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1.
Ciudad Autónoma de Buenos Aires; Comisión Nacional de Evaluación de Tecnologías de Salud; Marzo 2021. 30 p. (Informe de Evaluación de Tecnologías Sanitarias N°15, 15).
Monografia em Espanhol | LILACS, BINACIS, ARGMSAL | ID: biblio-1151674

RESUMO

El presente informe es producto del trabajo colaborativo de la Comisión Nacional de Evaluación de Tecnologías de Salud (CONETEC), dependiente del Ministerio de Salud de la Nación y creada por RM N° 623/2018. La CONETEC realiza evaluaciones y emite recomendaciones a la autoridad sanitaria sobre la incorporación, forma de uso, financiamiento y políticas de cobertura de las tecnologías sanitarias desde una perspectiva global del sistema de salud argentino. En sus evaluaciones y recomendaciones, la CONETEC tiene en cuenta criterios de calidad, seguridad, efectividad, eficiencia y equidad, evaluados bajo dimensiones éticas, médicas, económicas y sociales. Sus resultados son consensuados mediante discusiones públicas y ponderados a través de un marco de valor explícito, con la participación de todos los actores involucrados en el proceso de toma de decisiones en salud. Los informes y recomendaciones de esta comisión surgen de este proceso público, transparente y colaborativo, siendo de libre consulta y acceso para toda la sociedad.


Assuntos
Idoso , Leucemia/tratamento farmacológico , Leucemia/epidemiologia
2.
Artigo em Chinês | MEDLINE | ID: mdl-33535343

RESUMO

Objective: To analyze the diagnosis of 3 cases of leukemia applying for the diagnosis of occupational radiogenic neoplasms. Methods: Retrospective analysis the occupational history, the disease history and the probability of causation (PC value) information of 3 radiological workers. Results: Two cases' PC value of 95% confidence limit of were >50%, and they were diagnosed as radiogenic neoplasms. One case was <50% and diagnosed as nonoccupational radiogenic neoplasms. Conclusion: The probability of causation analysis has important guiding significance for the diagnosis of occupational radiogenic neoplasms. Radiological workers should improve their awareness of self-protection and reduce the occurrence of occupational diseases.


Assuntos
Leucemia , Doenças Profissionais , Exposição Ocupacional , Humanos , Leucemia/diagnóstico , Leucemia/epidemiologia , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Probabilidade , Radiografia , Estudos Retrospectivos
3.
J Formos Med Assoc ; 120(1 Pt 1): 226-233, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32439247

RESUMO

BACKGROUND/PURPOSE: Leukemia cutis (LC), by definition, is the infiltration of neoplastic leukocytes in the skin. The overall incidence of LC is rare. We aimed to investigate the association between clinical characteristics, classifications and prognosis among different types of LC in Taiwan. METHODS: We performed a retrospective analysis of forty-two patients with histopathology proven LC based on skin biopsies in a medical center in Southern Taiwan from 1997 to 2018. The study involved medical records of the patients, clinical manifestations, and outcomes according to different types of leukemia. RESULTS: This series consisted of 27 males and 15 females, and the mean age was 55.7 years old. The most common cutaneous features were papules (38%) and nodules (29%), followed by plaques (16%) and ulcers (10%). The most commonly affected sites were the trunk (33%) and extremities (31.5%), although generalized distribution (14%) was not rare. The prognosis of LC was very poor, 76.2% of patients (32/42) died during the follow-up, and the median survival time was 7.2 months (95% CI, 4.53-9.87 months). No statistical significance was found (P = 0.068 for survival curves) among different types of LC. CONCLUSION: This study was the first large-scale research in regarding to LC of Han Chinese. The commonest clinical presentations were papules and nodules, and the predilection sites were trunk and extremities. Besides, there was the high frequency of LC from AML and MDS in Taiwan. Clinicians should pay more attention to the leukemia patients with extramedullary manifestations due to poor survival outcomes.


