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1.
Nutr. hosp ; 37(1): 56-64, ene.-feb. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-187574

RESUMO

Introducción: los supervivientes de leucemia aguda infantil (LAI) tienen riesgo de desarrollar obesidad. El objetivo del estudio fue evaluar la composición corporal en estos pacientes mediante las diferentes técnicas de empleadas en la práctica clínica y compararlas con el empleo del índice de masa corporal (IMC). Métodos: estudio transversal de 39 supervivientes de LAI con más de diez an~os desde el diagnóstico. Se evaluó el grado de acuerdo entre diferentes técnicas antropométricas y composición corporal y se analizaron factores de riesgo asociados al desarrollo de obesidad. Resultados: prevalencia de obesidad según porcentaje masa grasa por IMC 38,5%, perímetro cintura 46,1%, sumatorio cuatro pliegues 51,3% y bioimpedanciometría (BIA) 56,4%. Existe adecuada correlación entre los métodos, pero el IMC infraestima la adiposidad respecto al perímetro de cintura (-1,03 ± 2,01), pliegues (-2,95 ± 5,78 y BIA (-3,78 ± 7,4), con mayor infraestimación en % masa magra > 28%. Tres pacientes mostraron sarcopenia y solo uno, obesidad sarcopénica. La adiposidad estimada por el perímetro de cintura fue el parámetro con mejor asociación con los factores de riesgo cardiovascular (colesterol-LDL: r = 0,703; colesterol-HDL: r = -0,612; p < 0,05 e hipertensión: OR 4,17; IC 95%: 1,012-19,3). Los factores de riesgo asociados a obesidad fueron: sexo femenino, alto riesgo tumoral, tratamiento con radioterapia y trasplante de progenitores hematopoyéticos. Conclusiones: el IMC infraestima el porcentaje de supervivientes obesos respecto al empleo del perímetro de cintura, pliegues cutáneos y bioimpedanciometría, existiendo riesgo de clasificar erróneamente a sujetos obesos como no obesos. El sexo femenino, el alto riesgo tumoral, la radioterapia y el trasplante son factores de riesgo para presentar obesidad


Background: survivors of childhood acute leukemia are at risk for obesity. The purpose was to evaluate the different clinical measurements of body composition and to compare with body mass index (BMI). Methods: cross-sectional study of 39 survivors with more than ten years of survivorship since diagnosis. Anthropometry and body composition accuracy measurements were determined and also obesity risk factors. Results: obesity prevalence by body fat percentage were: 38.5 % for BMI; 46.1 % for waist circumference; 51.3 % for skinfolds and 56.4 % for bioelectrical impedance analysis (BIA). There was a good correlation among the measurements, but BMI underestimated the percent body fat among childhood leukemia survivors in comparison with: waist circumference (-1.03 ± 2.01), skinfolds (-2.95 ± 5.78) and BIA (-3.78 ± 7.4), and this bias appears to be more variable with increasing percent of body fat > 30 %. Three patients showed sarcopenia and only one sarcopenic obesity. Waist circumference fat mass was the better predictor of cardiovascular risk factors (LDL-cholesterol: r = 0.703; HDL-cholesterol: r = -0.612; p < 0.05 and hypertension: OR 4.17; IC 95 %: 1.012-19.3). Obesity risk factors were: female sex, high-risk tumor, radiotherapy and stem cell transplantation. Conclusions: BMI underestimates obese childhood leukemia survivors in comparison with waist circumference, skinfolds and bioelectrial impedance analysis. BMI use could misclassify obese survivors as non-obese. Female sex, high tumoral risk and coadyuvant treatments (radiotherapy and stem cell transplant) are risk factors for adiposity


Assuntos
Humanos , Composição Corporal , Antropometria/métodos , Sobrevivência , Impedância Elétrica , Obesidade/epidemiologia , Leucemia/epidemiologia , Índice de Massa Corporal , Fatores de Risco , Estudos Transversais , Obesidade Pediátrica/complicações , Sarcopenia/complicações , Radioterapia/métodos , Circunferência da Cintura , Pregas Cutâneas , Leucemia/terapia
3.
Med. clín (Ed. impr.) ; 152(5): 167-173, mar. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-181978

RESUMO

Introducción: El aumento en la supervivencia de la leucemia aguda (LA) infantil conlleva un incremento de morbilidades a largo plazo que acompañado del impacto ocasionado por el tratamiento puede alterar la calidad de vida (CV). Objetivo: Evaluar la prevalencia de comorbilidades crónicas, CV y predictores de su desarrollo en supervivientes de LA. Métodos: Estudio transversal de una cohorte de 54 individuos con más de 10 años de supervivencia tras diagnóstico de LA. Se evaluaron la presencia de comorbilidades y la CV global, física y mental mediante cuestionario SF-36. Resultados: El 53,7% presentó ≥ 1 comorbilidad crónica (24,7% hipotiroidismo; 20,3% obesidad; 14,8% síndrome metabólico; 18,5% disfunción cardiaca subclínica). El 20,3% de ellas fueron comorbilidades graves. El 73,3% de LA alto riesgo y el 66,6% de los tratados con radioterapia o trasplante presentaron comorbilidad tardía, p<0,05. La puntuación media de CV global fue 86,3 (14) (muy buena). Reportaron peor CV global los pacientes con LA de alto riesgo (83,2 vs. 89,5), comorbilidades graves (80,4 vs. 88,7) y del sexo femenino (81,8 vs. 89,9), p <0,05. Los pacientes obesos (80 vs. 92), hipotiroideos (84,9 vs. 92,4) y tratados con RT (82,3 vs. 87,5) tuvieron peor CV física (p <0,05) y aquellos con hipogonadismo (68,2 vs. 83,6) y tratados con TPH (77,2 vs. 83,1) menos puntuación en CV mental, p <0,05. Conclusiones: Los supervivientes de LA presentan una alta prevalencia de comorbilidades crónicas, asociadas al tratamiento recibido. A pesar de que estas influyen en alguna de las subescalas de su CV, la percepción global fue muy buena, incluso superior a la media de la población general


