RESUMO
The purpose of this study was to develop a cost-effective protocol for the mobilization of peripheral blood stem cells (PBSC) in patients with malignancy. Thirty consecutive patients were randomized to mobilize PBSC with the late addition of a standard 250 microg dose of G-CSF (Neutrogen) from day 8 or early addition of the same dose of G-CSF from day 2, following cyclophosphamide (CY) 4 g/m2. The median yield of CD34+ cells from evaluated patients was 7.87 x 10(6)/kg (range, 2.06-27.25), collected in a median of four apheresis (range, 2-9). Target CD34 + cell doses > or = 2.0 x 10(6)/kg were achieved in all patients able to be evaluated. There were no statistically significant differences in CD34+ cell yields or toxicities. Overall engraftment occurred with median days to neutrophils > or = 0.5 x 10(9)/L or platelets > 20 x 10(9)/L of 11 and 17 days, respectively. However, the duration of G-CSF administration was markedly shorter in the late use of G-CSF group than in the early use of G-CSF group, with a median of 9 days compared with 15 days (p<0.001). PBSC harvesting after priming with CY plus delayed use of G-CSF made it a safe and cost-effective procedure.
Assuntos
Antineoplásicos Alquilantes/uso terapêutico , Ciclofosfamida/uso terapêutico , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Mobilização de Células-Tronco Hematopoéticas/economia , Mobilização de Células-Tronco Hematopoéticas/métodos , Adulto , Idoso , Antígenos CD34/imunologia , Antígenos CD34/metabolismo , Antineoplásicos Alquilantes/efeitos adversos , Neoplasias da Mama/terapia , Análise Custo-Benefício , Ciclofosfamida/efeitos adversos , Esquema de Medicação , Feminino , Sobrevivência de Enxerto , Fator Estimulador de Colônias de Granulócitos/efeitos adversos , Mobilização de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas , Células-Tronco Hematopoéticas/imunologia , Células-Tronco Hematopoéticas/metabolismo , Humanos , Linfoma não Hodgkin/terapia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/terapia , Sarcoma de Ewing/terapiaRESUMO
The purposes of this study were to evaluate the long-term stability of deep overbite correction in Class II Division 2 malocclusion and to search for predictors of postretention overbite. The sample of 62 (31 males, 31 females) was limited to Class II Division 2 patients with initial deep overbite and successful orthodontic treatment as judged clinically at the end of treatment. Study models and cephalograms were analyzed before treatment, after treatment, and out of retention (average 15 years). The sample was divided into two groups according to the degree of postretention overbite: Group 1 (N=33; overbite > or = 4.0 mm at T3, mean = 5.17 +/- 0.87) and group 2 (N=29; overbite <4.0 mm at T3, mean = 2.95 +/- 0.87). The results showed that patients with very upright pretreatment maxillary and mandibular incisors tended to have deeper initial overbite and a tendency to return to their original relationship by the postretention stage. Posttreatment vertical growth contributed to maintenance of overbite correction. By stepwise multiple regression analysis, initial overbite was selected as the most important predictor of postretention overbite. Initial overbite was positively related with postretention overbite.