Assuntos
Leucemia , Neoplasias Cutâneas , Feminino , Humanos , Leucemia/epidemiologia , Infiltração Leucêmica , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Pele , Taiwan/epidemiologia
4.
Lancet Haematol ; 7(10): e737-e745, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32798473

RESUMO

BACKGROUND: Several small studies on patients with COVID-19 and haematological malignancies are available showing a high mortality in this population. The Italian Hematology Alliance on COVID-19 aimed to collect data from adult patients with haematological malignancies who required hospitalisation for COVID-19. METHODS: This multicentre, retrospective, cohort study included adult patients (aged ≥18 years) with diagnosis of a WHO-defined haematological malignancy admitted to 66 Italian hospitals between Feb 25 and May 18, 2020, with laboratory-confirmed and symptomatic COVID-19. Data cutoff for this analysis was June 22, 2020. The primary outcome was mortality and evaluation of potential predictive parameters of mortality. We calculated standardised mortality ratios between observed death in the study cohort and expected death by applying stratum-specific mortality rates of the Italian population with COVID-19 and an Italian cohort of 31 993 patients with haematological malignancies without COVID-19 (data up to March 1, 2019). Multivariable Cox proportional hazards model was used to identify factors associated with overall survival. This study is registered with ClinicalTrials.gov, NCT04352556, and the prospective part of the study is ongoing. FINDINGS: We enrolled 536 patients with a median follow-up of 20 days (IQR 10-34) at data cutoff, 85 (16%) of whom were managed as outpatients. 440 (98%) of 451 hospitalised patients completed their hospital course (were either discharged alive or died). 198 (37%) of 536 patients died. When compared with the general Italian population with COVID-19, the standardised mortality ratio was 2·04 (95% CI 1·77-2·34) in our whole study cohort and 3·72 (2·86-4·64) in individuals younger than 70 years. When compared with the non-COVID-19 cohort with haematological malignancies, the standardised mortality ratio was 41·3 (38·1-44·9). Older age (hazard ratio 1·03, 95% CI 1·01-1·05); progressive disease status (2·10, 1·41-3·12); diagnosis of acute myeloid leukaemia (3·49, 1·56-7·81), indolent non-Hodgin lymphoma (2·19, 1·07-4·48), aggressive non-Hodgkin lymphoma (2·56, 1·34-4·89), or plasma cell neoplasms (2·48, 1·31-4·69), and severe or critical COVID-19 (4·08, 2·73-6·09) were associated with worse overall survival. INTERPRETATION: This study adds to the evidence that patients with haematological malignancies have worse outcomes than both the general population with COVID-19 and patients with haematological malignancies without COVID-19. The high mortality among patients with haematological malignancies hospitalised with COVID-19 highlights the need for aggressive infection prevention strategies, at least until effective vaccination or treatment strategies are available. FUNDING: Associazione italiana contro le leucemie, linfomi e mieloma-Varese Onlus.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Neoplasias Hematológicas/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Infecções por Coronavirus/tratamento farmacológico , Feminino , Seguimentos , Neoplasias Hematológicas/terapia , Humanos , Pacientes Internados , Itália/epidemiologia , Leucemia/epidemiologia , Leucemia/terapia , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/terapia , Masculino , Pessoa de Meia-Idade , Transtornos Mieloproliferativos/epidemiologia , Transtornos Mieloproliferativos/terapia , Neoplasias de Plasmócitos/epidemiologia , Neoplasias de Plasmócitos/terapia , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
6.
Med. clín (Ed. impr.) ; 155(4): 152-158, ago. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-195761

RESUMO

ANTECEDENTES Y OBJETIVO: La mielofibrosis es una neoplasia mieloproliferativa crónica infrecuente. Nuestro objetivo fue describir las características clínico-biológicas, el tratamiento y el curso evolutivo de los pacientes con mielofibrosis en España. MATERIAL Y MÉTODOS: Se analizaron 1.000 pacientes del Registro Español de Mielofibrosis diagnosticados de mielofibrosis primaria (n=641) o secundaria (n=359). RESULTADOS: La mediana de edad era de 68 años. La frecuencia de sintomatología constitucional, anemia moderada o severa (Hb<10g/dl) y esplenomegalia sintomática fue del 35, 36 y 17%, respectivamente. La incidencia de trombosis y hemorragia fue de 1,96 y 1,6 eventos por 100 años-paciente, respectivamente. La incidencia acumulada de leucemia fue del 15% a los 10 años. Para la anemia se emplearon principalmente agentes eritropoyéticos y danazol. A partir del 2010 se observó un incremento significativo del uso de ruxolitinib. Un 7,5% de los pacientes fue trasplantado. El 42% de los enfermos falleció, debido principalmente al deterioro clínico provocado por la mielofibrosis y a la transformación leucémica. La supervivencia mediana de la serie fue de 5,7 años. El IPSS identificó 4 grupos de riesgo: la supervivencia mediana no se alcanzó en el de bajo riesgo, mientras que fue de 8,8 años, 5,3 años y 2,8 años en los de riesgo intermedio-1, intermedio-2 y alto, respectivamente. CONCLUSIONES: la mielofibrosis es una enfermedad invalidante que afecta sobre todo a personas de edad avanzada y cuyo tratamiento es fundamentalmente sintomático. A pesar de su heterogeneidad clínica se dispone de modelos pronósticos útiles para la selección de candidatos a trasplante