Background: Survival of childhood acute lymphoblastic leukaemia involves an increasing risk of long-term morbidities. Due to the impact of cancer treatment and comorbidities, AL survivors may experience a decrease in their health-related quality of life. Objective: We aimed to describe the long-term comorbidities, related quality of life and their development predictors in these survivors. Methods: cross-sectional study of 54 survivors aged ≥18 and who have a survival rate of more than 10 years. Quality of life was assessed by personal interview using SF-36 questionnaire. Results: 53.7% of AL survivors developed more than one comorbidity (24.7% hypothyroidism; 20.3% obesity; 14.8% metabolic syndrome; 18.5% subclinical cardiac dysfunction); 20.3% of them were severe. 73.3% of high-risk leukaemias and 66.6% of patients treated with radiotherapy or stem cells transplantation reported long-term comorbidity, P<.05. Global quality of live score was: 86.3 (14) (classified as very good). Patients with high-risk acute leukaemia (83.2 vs. 89.5), severe long-term comorbidities (80.4 vs. 89.7) and females (81.8 vs. 89.9), reported worse quality of life, P<.05. Physical summary score was worse in: obese (80 vs. 92) and hypothyroid (84.9 vs. 92.4) and radiotherapy-treated survivors (82.3 vs. 87.5); mental summary was worse in survivors with hypogonadism (68.2 vs. 86.3) and trasplanted patients (77.2 vs. 83.1), P<.05. Conclusions: Acute leukaemia survivors reported an increase prevalence of chronic comorbidities, related to cancer-treatment. Despite a decrease in scores for certain physical or mental items, global quality of life was very good in all acute leukaemia survivors, even better than compared with the general population


Assuntos
Humanos , Masculino , Feminino , Criança , Leucemia/epidemiologia , Qualidade de Vida , Sobreviventes , Estudos Transversais , Inquéritos e Questionários , Leucemia Mieloide/epidemiologia , Antropometria
4.
Apunts, Med. esport (Internet) ; 53(200): 155-162, oct.-dic. 2018. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-180020

RESUMO

Malos hábitos como el sedentarismo, obesidad o sobrealimentación, se relacionan a la evolución de estados pro-inflamatorios crónicos, principal factor de riesgo para el desarrollo de enfermedades crónicas no transmisibles (ECNT). Sin embargo, modificar únicamente el peso corporal no reduce el riesgo, es necesario también aumentar la masa muscular, dando a entender que existe una relación benéfica asociada a este tejido que no está totalmente dilucidada. Durante los últimos años, las explicaciones celulares más interesantes se han enfocado en la producción de citokinas musculares denominadas miokinas, dentro de las que se destacan la interleucina 6, el factor inhibidor de la leucemia, entre otras recientemente estudiadas como lo son la mionectina y la musclina. Debido a los múltiples avances, se realiza una revisión que pretende: presentar los hallazgos más recientes y representativos acerca de las miokinas, corregir conceptos y demostrar su aplicabilidad en la prescripción del ejercicio físico para la salud


Bad habits such as sedentary lifestyle, obesity or overfeeding, are related to the production of chronic pro-inflammatory states, the main risk factor for the development of chronic noncommunicable diseases (CNCD). However, modifying only the body weight does not reduce the risk, it is necessary to increase muscle mass, this implies there is a beneficial relationship associated with the muscle tissue that is not fully elucidated. During the last years, the most interesting cellular explanations have focused on the production of muscle cytokines called myokines, among which stand out interleukin 6, the inhibitory factor of leukemia, with others recently studied such as mionectine and muscline. Due to the multiple advances, this intends to present the most recent and representative findings about myokines, correct concepts and demonstrate their applicability in the prescription of physical exercise for health


Assuntos
Humanos , Exercício Físico/fisiologia , Músculo Esquelético/enzimologia , Músculo Esquelético/metabolismo , Interleucina-6/metabolismo , Interleucina-15/metabolismo , Estilo de Vida , Índice de Massa Corporal , Leucemia/enzimologia , Leucemia/metabolismo
5.
Enferm. glob ; 17(52): 401-415, oct. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-173990

RESUMO

Objetivo: Evaluar la calidad de vida de los pacientes adultos con cáncer hematológico de acuerdo con la modalidad de trasplante de células madre hematopoyéticas durante las etapas de hospitalización. Método: Estudio cuantitativo, observacional, longitudinal y analítico con 55 participantes adultos diagnosticados con cáncer hematológico sometidos al trasplante de células madre hematopoyéticas desde septiembre de 2013 hasta noviembre de 2015. Se utilizaron tres instrumentos, uno para caracterización sociodemográfica y clínica y dos instrumentos para evaluar la calidad de vida: el Quality Of Life Questionnaire - Core 30 (QLQ-C30), versión 3.0 portugués, desarrollado por la European Organization Research Treatment of Cancer (EORTC) y el cuestionario FunctionalAssessmentCancerTherapy- Bone Marrow Transplantation (FACT-BMT), versión 4.0 portugués, desarrollado por la Functional Assessment of ChronicIllness Therapy (FACIT), ambos validados para Brasil. Resultado: Los resultados demostraron que el promedio de edad para el trasplante de células madre hematopoyéticas autólogo fue de 45 años, el predominio del diagnóstico mieloma múltiple y para el trasplante de células madre alogénico fue de 31 años y como diagnóstico predominante la leucemia. La evaluación de la calidad de vida con ambos cuestionarios y modalidades demostró descenso significativo de los valores en todos los dominios evaluados, con predominio de peores puntuaciones en el período de pancitopenia, excepto para la función emocional. Conclusión: La presente investigación concluye que el trasplante de células madre hematopoyéticas altera la calidad de vida durante la hospitalización para ambas modalidades de trasplante. Los enfermeros deben promover intervenciones para mejorar la calidad de vida de los pacientes, abarcando dominios físicos, emocionales, sociales y funcionales


