-DLBCL patients (52.7 years) was lower than that of nongerminal center-DLBCL patients (59.4 years) (P=0.021); in addition, it was lower in patients with negative iPET-CT findings (52.7 years) versus positive findings (59.4 years) (P=0.031). The overall survival at 48 months was 100% for iPET-CT-negative GC-DLBCL patients and 61.2% for iPET-CT-positive GC-DLBCL patients (P=0.002). Progression-free survival at 30 months was 100% for iPET-CT-negative GC-DLBCL patients and 60.3% for iPET-CT-positive GC-DLBCL patients (P=0.001).ConclusionWe conclude that iPET-CT associated with cell origin identified a very good prognostic group in DLBCL patients treated with R-CHOP. Video Abstract: http://links.lww.com/NMC/A59
- Splenic diffuse red-pulp small B-cell lymphoma associated with hepatitis B virus: a report of two cases(2016) KERBAUY, Mariana Nassif; FERNANDES, Carolina Melo; BEZERRA, Evandro Dantas; LAGE, Luis Alberto de Padua Covas; SIQUEIRA, Sheila Aparecida Coelho; PEREIRA, JulianaCONTEXT: Splenic diffuse red-pulp small B-cell lymphoma is a rare disease, representing less than 1% of all non-Hodgkin lymphomas (NHL). This entity is characterized by involvement of bone marrow sinusoids and peripheral blood. The majority of cases are at an advanced stage when diagnosed. Its pathogenesis is still poorly understood. CASE REPORTS: We report on two patients with chronic non-replicating hepatitis B virus (HBV) who developed splenic diffuse red-pulp small B-cell lymphoma. Both of them were in stage IV at diagnosis and evolved with aggressive disease. Both of them achieved a complete response through chemotherapy, but one of them died due to infectious complications during bone marrow transplantation. The other decided not to undergo transplantation and continues not to show any evidence of disease today (three years after treatment). Some studies have shown a possible association between B-cell NHL and HBV. Nonetheless, the mechanism through which this oncogenic virus interacts with B-cell NHL is still poorly understood. HBV is lymphotropic and may insert into the host's genome, thus causing overexpression of oncogenes and downregulation of tumor suppressor genes. Therefore, chronic stimulation by HBV can increase B-cell proliferation, which promotes monoclonal expansion of these cells and results in malignancy. CONCLUSION: HBV may be implicated in the pathogenesis of this lymphoma, although no direct association between these two entities could be proved in the present study. Further investigations are necessary.
bookPart Imunofenotipagem(2016) PEREIRA, Juliana; MEIRELES, Ana Luisa Langanke Pedroso; LAGE, Luís Alberto de Pádua Covas