RESUMO
A 41-year-old female with 21 weeks of gestation is admitted to the hospital complaining of abdominal pain in epigastrium accompanied with pyrosis, nausea and vomit. Physical examination revealed a gravidic uterus at the level of the umbilicus and a painless epigastric mass. Laboratory test were normal. MRI showed a solid mass near the pancreatic body with dimensions of 6.4 x 6.2 x 4.8 cm compressing the stomach, duodenum and yeyunum, involving the superior third of the mesenteric vessels.
Assuntos
Parede Abdominal , Linfoma , Neoplasias Pancreáticas , Feminino , Humanos , Gravidez , Adulto , Duodeno , Pâncreas , Dor Abdominal/etiologia , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/diagnóstico por imagemRESUMO
BACKGROUND: Low-dose all-transretinoic acid (LD-ATRA) has shown similar peak plasma concentrations and a mean area under the concentration time curve in comparison with standard doses of ATRA. We evaluated the efficacy of LD-ATRA plus anthracycline-based chemotherapy in patients with newly diagnosed acute promyelocytic leukemia (APL). PATIENTS AND METHODS: Patients diagnosed with APL during the period of 2002 to 2014 were included. They received ATRA 25 mg/m(2) plus anthracycline (doxorubicin or mitoxantrone) as induction chemotherapy, followed by 3 consolidations with LD-ATRA and anthracycline and maintenance therapy with intermittent LD-ATRA and oral chemotherapy for 2 years. RESULTS: Twenty-two patients with a median age of 28 years (range, 18-55 years) were included; 17 (77%) were in the low-risk group. Complete remission occurred in 86%, and the early death rate was 9%. At a median follow-up of 32 months (range, 4-126 months) disease-free survival (DFS) was 75% and overall survival (OS) was 86%, with a relapse rate of 27% for the entire follow-up period. CONCLUSION: LD-ATRA plus anthracycline is safe and effective in achieving CR of APL. The early death rate is similar to that of treatment with standard doses, but it appears to be inferior in preventing relapses.