Objetivo: Avaliar a qualidade de vida dos pacientes adultos com câncer hematológico de acordo com a modalidade de transplante de células-tronco hematopoética durante as etapas de hospitalização. Método: Estudo quantitativo, observacional, longitudinal e analítico, com 55 participantes adultos, diagnosticados com câncer hematológico que se submeteram ao transplante de células-tronco hematopoéticas de setembro de 2013 a novembro de 2015. Foram utilizados três instrumentos, um para caracterização sociodemográfica e clínica e dois instrumentos para avaliação da qualidade de vida: o QualityOf Life Questionnaire-Core 30(QLQ-C30), versão 3.0 português, desenvolvido pela European Organization Research Treatment of Cancer (EORTC) e o questionário Functional Assessment Cancer Therapy-Bone Marrow Transplantation (FACT-BMT), versão 4.0 português, desenvolvido pela Functional Assessment of ChronicIllnessTherapy(FACIT), ambos validados para o Brasil. Resultado: Os resultados demonstraram que a média de idade para o transplante de células-tronco hematopoéticas autólogo foi 45 anos e predomínio do diagnóstico mieloma múltiplo e para o transplante de células-tronco alogênico foi 31 anos e como diagnostico predominante a leucemia. A avaliação da qualidade de vida com ambos os questionários e modalidades demonstrou que há queda significante dos valores em todos os domínios avaliados, com predomínio de piores pontuações no período de pancitopenia, exceto para a função emocional. Conclusão: A presente pesquisa conclui que o transplante de células-tronco hematopoéticas altera a qualidade de vida durante a hospitalização para ambas as modalidades de transplante. Cabe à enfermeira promover intervenções para melhorar a Qualidade de Vida dos pacientes, abrangendo domínios físicos, emocionais, sociais e funcionais


Objective: To evaluate the quality of life of adult patients with hematologic cancer according to the modality of hematopoietic stem cell transplant during hospitalization stages. Method: A quantitative, observational, longitudinal and analytical study with 55 adult participants diagnosed with hematologic cancer who underwent hematopoietic stem cell transplant between September 2013 and November 2015. Three instruments were used, one for sociodemographic and clinical characterization, and two instruments for quality of life assessment, as follows: the Quality Of Life Questionnaire-Core30 (QLQ-C30), version 3.0 in Portuguese developed by the European Organization Research Treatment of Cancer (EORTC) and the Functional Assessment Cancer Therapy-Bone Marrow Transplantation (FACT-BMT) questionnaire, version 4.0 in Portuguese developed by the Functional Assessment of Chronic Illness Therapy (FACIT), both validated for Brazil. Result: The results showed the mean age for autologous hematopoietic stem cell transplant was 45 years, the prevalence of multiple myeloma diagnosis and for allogeneic stem cell transplant was 31 years, and leukemia was the predominant diagnosis. The quality of life assessment with both questionnaires and modalities showed a significant decrease in values in all domains evaluated, with predominance of worse scores in the pancytopenia period, except for the emotional function. Conclusion: The present study concludes that hematopoietic stem cell transplant changes the quality of life during hospitalization for both transplant modalities. The promotion of interventions to improve patients' quality of life by covering physical, emotional, social and functional domains is the nurses' role


Assuntos
Humanos , Transplante Autólogo/psicologia , Transplante Homólogo/psicologia , Neoplasias Hematológicas/cirurgia , Transplante de Células-Tronco Hematopoéticas/psicologia , Cuidados de Enfermagem/métodos , Qualidade de Vida , Perfil de Impacto da Doença , Mieloma Múltiplo/cirurgia , Leucemia/cirurgia , Hospitalização/estatística & dados numéricos , Enfermagem Oncológica/organização & administração
6.
Rev. Esp. Cir. Ortop. Traumatol. (Ed. Impr.) ; 61(5): 331-338, sept.-oct. 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-166052

RESUMO

Objetivo. Valorar la incidencia de necrosis avascular de cadera (NAVC) en pacientes con leucemia sometidos a altas dosis de corticoides tratados en nuestro hospital para evaluar si es necesaria la creación de un protocolo de detección precoz. Material y métodos. Estudio observacional-descriptivo y retrospectivo de 2005 a 2016 de 253 pacientes diagnosticados de leucemia en edad pediátrica. Se identificaron los pacientes con patología osteomuscular y se analizaron los pacientes con necrosis avascular. Resultados. Un total de 26 pacientes (10%) presentaron síntomas osteomusculares. Se analizaron 3 pacientes con NAVC (1,2%). Una niña, de 7 años, se trató de forma conservadora con tracción-suspensión y descarga. Dos niños de 11 y 15,4 años, que desarrollaron una enfermedad de injerto contra huésped secundaria al trasplante de médula ósea, cuyo tratamiento incluye altas dosis de corticoides, desarrollaron necrosis avascular de cadera. Uno se trató con bifosfonatos y forage y el otro terminó con una artroplastia total de sustitución. Discusión. La aparición de síntomas musculoesqueléticos durante el tratamiento de la leucemia es diferente según la serie bibliográfica (0,43-12,6%). Algunos autores observan un incremento del riesgo en pacientes de sexo femenino entre los 10 y 17 años. Un estudio retrospectivo observa que existe una demora de 3,9 meses en el diagnóstico de la NAVC desde el comienzo del dolor. Otros autores relacionan la NAV con las articulaciones de carga, la edad y las altas dosis de corticoides. Conclusión. Basado en la baja incidencia de NAVC en nuestra población de pacientes menores de 14 años tratados de leucemia, pensamos que no es rentable la creación de protocolos de diagnóstico. Sin embargo, sí que es recomendable la vigilancia estricta de los pacientes con factores de riesgo potenciales reconocidos en la literatura (AU)