Background and objective Myelofibrosis: is an infrequent chronic myeloproliferative neoplasm. We aimed to describe the clinico-biological characteristics, treatment, and evolutive course of myelofibrosis patients in Spain. MATERIAL AND METHODS: A total of 1,000 patients from the Spanish Registry of Myelofibrosis diagnosed with primary (n=641) or secondary (n=359) myelofibrosis were analysed. RESULTS: Median age was 68 years. The frequency of constitutional symptoms, moderate to severe anaemia (Hb<10g/dL), and symptomatic splenomegaly was 35%, 36%, and 17%, respectively. The rate of thrombosis and haemorrhage was 1.96 and 1.6 events per 100 patient-years, respectively. The cumulative incidence of leukaemia at 10 years was 15%. The most frequent therapies for the anaemia were the erythropoiesis stimulating agents and danazol. From 2010, a progressive increase in the use of ruxolitinib was noticed. A total of 7.5% of patients were transplanted. During the observation period, 42% of patients died mainly due to the clinical deterioration caused by myelofibrosis or leukaemic transformation. The median survival of the series was 5.7 years. Four different risk categories were identified by the IPSS: median survival was not reached in the low risk group and was 8.8 years, 5.3 years, and 2.8 years in the intermediate-1, intermediate-2, and high-risk groups, respectively. CONCLUSIONS: Myelofibrosis is a disabling condition mainly affecting elderly people. Its treatment is mostly driven by symptom control. Despite its clinical heterogeneity, several prognostic models are useful to select candidates for transplantation


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Mielofibrose Primária/epidemiologia , Mielofibrose Primária/patologia , Espanha/epidemiologia , Registros , Trombose/epidemiologia , Hemorragia/epidemiologia , Leucemia/epidemiologia , Anemia/tratamento farmacológico , Anemia/epidemiologia , Prognóstico , Grupos de Risco , Taxa de Sobrevida
7.
PLoS One ; 15(6): e0232800, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497148

RESUMO

Second primary breast cancer (SPBC) is becoming one of the major obstacles to breast cancer (BC) control. This study was aimed to determine the trend of SPBC incidence over time and the risk of developing SPBC in site-specific primary cancer survivors in the United States. The Surveillance, Epidemiology, and End Results (SEER) 13 registry (1992-2015) was used to identify SPBC patients with previous malignancies. Standardized incidence ratio (SIR) was computed to compare the incidence rates of the observed cases of SPBC in cancer survivors over the expected cases in the general population. Elevated risk of SPBC was observed in women with previous BC (SIR = 1.74) or thyroid cancer (SIR = 1.17). Women with initial skin melanoma in older age (≥50 years) (SIR = 1.11), or White race (SIR = 1.11) presented an elevated incidence of SPBC than the general female population. Besides, Asian/Pacific Islander (API) women with cancer of corpus uteri, ovary, bladder, or kidney were prone to developing SPBC when compared with the general population, with SIRs of 1.61, 1.35, 1.48, and 1.70, respectively. Male BC patients showed profound risk of developing SPBC (SIR = 34.86). Male leukemia patients also presented elevated risk of developing SPBC (SIR = 2.06). Our study suggests significant increase of SPBC in both sexes in the United States. Elevated risk of SPBC exists in survivors with primary BC, female thyroid cancer, male leukemia, and API female cancer patients with primary genitourinary cancer. Our study is helpful in developing strategies for BC control and prevention on specific first primary cancer survivors with an elevated risk of SPBC.


