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1.
J Cancer Epidemiol ; 2020: 8021095, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32670373

RESUMO

Background: The impact of the dose intensity administered in consolidation in Latin America is unknown. This study aimed to evaluate the relative dose intensity (RDI) in consolidation and its impact in overall survival. Methods: A retrospective study of 86 patients with AML who were diagnosed between 2010 and 2016 with a 2-year follow-up in a fourth-level Colombian hospital was carried out. Clinical characteristics were reported, Kaplan-Meier was used for estimating the overall survival, and Cox regression was used for multivariate analysis. Results: The median overall survival (OS) was 20.83 months, and the median event-free survival (EFS) was 16.83 months. 64.3% of the patients achieved remission after the 7 + 3 chemotherapy induction treatment. Patients under 30 years of age, with white blood cell counts less than 100.000 cells/mm3 who responded to induction treatment had a better OS. Additionally, patients receiving an RDI greater than 0.75 of the planned consolidation dose had better survival. The prognostic variables with impact in the OS were the leukocyte count in peripheral blood at diagnosis, the RDI in consolidation treatment with HIDAC and the response obtained after induction. Conclusion: This retrospective study allowed us to know the epidemiology of AML in a reference Colombian Hospital. Additionally, in our knowledge, it is the first study that reports the RDI in consolidation with HIDAC in Latin America as a prognostic factor that directly impacts the OS.

2.
J Exp Clin Cancer Res ; 36(1): 37, 2017 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-28245840

RESUMO

BACKGROUND: Survival of adults with B-Acute Lymphoblastic Leukemia requires accurate risk stratification of patients in order to provide the appropriate therapy. Contemporary techniques, using clinical and cytogenetic variables are incomplete for prognosis prediction. METHODS: To improve the classification of adult patients diagnosed with B-ALL into prognosis groups, two strategies were examined and combined: the expression of the ID1/ID3/IGJ gene signature by RT-PCR and the immunophenotypic profile of 19 markers proposed in the EuroFlow protocol by Flow Cytometry in bone marrow samples. RESULTS: Both techniques were correlated to stratify patients into prognostic groups. An inverse relationship between survival and expression of the three-genes signature was observed and an immunophenotypic profile associated with clinical outcome was identified. Markers CD10 and CD20 were correlated with simultaneous overexpression of ID1, ID3 and IGJ. Patients with simultaneous expression of the poor prognosis gene signature and overexpression of CD10 or CD20, had worse Event Free Survival and Overall Survival than patients who had either the poor prognosis gene expression signature or only CD20 or CD10 overexpressed. CONCLUSION: By utilizing the combined evaluation of these two immunophenotypic markers along with the poor prognosis gene expression signature, the risk stratification can be significantly strengthened. Further studies including a large number of patients are needed to confirm these findings.


Assuntos
Antígenos CD20/metabolismo , Cadeias J de Imunoglobulina/genética , Proteína 1 Inibidora de Diferenciação/genética , Proteínas Inibidoras de Diferenciação/genética , Proteínas de Neoplasias/genética , Neprilisina/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras B/classificação , Adolescente , Adulto , Feminino , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Humanos , Imunofenotipagem , Masculino , Pessoa de Meia-Idade , Leucemia-Linfoma Linfoblástico de Células Precursoras B/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras B/imunologia , Prognóstico , Análise de Sobrevida , Adulto Jovem
3.
J Exp Clin Cancer Res ; 35: 64, 2016 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-27044543

RESUMO

BACKGROUND: B-Acute lymphoblastic leukemia (B-ALL) represents a hematologic malignancy with poor clinical outcome and low survival rates in adult patients. Remission rates in Hispanic population are almost 30% lower and Overall Survival (OS) nearly two years inferior than those reported in other ethnic groups. Only 61% of Colombian adult patients with ALL achieve complete remission (CR), median overall survival is 11.3 months and event-free survival (EFS) is 7.34 months. Identification of prognostic factors is crucial for the application of proper treatment strategies and subsequently for successful outcome. Our goal was to identify a gene expression signature that might correlate with response to therapy and evaluate the utility of these as prognostic tool in hispanic patients. METHODS: We included 43 adult patients newly diagnosed with B-ALL. We used microarray analysis in order to identify genes that distinguish poor from good response to treatment using differential gene expression analysis. The expression profile was validated by real-time PCR (RT-PCT). RESULTS: We identified 442 differentially expressed genes between responders and non-responders to induction treatment. Hierarchical analysis according to the expression of a 7-gene signature revealed 2 subsets of patients that differed in their clinical characteristics and outcome. CONCLUSIONS: Our study suggests that response to induction treatment and clinical outcome of Hispanic patients can be predicted from the onset of the disease and that gene expression profiles can be used to stratify patient risk adequately and accurately. The present study represents the first that shows the gene expression profiling of B-ALL Colombian adults and its relevance for stratification in the early course of disease.