Objective. To evaluate the incidence of avascular necrosis of the hip in leukaemia patients treated in our hospital with high doses of corticosteroids in order to evaluate the necessity for an early detection protocol. Material and methods. Observational-descriptive and retrospective study from 2005 to 2016 of 253 patients diagnosed with paediatric leukaemia. Patients with musculoskeletal pathology were identified and patients with avascular necrosis were analysed. Results. A total of 26 patients (10%) had musculoskeletal symptoms. Three patients with avascular necrosis (1.2%) were analysed. One girl, 7 years old, was treated conservatively with traction - suspension and discharge. Two boys, an 11 and a 15.4 year-old,who developed graft-versus-host disease secondary to bone marrow transplantation, and whose treatment included high doses of corticosteroids, developed avascular necrosis of the hip. One was treated with bisphosphonates and forage and the other ended up with a total hip arthroplasty. Discussion. The occurrence of musculoskeletal symptoms during the treatment of leukaemia is different according to the bibliographic series (0.43 -12.6%). Some authors observe an increased risk in female patients between the ages of 10 and 17. A retrospective study reveals that there is a delay of 3.9 months in the diagnosis of CAP since the onset of pain. Other authors relate NAV to loading joints, age and high doses of corticosteroids. Conclusion. Based on the low incidence of avascular necrosis of the hip in our 14-year-old population treated for leukaemia, the creation of diagnostic protocols seems not to be necessary. However, close monitoring of patients with potential risk factors recognized in the literature, is advisable (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Estudos de Avaliação como Assunto , Necrose da Cabeça do Fêmur/diagnóstico , Leucemia/complicações , Necrose da Cabeça do Fêmur/epidemiologia , Corticosteroides/administração & dosagem , Diagnóstico Precoce , Infiltração Leucêmica/complicações , Estudos Retrospectivos , Difosfonatos/administração & dosagem , Fatores de Risco , Prednisona/administração & dosagem , Dexametasona/administração & dosagem , Pelve , Pelve/cirurgia , Osteoartrite do Quadril , Osteoartrite do Quadril/cirurgia
7.
Clin. transl. oncol. (Print) ; 19(9): 1059-1066, sept. 2017. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-165206

RESUMO

Osteoblasts are one among the critical components of the endosteal bone marrow (BM) niche. In addition to hematopoietic stem cell fate, their role in leukemogenesis as well as metastasis of a variety of cancers has been demonstrated in various studies. In this regard, endosteal niche can have a dual role as an initiator and protective role against leukemia. Knowledge of growth factors, chemokines and cytokines secreted by osteoblasts as well as their interaction with signaling pathways inform our understanding of the development, prognosis, recurrence and treatment of malignant BM diseases. Clinical progress in targeting the endosteal niche is also discussed (AU)


No disponible


Assuntos
Humanos , Osteoblastos/patologia , Medula Óssea/patologia , Nicho de Células-Tronco , Metástase Neoplásica/diagnóstico , Metástase Neoplásica/patologia , Leucemia/patologia , Prognóstico , Tratamento Farmacológico/instrumentação , Tratamento Farmacológico/métodos , Leucemia/diagnóstico , Leucemia/tratamento farmacológico , Antineoplásicos/uso terapêutico
8.
Clin. transl. oncol. (Print) ; 19(8): 951-960, ago. 2017. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-164673

RESUMO

Despite significant progress in the treatment of different types of leukemia, relapse remains a challenging clinical problem that is observed in a number of patients who are often resistant to chemotherapy and exhibit multi-drug resistance. Identification of new functional biomarkers, including microRNAs, is essential to determine prognosis and relapse at the time of diagnosis. The aim of this study was to detect the specific microRNAs involved in predicting relapse or progression in acute and chronic leukemias, as well as their relationship with overall survival (OS) and relapse-free survival (RFS). The relevant literature was identified through a PubMed and Scholar search (2008-2016) of English-language papers using the terms Leukemia, microRNAs, survival and relapse. Different leukemia types and subtypes show specific microRNA expression profile and different changes, which can be useful in the differentiation between leukemias and evaluation of relapse at the time of diagnosis. Altered microRNA expression profiles can turn these molecules into oncogenes or tumor suppressors, which affect the expression of relapse-related genes. Therefore, monitoring of specific microRNA expression profiles from diagnosis and during follow-up of patients can contribute to the assessment of outcome and determination of relapse and prognosis of leukemic patients (AU)


No disponible


Assuntos
Humanos , MicroRNAs/análise , Biomarcadores/análise , Leucemia/diagnóstico , Leucemia/genética , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/genética , Síndromes Mielodisplásicas/diagnóstico , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/genética , Resistência a Medicamentos , Resistência a Medicamentos/genética , Síndromes Mielodisplásicas/genética
9.
Clin. transl. oncol. (Print) ; 19(8): 1010-1017, ago. 2017. tab, `bgraf, ilus
Artigo em Inglês | IBECS | ID: ibc-164679