Assuntos
Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama/epidemiologia , Sobreviventes de Câncer , Segunda Neoplasia Primária/epidemiologia , Adulto , Fatores Etários , Idoso , Grupos de Populações Continentais/estatística & dados numéricos , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Leucemia/epidemiologia , Masculino , Melanoma/epidemiologia , Pessoa de Meia-Idade , Neoplasias Hormônio-Dependentes/epidemiologia , Especificidade de Órgãos , Programa de SEER , Neoplasias Cutâneas/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia , Estados Unidos/epidemiologia , Neoplasias Urogenitais/epidemiologia
9.
Sci Rep ; 10(1): 7759, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32385396

RESUMO

Red bone marrow and brain tissue are highly radiosensitive in children. We investigate the relationship between childhood computed tomography (CT) exposure and leukaemia, intracranial malignancy and lymphoma. All participants in the study were aged less than 16 years. A total of 1,479 patients in the leukaemia group, 976 patients in the intracranial malignancy group and 301 patients in the lymphoma group were extracted from the Catastrophic Illness Certificate Database in Taiwan as the disease group. In total, 126,677 subjects were extracted from the Longitudinal Health Insurance Database 2010 of the Taiwan National Health Insurance Research Database as the non-disease group. The odds ratios (ORs) and 95% confidence intervals (CIs) for childhood CT exposure and times of childhood CT were estimated. Childhood CT exposure was correlated to the intracranial malignancy group in both one-year (OR = 1.95, 95% CI 1.40-2.71, p < 0.001) and two-year (OR = 1.56, 95% CI 1.04-2.33, p = 0.031) exclusion periods. The time of childhood CT was also correlated to intracranial malignancy in both one-year (OR = 1.69, 95% CI 1.34-2.13, p < 0.001) and two-year (OR = 1.55, 95% CI 1.17-2.04, p = 0.002) exclusion periods. The results indicated that childhood CT exposure was correlated with an increased risk of future intracranial malignancy.


Assuntos
Neoplasias Encefálicas/epidemiologia , Neoplasias Encefálicas/etiologia , Leucemia/epidemiologia , Leucemia/etiologia , Linfoma/epidemiologia , Linfoma/etiologia , Tomografia Computadorizada por Raios X/efeitos adversos , Adolescente , Fatores Etários , Neoplasias Encefálicas/prevenção & controle , Criança , Pré-Escolar , Bases de Dados Factuais , Suscetibilidade a Doenças , Feminino , Humanos , Leucemia/prevenção & controle , Linfoma/prevenção & controle , Masculino , Razão de Chances , Vigilância da População , Medição de Risco , Fatores de Risco , Taiwan/epidemiologia
10.
Pediatr Blood Cancer ; 67(8): e28408, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32437093

RESUMO

BACKGROUND: In this study, we aimed to evaluate incidence rates and family risk of the most common childhood cancers, tumors in the central nervous system (CNS), and leukemia among individuals from Norway and individuals with Scandinavian ancestry living in Utah. METHODS: We used the Utah Population Database and the Norwegian National Population Register linked to Cancer registries to identify cancers in children born between 1966 and 2015 and their first-degree relatives. We calculated incidence rates and hazards ratios. RESULTS: The overall incidence of CNS tumors increased with consecutive birth cohorts similarly in Utah and Norway (both P < 0.001). Incidence rates of leukemia were more stable and similar in both Utah and in Norway with 4.6/100 000 person-years among children (<15 years) born in the last cohort. A family history of CNS tumors was significantly associated with risk of childhood CNS tumors in Utah HR = 3.05 (95% CI 1.80-5.16) and Norway HR = 2.87 (95% CI 2.20-3.74). In Norway, children with a first-degree relative diagnosed with leukemia had high risk of leukemia (HR = 2.39, 95% CI 1.61-3.55). CONCLUSION: Despite geographical distance and assumed large lifestyle differences, two genetically linked pediatric populations show similar incidences of CNS tumors and leukemia in the period 1966-2015. CNS tumors and leukemia aggregated in families in both countries.


Assuntos
Neoplasias do Sistema Nervoso Central , Família , Predisposição Genética para Doença , Leucemia , Sistema de Registros , Adolescente , Adulto , Idoso , Neoplasias do Sistema Nervoso Central/epidemiologia , Neoplasias do Sistema Nervoso Central/etnologia , Neoplasias do Sistema Nervoso Central/genética , Criança , Pré-Escolar , Feminino , Humanos , Leucemia/epidemiologia , Leucemia/etnologia , Leucemia/genética , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Utah/epidemiologia
11.
Ann Hematol ; 99(7): 1543-1550, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32430702

