RESUMO
A infusao de células hematopoéticas totipotentes criopreservadas permite a recuperaçao da hematopoese após quimioterapia mieolblativa. Objetivo. A formaçao de cristais de gelo durante o processo de congelamento é o fator principal que causa ruptura das estruturas celulares. A criopreservaçao dessas células a uma taxa constante preveniria os danos causados pelo congelamento brusco. Métodos. Vinte e três pacientes com mediana de 25 anos (variaçao 3-57) tiveram a medula óssea e/ou células-tronco periféricas (CTP) coletadas no período de março de 1993 a outubro de 1994, totalizando 86 congelamentos. Os pacientes apresentavam as seguintes neoplasias: linfoma nao-Hodgkin (n=5), leucemia mielóide aguda (n=8), leucemia linfóide aguda (n=6), doença de Hodkin (n=3) e mieloma múltiplo (n=1). O congelamento foicontrolado por um computador, acoplado ao sistema, às seguintes temperaturas: -1 graus Celsius/min até -45 graus Celsius e depois a -10 graus Celsius/min até -80 graus Celsius. Após o congelamento, as células foram mantidas em freezer a -110 graus Celsius até o momento da infusao. Para obtençao das CTP, empregou-se o fator de crescimento estimulante de granulócitos (G-CSF). Resultados. Uma mediana de 3,16 x 10(8) céls./kg (variaçao 0,86-24,22) de CTP e 2,03 x 10(8) céls./kg (variaçao 0,19-12,21) de medula óssea foi congelada. A mediana para atingir granulócitos maior ou igual a 500/muL e plaquetas maior que 20.000/muL foi de 12 dias (variaçao 8-40) e 31 dias (variaçao 8-80), respectivamente. Todos os pacientes tiveram recuperaçao hematopoética após a infusao das células criopreservadas. Conclusao. A criopreservaçao em congelador program vel permite o armazenamento de células hematopoéticas e, potencialmente, pode causar menor dano celular.
Assuntos
Feminino , Humanos , Pré-Escolar , Pessoa de Meia-Idade , Adulto , Adolescente , Criança , Medula Óssea , Criopreservação/métodos , Células-Tronco , Antineoplásicos/uso terapêutico , Congelamento , Hematopoese , Neoplasias/tratamento farmacológico , Transplante Autólogo/métodosRESUMO
UNLABELLED: The cryopreservation of hematopoietic stem cells can be used for rescuing the hematopoiesis after high dose chemotherapy. PURPOSE: The ice crystal formation during the freezing procedure is the key point that can be harmful to the cells. The cryopreservation of hematopoietic stem cells in a controlled-rate freezer could decrease the cell damage. METHODS: Twenty-three patients with a median age of 26 years (range 03-57) had bone marrow and/or peripheral blood stem cells harvested from March 1993 through October 1994, ending up to 86 freezing procedures. The patient's diagnoses are as follows: Non-Hodgkin's Lymphoma (n = 5); Acute Myelogenous Leukemia (n = 8); Acute Lymphocytic Leukemia (n = 6); Hodgkin's disease (n = 3); Multiple Myeloma (n = 1). The cells were frozen away in a controlled-rate freezer chamber at the following rate: -1 degree C/min from room temperature to -45 degrees C and then, at -10 degrees C/min down to -80 degrees C. After freezing, the cells were kept into mechanical freezers until the marrow infusion. To mobilize PBSC (peripheral blood stem cells), G-CSF (granulocyte colony stimulating factor) was given. RESULTS: A median of 3.16 x 10(8) cells/kg (range 0.86-24.22) of PBSC and 2.03 x 10(8) cells/kg (0.19-12.21) of bone marrow cells were frozen. The median time to reach granulocytes greater than 500/microL and platelets greater than 20,000/microL was 12 days (range 8-40) and 31 days (range 8-80), respectively. All patients had marrow engraftment after infusion of hematopoietic stem cells. CONCLUSION: The cryopreservation procedure using a controlled-rate freezer can store hematopoietic stem cells and potentially, cause less damage to the cells.
Assuntos
Medula Óssea , Criopreservação/métodos , Células-Tronco , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Hematopoese , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The actual significance of the type of BCR-ABL rearrangement in chronic myeloid leukemia (CML) prognosis remains controversial. Also, the molecular events that lead to CML progression are largely unknown. We analyzed the M-BCR breakpoint position in 64 CML patients by Southern blot and correlated the molecular findings with the cytogenetic, hematologic, and clinical data. No statistically significant differences were found with respect to the clinical and hematologic data presented at diagnosis or in the median duration of chronic phase (CP) and survival between the groups of patients with 5' and 3' breakpoints. We also studied by PCR-SSCP and direct sequencing the p53 gene in patients with specimens available in both chronic phase and blast crisis. We identified p53 mutations in 17% of the blast crisis samples analyzed, whereas no abnormalities were found in CP. This finding suggests that only in a minor fraction of cases are lesions in the p53 gene involved in transformation. Given the present findings, along with previous reports, we believe that a novel mechanism to explain the heterogeneity of CML should be postulated and actively pursued, as should the identification of secondary molecular events more consistently involved in progression.
Assuntos
Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Proteínas Oncogênicas/genética , Proteínas Tirosina Quinases , Proteínas Proto-Oncogênicas , Transformação Genética , Proteína Supressora de Tumor p53/genética , Adolescente , Adulto , Idoso , Sequência de Bases , Criança , Sondas de DNA , Feminino , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/mortalidade , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , Polimorfismo Conformacional de Fita Simples , Prognóstico , Proteínas Proto-Oncogênicas c-abl/genética , Proteínas Proto-Oncogênicas c-bcr , Análise de SobrevidaRESUMO
PURPOSE: To evaluate patients in the preoperative period of cardiovascular surgery for HIV antibody in the serum. MATERIAL AND METHODS: 1200 patients older than 15 years tested for HIV antibody before cardiovascular surgery with an enzyme immunoassay test (ELISA). When the results were ELISA positive ou inconclusive, another sample was collected for confirmatory test (Western Blot). We also analysed risk factors, clinical status of HIV infection and postoperative evolution. RESULTS: ELISA test for HIV antibody were negative in 1180 (98.3%) patients, inconclusive in 14 and positive in 6. One ELISA inconclusive and six ELISA positive patients resulted Western Blot positive. All of the seven patients were asymptomatic (group II) in relation to HIV infection, including four bisexual men, two transfusion recipients men and a woman with an undetermined source of infection. Only the two transfusion recipients had their risk factor identified before testing. All of them were submitted to surgery with no immediate postoperative complication. CONCLUSION: Seven (0.58%) patients had HIV antibody (Western Blot assay) but in only two risk factors were identified by routine preoperative anamnesis.