RESUMO

Introduction/purpose. BRG1 is a key regulator of leukemia stem cells. Indeed, it has been observed that this type of cells is unable to divide, survive and develop new tumors when BRG1 is down-regulated. Materials and methods. We assessed BRG1 and miR-155 expression in 23 leukemia cell lines, and two no pathological lymphocyte samples using qPCR. MiR-155 transfection and western blot were used to analyze the relationship between miR-155 and its validated target, BRG1, by measuring protein expression levels. The effect of miR-155 on cell proliferation and prednisolone sensitivity were studied with resazurin assay. Results. BRG1 expression levels could correlate negatively with miR-155 expression levels, at least in Burkitt’s lymphoma and diffuse large B cell lymphoma (DLBCL) cell lines. To clarify the role of miR-155 in the regulation of BRG1 expression, we administrated miR-155 mimics in different leukemia/lymphoma cell lines. Our results suggest that miR-155 regulate negatively and significantly the BRG1 expression at least in the MOLT4 cell line. Conclusion. Our study revealed a previously unknown miR-155 heterogeneity that could result in differences in the treatment with miRNAs in our attempt to inhibit BRG1. However, the expression levels of BRG1 and miR-155, before prednisolone treatment were not statistically significantly associated prednisolone sensitive leukemia cells (AU)


No disponible


Assuntos
Humanos , Linhagem Celular Tumoral , MicroRNAs/análise , Prednisolona/uso terapêutico , Leucemia Linfocítica Crônica de Células B/diagnóstico , Leucemia Linfocítica Crônica de Células B/genética , Linfócitos/citologia , Linfócitos/patologia , Linfoma/diagnóstico , Leucemia/diagnóstico , Reação em Cadeia da Polimerase/métodos , Linhagem Celular/citologia , Linhagem Celular/patologia , Western Blotting
10.
Clin. transl. oncol. (Print) ; 19(3): 301-316, mar. 2017. tab, graf
Artigo em Inglês | IBECS | ID: ibc-160186

RESUMO

Objective. We have analysed incidence and survival trends of children and adolescents with leukaemia registered in Spanish population-based cancer registries during the period 1983-2007. Methods. Childhood and adolescent leukaemia cases were drawn from the 11 Spanish population-based cancer registries. For survival, registries with data for the period 1991-2005 and follow-up until 31-12-2010 were included. Overall incidence trends were evaluated using joinpoint analysis. Observed survival rates were estimated using Kaplan-Meier, and trends were tested using the log-rank test. Results. Based on 2606 cases (2274 children and 332 adolescents), the overall age-adjusted incidence rate (ASRw) of leukaemia was 47.9 cases per million child-years in children and 23.8 in adolescents. The ASRw of leukaemia increased with an annual percentage change of 9.6 % (95 % CI: 2.2-17.6) until 1990 followed by a stabilisation of rates. In adolescents, incidence did not increase. Five-year survival increased from 66 % in 1991-1995 to 76 % in 2001-2005. By age, survival was dramatically lower in infants (0) and adolescents (15−19) than in the other age groups and no improvement was observed. In both children and adolescents, differences in 5-year survival rates among major subgroups of leukaemias were significant. Conclusions. The increasing incidence trends observed in childhood leukaemias during the study period were confined to the beginning of the period. Remarkable improvements in survival have been observed in Spanish children with leukaemias. However, this improvement was not observed in infants and adolescents (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Leucemia/epidemiologia , Leucemia/prevenção & controle , Sobrevivência , Neoplasias/epidemiologia , Ficha Clínica , Registros/legislação & jurisprudência , Leucemia Linfoide/epidemiologia , Leucemia Linfoide/prevenção & controle , Leucemia Mieloide Aguda/epidemiologia , Espanha/epidemiologia , Europa (Continente)/epidemiologia
11.
Arch. Soc. Esp. Oftalmol ; 92(3): 145-148, mar. 2017. ilus
Artigo em Espanhol | IBECS | ID: ibc-160966

RESUMO

CASO CLÍNCO:Mujer de 43 años con leucemia linfoblástica T en remisión completa, remitida por sospecha de necrosis retiniana herpética/retinitis leucémica en el ojo izquierdo (OI). La agudeza visual era de unidad y el fondo de ojo presentaba retinitis y hemorragias en periferia. Ante estudio hematológico negativo, recibió tratamiento por retinitis por citomegalovirus. Tras mejoría inicial, aparece papilitis en el OI y restricción de la motilidad en el ojo derecho. La resonancia y punción lumbar confirman la recidiva leucémica. DISCUSIÓN: La afectación ocular puede preceder a la recaída hematológica, por eso debe sospecharse ante sintomatología ocular. Además, son frecuentes las infecciones oportunistas en inmunodeprimidos


CLINICAL CASE: A 43-year-old woman in remission from T- cell acute lymphoblastic leukaemia was referred to our hospital with suspected leukaemic retinitis. The funduscopic examination of her left eye revealed multifocal yellow-white peripheral retinitis and retinal haemorrhage. The patient was treated for cytomegalovirus retinitis after an extended haematological investigation showed no abnormalities. Initial improvement was followed by papillitis in the left eye and motility restriction in the right eye. Magnetic resonance and lumbar puncture confirmed leukaemia relapse. Specific treatment was initiated with complete resolution. DISCUSSION: Ocular involvement may precede haematological leukaemia relapse. Physicians should be alerted when ocular symptoms appear in these cases


Assuntos
Humanos , Feminino , Adulto , Retinite por Citomegalovirus/complicações , Retinite por Citomegalovirus/diagnóstico , Retinite por Citomegalovirus/terapia , Papiledema/complicações , Papiledema/diagnóstico , Nervo Óptico , Nervo Óptico , Leucemia/complicações , Leucemia Aguda Bifenotípica/complicações , Retinite por Citomegalovirus/tratamento farmacológico , Retinite por Citomegalovirus/radioterapia
13.
Actas dermo-sifiliogr. (Ed. impr.) ; 107(9): e65-e69, nov. 2016. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-157400