RESUMO

The major sources of the data on the hematological malignancies in the post-Chernobyl period in the regions of Ukraine differing by the levels of the residual contamination with radionuclides have been analyzed. According to the data collected from the primary hematological facilities in Ukraine in 2010-2017, the incidence of lymphoid neoplasms from mature B cells, acute myeloid leukemia, and multiple myeloma in the most contaminated regions was higher than in the less contaminated ones. For the first time, the relative contribution of the several specific types of leukemia in the total diagnosed hematological malignancies has been analyzed throughout 1997-2017 based on the in-house database compiled by the Reference Laboratory of RE Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, the National Academy of Sciences of Ukraine. In 2011-2017, the Reference Laboratory provided the diagnostic studies in about 26% of all Ukrainian patients with tumors of hematopoietic and lymphoid tissues (34% of patients with different forms of acute and chronic leukemia). The increased proportion of acute myeloid leukemia and chronic lymphocytic leukemia in the total diagnosed cases of overall leukemia in the patients from contaminated regions has been demonstrated following Chernobyl accident.


Assuntos
Acidente Nuclear de Chernobyl , Neoplasias Hematológicas/epidemiologia , Neoplasias Hematológicas/etiologia , Neoplasias Induzidas por Radiação/epidemiologia , Bases de Dados Factuais , Feminino , História do Século XX , História do Século XXI , Humanos , Incidência , Leucemia/epidemiologia , Leucemia/etiologia , Linfoma/epidemiologia , Linfoma/etiologia , Masculino , Dados Preliminares , Cinza Radioativa/efeitos adversos , Cinza Radioativa/estatística & dados numéricos , Sistema de Registros , Ucrânia/epidemiologia
12.
Cancer Causes Control ; 31(6): 559-567, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32277327

RESUMO

PURPOSE: The type of dwelling where a child lives is an important factor when considering residential exposure to environmental agents. In this paper, we explore its role when estimating the potential effects of magnetic fields (MF) on leukemia using data from the California Power Line Study (CAPS). In this context, dwelling type could be a risk factor, a proxy for other risk factors, a cause of MF exposure, a confounder, an effect-measure modifier, or some combination. METHODS: We obtained information on type of dwelling at birth on over 2,000 subjects. Using multivariable-adjusted logistic regression, we assessed whether dwelling type was a risk factor for childhood leukemia, which covariates and MF exposures were associated with dwelling type, and whether dwelling type was a potential confounder or an effect-measure modifier in the MF-leukemia relationship under the assumption of no-uncontrolled confounding. RESULTS: A majority of children lived in single-family homes or duplexes (70%). Dwelling type was associated with race/ethnicity and socioeconomic status but not with childhood leukemia risk, after other adjustments, and did not alter the MF-leukemia relationship upon adjustment as a potential confounder. Stratification revealed potential effect-measure modification by dwelling type on the multiplicative scale. CONCLUSION: Dwelling type does not appear to play a significant role in the MF-leukemia relationship in the CAPS dataset as a leukemia risk factor or confounder. Future research should explore the role of dwelling as an effect-measure modifier of the MF-leukemia association.


Assuntos
Campos Eletromagnéticos , Exposição Ambiental/estatística & dados numéricos , Leucemia/epidemiologia , Características de Residência/estatística & dados numéricos , California/epidemiologia , Criança , Humanos , Fatores de Risco , Classe Social
13.
Pediatr Hematol Oncol ; 37(5): 390-411, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32202958

RESUMO

Disseminated intravascular coagulation (DIC) may complicate malignant disease. Numerous studies have investigated this association in adults, however only sparse knowledge exists on DIC in pediatric cancer patients. The objective of this article was to systematically review the literature regarding DIC in pediatric malignancies. PubMed and Embase were searched for relevant articles on January 31, 2020. In total, 6,070 articles were identified out of which 24 articles met inclusion and exclusion criteria. These were included in the qualitative synthesis. The National Institutes of Health's Quality Assessment Tools was used to assess bias in the included articles. The studies were of only moderate quality mainly based on medical charts and demonstrated high heterogeneity, especially as regards to diagnostic criteria. DIC was reported most frequently in patients with acute leukemia, particularly the subtype acute promyelocytic leukemia (APL). Standard coagulation parameters were used as diagnostic laboratory tests supporting the diagnosis of DIC. Hemorrhage was the predominant clinical manifestation, whereas thromboembolic events and organ failure were reported less frequently. Unfractionated heparin, platelet concentrate and fresh frozen plasma were the most frequently used supportive treatment agents. Hemorrhage accounted for the majority of deaths in children with acute leukemia and solid tumors. In conclusion, only a limited number of studies, being heterogenous and of moderate quality, have investigated DIC in pediatric malignancy. Notably, this entity seems to be complicated mainly by hemorrhage. High quality studies are needed to evaluate diagnosis, clinical manifestations and optimal treatment of DIC in childhood cancers.