Assuntos
Hispano-Americanos/genética , Cadeias J de Imunoglobulina/genética , Proteína 1 Inibidora de Diferenciação/genética , Proteínas Inibidoras de Diferenciação/genética , Proteínas de Neoplasias/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/etnologia , Regulação para Cima , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Feminino , Perfilação da Expressão Gênica/métodos , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Indução de Remissão , Análise de Sobrevida , Resultado do Tratamento , Adulto Jovem
5.
Acta méd. colomb ; 18(5): 244-9, sept.-oct. 1993. tab
Artigo em Espanhol | LILACS | ID: lil-183309

RESUMO

OBJETIVO: demostrar la eficacia y seguridad del fluconazol en la profilaxis de la candidiasis orofaríngea en pacientes con neoplasia hematológica e inmunosuprimidos médicamente. DISEÑO: estudio doble ciego, prospectivo, comparativo con placebo. UBICACION: consulta externa de las instituciones que que participaron. PACIENTES: 53 pacientes ambulatorios con neoplasia hematológica, sin candidiasis orofarígea, comprobada por microbiología, a los cuales se les iniciaba ciclo terapéutico con antineoplásicos. INTERVENCION: doble ciego al azar; administración de 10 ml de jarabe en dosis única diaria conteniendo 50 mg de fluconazol o excipientes, durante todo el período de tratamiento antimicótico tópico o sistémico asociado. PRINCIPAL RESULTADO A EVALUAR: evitar la candidiasis orofarígea. RESULTADOS: 53 pacientes estudiados; 26 recibieron fluconazol y 27 placebo, CLINICA:ninguno de los pacientes que recibieron fluconazol presentó cuadro clínico durante tratamiento; cuatro de los que recibieron placebo sí la presentaron (p<0.02 en favor de fluconazol); adicionalmente, una paciente presentó candiduria y cuadro séptico, obligando a abrir el código. Fue tratada con fluconazol parenteral y curó en corto tiempo. MICROBIOLOGIA: frotis pretratamiento: un paciente colonizado en el grupo placebo (X²=no significativo); postratamiento, cuatro pacientes del grupo placebo tenían presencia de levaduras (P<0.05,en favor de fluconazol). Solo uno de los cultivos pretratamiento se apreció crecimiento, uno de ellos masivo (p<0.05,en favor de fluconazol). SEGURIDAD : cuatro pacientes presentaron eventos adversos. Tres fueron en el grupo que recibió fluconazol, uno de los cuales presentó vómito severo que obligo a la suspensión del tratamiento; otro, disnea moderada asociada a obstrucción de vías aéreas por reacción anafiláctica relacionada con administración concomitante de penicilina, y otro ictericia leve, que cedió espontáneamente al suspender el tratamiento. El otro paciente, que estaba recibiendo placebo, presentó dolores abdominales, tipo cólico, posiblemente relacionados con el empleo concomitante de un antiparasitario. CONCLUSIONES : el fluconazol en dosis única diaria de 50 mg durante el período de terapía inmunosupresora, demostró ser eficaz como profiláctico de la candidiasis orofaríngea, además de fácil cumplimiento por el paciente y muy bien tolerado.


Assuntos
Humanos , Candidíase Bucal/classificação , Candidíase Bucal/complicações , Candidíase Bucal/diagnóstico , Candidíase Bucal/tratamento farmacológico , Candidíase Bucal/epidemiologia , Candidíase Bucal/etiologia , Candidíase Bucal/microbiologia , Candidíase Bucal/fisiopatologia , Candidíase Bucal/terapia , Fluconazol/administração & dosagem , Fluconazol/efeitos adversos , Fluconazol , Fluconazol/farmacocinética , Fluconazol/farmacologia , Fluconazol/uso terapêutico
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