RESUMO

Las manifestaciones dermatológicas de las leucemias incluyen lesiones específicas e inespecíficas (infecciones oportunistas, púrpura y equimosis, síndrome de Sweet, etc.). La infiltración de leucocitos neoplásicos en la piel se conoce como leucemia cutis, y es de especial interés el diagnóstico por su implicación pronóstica. Hemos recogido los casos de leucemia cutis en nuestro servicio entre 1994 y 2014, con un total de 17 pacientes, y hemos evaluado sus características (edad, sexo, historia médica), la morfología de las lesiones y su relación con la enfermedad sistémica. En nuestra serie la mayoría de los pacientes fueron varones, y la asociación más frecuente fue con leucemia mieloide aguda y se presentó como nódulos o pápulas eritematosas en las extremidades de forma mayoritaria. Presentamos nuestra experiencia en el diagnóstico y manejo de esta entidad en los últimos 20 años, llamando la atención sobre las características clínicas para un diagnóstico precoz (AU)


Dermatologic manifestations of leukemia can be both specific and nonspecific (e.g., opportunistic infections, purpura and ecchymosis, Sweet syndrome). Leukemia cutis refers to the infiltration of the skin with neoplastic leukocytes and its early diagnosis has important prognostic implications. We report on 17 cases of leukemia cutis seen in our department between 1994 and 2014 and describe the characteristics of the patients (age, sex, medical history), the morphology of the lesions, and associations with systemic disease. Most of the patients were male and the most common associated malignancy was acute myeloid leukemia. The most frequent dermatologic manifestations were nodules or erythematous papules on the limbs. We describe our experience with the diagnosis and management of leukemia cutis over a period of 20 years and emphasize the importance of clinical signs in the early diagnosis of this condition (AU)


Assuntos
Humanos , Leucemia/complicações , Infiltração Leucêmica/complicações , Neoplasias Cutâneas/diagnóstico , Eritema/etiologia , Leucemia Mieloide Aguda/patologia
14.
Clin. transl. oncol. (Print) ; 18(10): 957-971, oct. 2016. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-155958

RESUMO

Angiogenesis, the process of blood vessel formation, is necessary for tissue survival in normal and pathologic conditions. Increased angiogenesis in BM niche is correlated with leukemia progression and resistance to treatment. Angiogenesis can interfere with disease progression and several angiogenic (such as vascular growth factors) as well as anti-angiogenic factors (i.e. angiostatin) can affect angiogenesis. Furthermore, miRs can affect the angiogenic process by inhibiting angiogenesis or increasing the expression of growth factors. Given the importance of angiogenesis in BM for maintenance of leukemic clones, recognition of angiogenic and anti-angiogenic factors and miRs as well as drug resistance mechanisms of leukemic blasts can improve the therapeutic strategies. We highlight the changes in angiogenic balance within the BM niche in different leukemia types. Moreover, we explored the pathways leading to drug resistance in relation to angiogenesis and attempted to assign interesting candidates for future research (AU)


No disponible


Assuntos
Humanos , Neovascularização Patológica/patologia , Neoplasias da Medula Óssea/patologia , Nicho de Células-Tronco , Leucemia/patologia , Análise Citogenética/métodos , Transdução de Sinais , Resistência a Medicamentos , Inibidores da Angiogênese
15.
Rev. esp. enferm. dig ; 108(10): 670-672, oct. 2016. ilus
Artigo em Espanhol | IBECS | ID: ibc-156754

RESUMO

La afectación gástrica por el virus varicela-zóster es una entidad clínica poco frecuente, cuya sospecha y diagnóstico precoz es importante para evitar las consecuencias derivadas de su elevada morbimortalidad que en pacientes inmunocomprometidos varía entre un 9% y 41% según las series. A continuación se describen dos casos de afectación gástrica por el virus de la varicela-zóster (VVZ) en dos pacientes con enfermedad hematooncológica. Habitualmente las lesiones gástricas van precedidas de la aparición de lesiones cutáneas pápulo-vesiculares características. Cuando la afectación gástrica es el primer síntoma de la enfermedad se puede producir un retraso en el diagnóstico y tratamiento de esta infección que puede conllevar consecuencias graves para el paciente inmunocomprometido. Es por ello que proponemos que sea una entidad tenida en cuenta en el algoritmo de estudio del paciente inmunocomprometido que presenta dolor abdominal y lesiones endoscópicas de tipo ulceroso (AU)


Gastric involvement with the varicella-zoster virus is an uncommon clinical condition where early suspicion and diagnosis are important to prevent the consequences deriving from its high morbidity and mortality, which in immunocompromised patients oscillate between 9% and 41% according to the various series. Two cases of gastric involvement with the varicella-zoster virus (VZV) in two patients with blood cancer are reported below. Gastric lesions are usually preceded by typical papulovesicular skin lesions. When gastric involvement is the first symptom of the disease its diagnosis and management may be delayed, which may entail severe consequences for immunocompromised patients. It is therefore that we suggest its inclusion in the algorithm for immunocompromised patients with abdominal pain and ulcer-like endoscopic lesions (AU)


Assuntos
Humanos , Varicela/complicações , Herpesvirus Humano 3/patogenicidade , Gastrite/virologia , Hospedeiro Imunocomprometido , Úlcera Gástrica/virologia , Dor Abdominal/etiologia , Leucemia/complicações , Linfoma não Hodgkin/complicações
16.
Nutr. hosp ; 33(3): 549-555, mayo-jun. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-154470