Assuntos
Coagulação Intravascular Disseminada/epidemiologia , Neoplasias/epidemiologia , Adolescente , Anticoagulantes/uso terapêutico , Coagulação Sanguínea , Criança , Pré-Escolar , Coagulação Intravascular Disseminada/diagnóstico , Coagulação Intravascular Disseminada/tratamento farmacológico , Coagulação Intravascular Disseminada/mortalidade , Hemorragia/tratamento farmacológico , Hemorragia/epidemiologia , Heparina/uso terapêutico , Humanos , Lactente , Leucemia/epidemiologia , Leucemia Promielocítica Aguda/epidemiologia , Neoplasias/mortalidade , Plasma , Trombose/tratamento farmacológico , Trombose/epidemiologia
14.
Arch Med Res ; 51(1): 54-62, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32086109

RESUMO

BACKGROUND: The umbilical cord blood bank at the Mexican Institute of Social Security (IMSS-CBB) was established in January 2005. This lead to the development of the UCB transplantation program. Herein, we describe the experience generated during these 13 years. STUDY DESIGN AND METHODS: Donor selection, as well as UCB collection, processing, and banking were performed under good manufacturing practices and standard operating procedures. UCB units were thawed, processed, and released for transplantation based on HLA and nucleated cell content. RESULTS: From January 2005-December 2017, 1,298 UCB units were banked; 164 of them were released for transplantation, and 118 UCB transplants were performed. Ninety-four transplants were performed in pediatric patients and 24 in adults. Sixty percent of them corresponded to patients with leukemia, 19% were patients with marrow failure, and the rest had immunodeficiency, hemoglobinopathy, metabolic disorders, or solid tumors. Engraftment was observed in 67 patients (57% of transplanted patients) and 64% of them were still alive when writing this article. In contrast, only 13 of the 51 (25%) non-engrafting patients were alive. At the time of writing this article, the disease-free survival rate was 37%, and the overall survival rate was 47%, with survival periods of 161-3,721 days. CONCLUSION: The IMSS UCB banking and transplantation program has had a significant impact for many IMSS patients. The hematopoietic transplantation program at our institution has benefited from the use of UCB as a source of transplantable cells.


Assuntos
Bancos de Sangue , Transplante de Células-Tronco de Sangue do Cordão Umbilical , Sangue Fetal , Programas Nacionais de Saúde , Adolescente , Adulto , Idoso , Bancos de Sangue/métodos , Bancos de Sangue/estatística & dados numéricos , Bancos de Sangue/tendências , Transtornos da Insuficiência da Medula Óssea/epidemiologia , Transtornos da Insuficiência da Medula Óssea/terapia , Criança , Pré-Escolar , Transplante de Células-Tronco de Sangue do Cordão Umbilical/normas , Transplante de Células-Tronco de Sangue do Cordão Umbilical/estatística & dados numéricos , Transplante de Células-Tronco de Sangue do Cordão Umbilical/tendências , Intervalo Livre de Doença , Feminino , Transplante de Células-Tronco Hematopoéticas/normas , Transplante de Células-Tronco Hematopoéticas/estatística & dados numéricos , História do Século XXI , Humanos , Lactente , Recém-Nascido , Leucemia/epidemiologia , Leucemia/terapia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Programas Nacionais de Saúde/organização & administração , Programas Nacionais de Saúde/normas , Programas Nacionais de Saúde/tendências , Gravidez , Estudos Retrospectivos , Taxa de Sobrevida , Adulto Jovem
15.
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
16.
Environ Pollut ; 258: 113476, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31902537

RESUMO

Exposure to chemicals produced by petrochemical industrial complexes (PICs), such as benzene, ionizing radiation, and particulate matters, may contribute to the development of leukemia. However, epidemiological studies showed controversial results. This systematic review and meta-analysis aimed to summarize the association between residential exposure to PICs and the risk of leukemia incidence, focusing on exposure-response effects. We searched PubMed, Embase, Web of Science, and Cochrane Library databases for studies published before September 1st, 2019. Observational studies investigating residential exposure to PICs and the risk of leukemia were included. The outcome of interest was the incidence of leukemia comparing to reference groups. Relative risk (RR) was used as the summary effect measure, synthesized by characteristics of populations, distance to PICs, and calendar time in meta-regression. We identified 7 observational studies, including 2322 leukemia cases and substantial reference groups, in this meta-analysis. Residential exposure to PICs within a maximal 8-km distance had a 36% increased risk of leukemia (pooled RR = 1.36, 95% CI = 1.14-1.62) compared to controls, regardless of sex and age. In terms of leukemia subtypes, residential exposure to PICs was associated with the risks of acute myeloid leukemia (AML, pooled RR = 1.61, 95% CI = 1.12-2.31) and chronic lymphocytic leukemia (CLL, pooled RR = 1.85, 95% CI = 1.11-6.42). In meta-regression, the positive association occurred after 10 years of follow-up with a pooled RRs of 1.21 (95% CI = 1.02-1.44) and then slightly increased to 1.77 (95% CI = 1.35-2.33) at 30 years after follow-up. No effect modification was found by sex, age, and geographic locations.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Benzeno/toxicidade , Exposição Ambiental/efeitos adversos , Leucemia/induzido quimicamente , Petróleo/toxicidade , Benzeno/efeitos adversos , Indústria Química , Humanos , Incidência , Leucemia/epidemiologia , Petróleo/efeitos adversos , Risco
17.
BMC Cancer ; 20(1): 48, 2020 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-31959128

RESUMO

BACKGROUND: Leukemia is the most common cancer in childhood. The estimated incidence rate of childhood leukemia in Colombia is one of the highest in America and little is known about its spatial distribution. PURPOSE: To explore the presence of space-time clustering of childhood leukemia in Colombia. METHODS: We included children less than 15 years of age with confirmed diagnosis of acute leukemia reported to the national surveillance system for cancer between 2009 and 2017. Kulldorff's spatio-temporal scan statistics were used with municipality and year of diagnosis as units for spatial and temporal analysis. RESULTS: There were 3846 cases of childhood leukemia between 2009 and 2017 with a specific mean incidence rate of 33 cases per million person-years in children aged 0-14 years. We identified five spatial clusters of childhood leukemia in different regions of the country and specific time clustering during the study period. CONCLUSION: Childhood leukemia seems to cluster in space and time in some regions of Colombia suggesting a common etiologic factor or conditions to be studied.


Assuntos
Leucemia/epidemiologia , Neoplasias/epidemiologia , Sistema de Registros/estatística & dados numéricos , Doença Aguda , Adolescente , Criança , Pré-Escolar , Colômbia/epidemiologia , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Leucemia/diagnóstico , Masculino , Neoplasias/diagnóstico , Conglomerados Espaço-Temporais
18.
Cancer Causes Control ; 31(3): 231-240, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31960178

RESUMO

BACKGROUND: This retrospective cohort study examines the trends in childhood leukaemia age-standardized incidence rates (ASIRs) (per million person-years) using cases which were diagnosed at age 0-19 years from 1980 to 2014 and recorded in the Kuwait Cancer Control Center (KCCC) registry. METHODS: Childhood leukaemia age-specific incidence rates overall and by sub-cohorts defined by age (0-4, 5-9, 10-14, and 15-19 years), sex (male, female) and nationality (Kuwaiti, non-Kuwaiti) were computed and age-standardized. Joinpoint regression models were used to evaluate trends in childhood leukaemia ASIRs. Average annual percent change (AAPC) and its 95% confidence interval (CI) were used to interpret the observed trends. RESULTS: During the study period, 1077 childhood leukaemia cases of 32.3 million person-years were diagnosed. From 1980 to 2014, the average annual childhood leukaemia ASIR was 53.1 (95% CI 20.9, 85.2). Overall childhood leukaemia ASIRs significantly decreased on average by 6.8% per year (AAPC = -6.8; 95% CI -12.1, -1.1; p = 0.02) from 1980 to 1993, but a marginally significant increase in ASIRs from 1993 to 2014 was recorded (AAPC = 2.5; 95% CI -0.5, 5.5; p = 0.10). During the entire period, childhood leukaemia ASIRs trends significantly (p < 0.05) increased among 6 of 16 sub-cohorts, which was more pronounced among females and 10-14-year-old children. CONCLUSIONS: Overall, ASIRs significantly increased from 1993 to 2014, which specifically seems to be driven by an increase in ASIRs among females and 10-14 -year-old children. These increasing trends underscore the potential involvement of a range of exposures. Future studies on unravelling such factors may help develop preventive measures to minimize childhood leukaemia risk in this and similar settings in the region.