RESUMO

Introducción: los supervivientes de leucemia aguda (LA) infantil presentan un riesgo incrementado de alteraciones metabólicas y cardiovasculares que aumentan su morbimortalidad a largo plazo. Objetivo: estimar la prevalencia de obesidad, resistencia a la insulina, dislipemia e hipertensión arterial como factores de riesgo cardiometabólico (FRCM) en un grupo de supervivientes de LA infantil, y analizar las posibles causas asociadas a su desarrollo. Material y métodos: estudio observacional retrospectivo en 47 supervivientes de LA tratados en un periodo de 4 años, que recibieron seguimiento durante 10 años. Resultados: el 40% de los participantes presentaron al menos un FRCM durante el seguimiento, siendo la dislipemia (aumento LDL) el más frecuente (38,3%), seguido de obesidad/sobrepeso (31,9%) y HTA sistólica (23,4%). El sexo femenino se estableció como factor de riesgo para el desarrollo de todos ellos (RR 1,6; RR 3,16; RR 1,69; p < 0,05). Ningún superviviente desarrolló diabetes mellitus, pero sí resistencia a la insulina el 19,4%. Los pacientes con leucemias de peor pronóstico presentaron mayor riesgo de desarrollar obesidad, resistencia a la insulina y aumento de LDL (RR 3,56; RR 4,08; RR 2,53; p < 0,05). Los pacientes tratados con trasplante de progenitores hematopoyéticos presentaron mayor riesgo de obesidad, aumento de LDL e HTA sistólica (RR 2,86; RR 2,39; RR 3,12; p< 0,05). Conclusiones: existe un aumento en la prevalencia de obesidad/sobrepeso, dislipemia, resistencia a la insulina y alteración de la tensión arterial sistólica en supervivientes de leucemia aguda infantil a lo largo del tiempo, especialmente en aquellos con enfermedades y tratamientos más agresivos (AU)


Background: Survivors of childhood acute leukemia (AL) face an increased risk of metabolic and cardiovascular late effects which increase their long-term morbimotality. Objective: To assess the prevalence of obesity, insulinresistance, dyslipidemia and hypertension as cardiometabolic risk factors in survivors of a childhood AL, and also to determine possible causes for these adverse cardiometabolic traits. Material and methods: A retrospective cohort study of 47 pediatric acute leukemia survivors diagnosed between 0-15 years, with a ten years follow-up. Results: Forty percent of participants had at least one cardiometabolic risk factor. Dyslipidemia (increased LDL cholesterol) was the most frequent (38.3%), secondly overweight/obese (31.9%), followed by systolic hypertension (23.4%). Females in contrast to males had an increased risk of developing all three risk factors (RR 1.6; RR 3.16; RR 1.69; p < 0.05). Only 19.4% of participants developed insulin resistance, while none were diagnosed with diabetes mellitus. High risk acute leukemia survivors were significantly more likely than low risk leukemia survivors to manifest multiple cardiometabolic traits like overweight/obesity, insulin resitance and dyslipidemia (RR 3.56; RR 2.39; RR 2.53; p < 0.05). Also, those who received hematopoietic cell trasplantation had an increased prevalence of overweight/obesity, increased LDL-cholesterol and systolic hypertension. Radiotherapy treatment was also associated with insulin resitance and systolic hypertension (RR 2.47; RR 2.53; p < 0.05). Conclusions: There is an increased risk of overweight/obesity, dyslipidemia, insulin resistance and systolic blood pressure modifi cation in childhood acute leukemia survivors, specially in those who were diagnosed as a high risk acute laukemia and those treated with more aggressive treatments (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Leucemia/epidemiologia , Doenças Cardiovasculares/epidemiologia , Síndrome Metabólica/epidemiologia , Sobreviventes/estatística & dados numéricos , Obesidade/epidemiologia , Dislipidemias/epidemiologia , Estudos Retrospectivos
18.
An. pediatr. (2003. Ed. impr.) ; 84(4): 195-202, abr. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-151005

RESUMO

Introducción: La leucemia mieloblástica aguda (LMA) constituye la segunda hemopatía maligna en la población pediátrica y una de las principales causas de mortalidad por cáncer infantil. La supervivencia se sitúa alrededor del 60% sin haber mejorado en las últimas décadas, por lo que son necesarios nuevos enfoques terapéuticos. El efecto antileucémico ejercido por los linfocitos y las células natural killer (NK) del sistema inmunológico está bien establecido en el trasplante de células madre hematopoyéticas pero también como estrategia de inmunoterapia adoptiva tras la quimioterapia de consolidación. Pacientes y métodos: De manera retrospectiva, se analizan las características clínicas de los pacientes diagnosticados de LMA en nuestro centro durante el período 1996-2014. Además en 10 leucemias agudas, 5 linfoides y 5 mieloides, se analizaron la intensidad media de fluorescencia de HLA-I, MICA-B, ULBP1-4, ligandos para los receptores de las células NK. Resultados: Un total de 67 pacientes formaron parte de este análisis. La supervivencia libre de eventos con una mediana de seguimiento de 25 meses fue del 62% (IC del 95%, 55-67). Las LMA con menor supervivencia fueron las secundarias, las no M3 y las carentes de marcadores citogenéticos favorables. La probabilidad de recaída fue del 38% (IC del 95%, 31-45). La expresión de HLA-I y ULBP-4 fue significativamente menor en los blastos mieloides que en los linfoides. Conclusiones: Nuestros resultados clínicos son similares a los descritos en la literatura. No se ha modificado significativamente la supervivencia en las últimas décadas y la probabilidad de recaída sigue siendo elevada. Los blastos mieloides podrían ser más susceptibles a las células NK al expresar menos HLA-I, por lo que estrategias de terapia celular podrían ser eficaces tal y como reportan otros grupos (AU)