Assuntos
Leucemia/epidemiologia , Sistema de Registros , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Kuweit/epidemiologia , Masculino , Estudos Retrospectivos , Adulto Jovem
19.
Transfusion ; 60(1): 46-53, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31850522

RESUMO

BACKGROUND: Using the Recipient and Donor Epidemiology Study-III (REDS-III) recipient and donor databases, we performed a retrospective analysis of platelet use in 12 US hospitals that were participants in REDS-III. STUDY DESIGN AND METHODS: Data were electronically extracted from participating transfusion service and blood center computer systems and from medical records of the 12 REDS-III hospitals. All platelet transfusions from 2013 to 2016 given to patients aged 18 years and older were included in the analysis. RESULTS: There were 28,843 inpatients and 2987 outpatients who were transfused with 163,719 platelet products (103,371 apheresis, 60,348 whole blood derived); 93.5% of platelets were leukoreduced and 72.5% were irradiated. Forty-six percent were transfused to patients with an International Classification of Diseases, 9th/10th Revision (ICD-9/10) diagnosis of leukemia, myelodysplastic syndrome (MDS), or lymphoma. The general ward and the intensive care unit (ICU) were the most common issue locations. Only 54% of platelet transfusions were ABO identical; and 60.6% of platelet transfusions given to Rh-negative patients were Rh positive. The most common pretransfusion platelet count range for inpatients was 20,000 to 50,000/µL, for outpatients it was 10,000 to 20,000/µL. Among ICU patients, 35% of platelet transfusion episodes had a platelet count of greater than 50,000/µL; this was only 8% for general ward and 2% for outpatients. The median posttransfusion increment, not corrected for platelet dose and/or patient size, ranged from 12,000 to 20,000/µL for inpatients, and from 17,000 to 27,000/µL for outpatients. CONCLUSIONS: These data from one of the largest reviews of platelet transfusion practice to date provide guidance for where to focus future clinical research studies and platelet blood management programs.


Assuntos
Hospitais , Leucemia , Linfoma , Síndromes Mielodisplásicas , Transfusão de Plaquetas , Plaquetoferese , Idoso , Feminino , Humanos , Leucemia/sangue , Leucemia/epidemiologia , Leucemia/terapia , Linfoma/sangue , Linfoma/epidemiologia , Linfoma/terapia , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/sangue , Síndromes Mielodisplásicas/epidemiologia , Síndromes Mielodisplásicas/terapia , Estudos Retrospectivos , Estados Unidos
20.
Leuk Res ; 88: 106268, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31760269

RESUMO

The developing fetus is exposed to chemicals, which are metabolized to electrophiles that form adducts with nucleophilic Cys34 of human serum albumin (HSA). By measuring these adducts in neonatal blood spots (NBS), we obtain information regarding fetal exposures during the last month of gestation. To discover potential risk factors for childhood leukemia resulting from in utero exposures, we used untargeted adductomics to measure HSA-Cys34 adducts in 782 archived NBS, collected from incident cases of childhood acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML) and matched population-based controls. Among a total of 28 Cys34 modifications that were measured, we found no differences in adduct abundances between childhood leukemia cases and controls overall. However, cases of T-cell ALL had higher abundances of adducts of reactive carbonyl species and a Cys34 disulfide of homocysteine was present at lower levels in AML cases. These results suggest that oxidative stress and lipid peroxidation may be etiologic factors of T-cell ALL, and alterations in one-carbon metabolism and epigenetic changes may be predictors of AML. Future replication of the results with larger sample sizes is necessary.


Assuntos
Teste em Amostras de Sangue Seco , Leucemia/diagnóstico , Triagem Neonatal/métodos , Proteômica/métodos , Espécies Reativas de Oxigênio/análise , Albumina Sérica Humana/análise , Adolescente , Idade de Início , Estudos de Casos e Controles , Criança , Pré-Escolar , Cromatografia Líquida de Alta Pressão , Teste em Amostras de Sangue Seco/métodos , Feminino , Humanos , Lactente , Recém-Nascido , Leucemia/sangue , Leucemia/epidemiologia , Peroxidação de Lipídeos , Masculino , Estresse Oxidativo/fisiologia , Processamento de Proteína Pós-Traducional , Espécies Reativas de Oxigênio/sangue , Albumina Sérica Humana/metabolismo
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