Introduction: Acute myeloid leukaemia (AML) is the second haematological malignancy in the paediatric population, and one of the leading causes of childhood cancer mortality. Survival is currently around 60%, with no improvement in last decades, suggesting that new therapeutic approaches are needed. The anti-leukaemia effect mediated by the lymphocytes and natural killer (NK) cells of the immune system has been established in haematopoietic stem cell transplantation, and also as adoptive immunotherapy after consolidation chemotherapy schemes. Patients and methods: A retrospective study was conducted on the clinical characteristics of patients diagnosed and treated for AML in our centre during 1996-2014. The mean fluorescence intensities of HLA-I, MICA/B and ULBP1-4, ligands for NK cell receptors, were also analysed in ten new diagnosed leukaemia cases, five myeloid and five lymphoid. Results: A total of 67 patients were used in this analysis. With a median follow up of 25 months, the event-free survival was 62% (95% CI: 55-67). Secondary AML, non-M3 phenotype, and the absence of favourable cytogenetic markers had a lower survival. The probability of relapse was 38% (95% CI: 31-45). The expression of HLA-I and ULBP-4 was significantly lower in myeloid than in lymphoid blast cells. Conclusions: Our clinical results are similar to those described in the literature. Survival did not significantly change in recent decades, and the likelihood of relapse remains high. Myeloid blasts might be more susceptible to the cytotoxicity of NK cells through their lower expression of HLA-I. NK therapy strategies in minimal disease situation could be effective, as reported by other groups (AU)


Assuntos
Humanos , Masculino , Feminino , Leucemia/epidemiologia , Leucemia/genética , Leucemia/mortalidade , Células Precursoras de Granulócitos/imunologia , Células Matadoras Naturais/citologia , Células Matadoras Naturais/imunologia , Histocompatibilidade , Sobrevivência , Quimioterapia Combinada/instrumentação , Quimioterapia Combinada/métodos , Quimioterapia Combinada , Imunoterapia/instrumentação , Imunoterapia/métodos , Imunoterapia , Estudos Retrospectivos
19.
Clin. transl. oncol. (Print) ; 18(3): 240-250, mar. 2016. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-148707

RESUMO

Central nervous system (CNS) impairment is commonly involved in leukemia, as it can be observed upon onset or relapse of the disease. It is associated with poor prognosis and is a challenging clinical problem. The objective of this paper was to provide a characterization of the CNS niche in leukemia, to elucidate the culprits of CNS involvement, including diagnostic micro RNAs (miRs) and early leukemia prognosis. CNS niche is a proper location for homing of leukemic stem cells, thus representing a candidate target in the treatment of leukemia. Recent advances in the study of leukemia hallmarks have enlightened miRs as novel biomarkers for diagnosis and detection of CNS involvement in leukemia, thus providing the opportunity to develop novel therapeutic approaches. Given the importance of prognosis and early diagnosis of CNS involvement in leukemias as well as the severe side effects of current treatments, diagnostic and therapeutic approaches should focus on identification and inhibition of the factors contributing to CNS involvement, including CXCR3, P-selectin glycoprotein ligand-1 and MCP1. MiRs such as miR-221 and miR-222 are emerging as potential tools for an innovative non-invasive therapy of CNS in leukemia affected patients (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Sistema Nervoso Central/citologia , Biomarcadores/análise , Ventilação não Invasiva/métodos , Líquido Cefalorraquidiano/metabolismo , Cromossomo Filadélfia , Terapêutica/instrumentação , Terapêutica/métodos , Leucemia/sangue , Leucemia/tratamento farmacológico , Nicho de Células-Tronco/genética , Sistema Nervoso Central/anormalidades , Biomarcadores/metabolismo , Ventilação não Invasiva/instrumentação , Líquido Cefalorraquidiano/citologia , Terapêutica/normas , Terapêutica , Leucemia/metabolismo , Leucemia/patologia , Nicho de Células-Tronco/fisiologia
20.
Clin. transl. oncol. (Print) ; 18(2): 113-124, feb. 2016. ilus
Artigo em Inglês | IBECS | ID: ibc-148215

RESUMO

Twist proteins are members of basic helix-loop-helix family and are major regulators of embryogenesis. In adult humans, Twist proteins are mainly expressed in precursor cells, including myogenic, osteoblastic, chondroblastic and myelomonocytic lineages, maintaining their undifferentiated state. In addition, they play important roles in lymphocyte function and maturation. Recently, several studies have reported regulatory roles for Twist in the function and development of hematopoietic cells as well as in survival and development of numerous hematological malignancies. It is activated by numerous signal transduction pathways, including Akt, nuclear factor κB, Wnt, signal transducer and activator of transcription 3, mitogen-activated protein kinase and Ras signaling. Activated Twist has an anti-apoptotic role and protects cancer cells from apoptotic cell death. In addition, overexpression of Twist promotes the process of epithelial-mesenchymal transition, which has an essential role in cancer metastasis. Hereby, we review the aberrant expression of Twist in hematopoietic malignancies such as leukemias, lymphomas and myelodysplastic syndrome, which is related with poor prognosis and drug resistance in these disorders. Inactivation of Twist by small RNAs technology or chemotherapeutic inhibitors targeting Twist and upstream or downstream molecules of Twist signaling pathways may be helpful in management of disease to improve treatment strategies in malignancies (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Biomarcadores/metabolismo , Neoplasias da Medula Óssea/metabolismo , Neoplasias da Medula Óssea/patologia , Neoplasias Hematológicas/sangue , Neoplasias Hematológicas/genética , Protamina Quinase/administração & dosagem , Epitélio/anormalidades , Leucemia/sangue , Nicho de Células-Tronco/genética , Biomarcadores/análise , Neoplasias da Medula Óssea/complicações , Neoplasias Hematológicas/metabolismo , Neoplasias Hematológicas/patologia , Protamina Quinase , Protamina Quinase/metabolismo , Apoptose/fisiologia , Epitélio/patologia , Leucemia/tratamento farmacológico , Nicho de Células-Tronco/fisiologia
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