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1.
J Clin Rheumatol ; 27(6S): S204-S211, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32028309

RESUMO

BACKGROUND: Acute transverse myelitis (ATM) is an infrequent but severe complication of systemic lupus erythematosus (SLE). The purpose of study was to describe clinical features and prognostic factors of patients with SLE-related ATM. METHODS: In this medical records review study, data were collected from 60 patients from 16 centers seen between 1996 and 2017 who met diagnostic criteria for SLE and myelitis as defined by the American College of Rheumatology/Systemic International Collaborating Clinics and the Working Group of the Transverse Myelitis Consortium, respectively. Objective neurological impairment was measured with American Spinal Injury Association Impairment Scale (AIS) and European Database for Multiple Sclerosis Grade Scale (EGS). RESULTS: Among patients included, 95% (n = 57) were female, and the average age was 31.6 ± 9.6 years. Myelitis developed after diagnosis of SLE in 60% (n = 36). Symmetrical paraparesis with hypoesthesia, flaccidity, sphincter dysfunction, AIS = A/B, and EGS ≥ 8 was the most common presentation. Intravenous methylprednisolone was used in 95% (n = 57), and 78.3% (n = 47) received intravenous cyclophosphamide. Sensory/motor recovery at 6 months was observed in 75% (42 of 56), but only in 16.1% (9 of 56) was complete. Hypoglycorrhachia and EGS ≥ 7 in the nadir were associated with an unfavorable neurological outcome at 6 months (p < 0.05). A relapse rate during follow-up was observed in 30.4% (17 of 56). Hypoglycorrhachia and hypocomplementemia seem to be protective factors for relapse. Intravenous cyclophosphamide was associated with time delay to relapse. CONCLUSIONS: Systemic lupus erythematosus-related ATM may occur at any time of SLE course, leading to significant disability despite treatment. Relapses are infrequent and intravenous cyclophosphamide seems to delay it. Hypoglycorrhachia, hypocomplementemia, and EGS at nadir are the most important prognostic factors.


Assuntos
Lúpus Eritematoso Sistêmico , Mielite Transversa , Adulto , Feminino , Humanos , América Latina , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Mielite Transversa/diagnóstico , Mielite Transversa/tratamento farmacológico , Mielite Transversa/epidemiologia , Recidiva Local de Neoplasia , Prognóstico , Adulto Jovem
2.
J Neuroophthalmol ; 39(2): 165-169, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30004999

RESUMO

BACKGROUND: Aquaporin-4 antibodies (AQP4-Ab) are associated with neuromyelitis optica spectrum disorder (NMOSD) and typically this disorder has a poor visual prognosis as a result of optic neuritis (ON). Our aim was to report the clinical features at onset and final visual outcomes at 6 months of patients with ON who were positive for AQP4-Ab vs. those who were negative for AQP4-Ab. METHODS: Retrospective cohort study. AQP4-Ab were tested by indirect immunofluorescence in 57 patients with a first episode of ON. All patients initially were referred for consideration of multiple sclerosis ON (MSON), NMOSD, or any other inflammatory central nervous system disorder during follow-up (41.31 ± 24.32 months). Our patients were diagnosed as having NMOSD, MSON, chronic relapsing inflammatory ON, and single isolated ON. Risk factors associated with visual outcomes of ON patients were assessed through an ordinal regression model. RESULTS: Positive AQP4-Ab were associated with male sex (P = 0.02), earlier age of onset (P = 0.01), and myelitis relapses (P = 0.04). Seronegative group had fewer recurrences of ON than the seropositive group (35% vs 58%, P = 0.14). Patients that were positive for AQP4-Ab did not have worse visual acuity at baseline and after 6 months. However, poor visual acuity during first attack was associated with a worse visual acuity at 6 months (odds ratio = 2.28, 95% CI [1.58-3.28], P = 0.03). CONCLUSIONS: At 6 months, positive AQP4-Ab vs negative AQP4-Ab patients no evidence of poorer visual acuity. Lower visual acuity at baseline was associated with poor visual recovery at 6 months.


Assuntos
Aquaporina 4/imunologia , Autoanticorpos/sangue , Neurite Óptica/imunologia , Acuidade Visual/fisiologia , Doença Aguda , Adulto , Idade de Início , Avaliação da Deficiência , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Masculino , Pessoa de Meia-Idade , Neuromielite Óptica/imunologia , Neurite Óptica/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Estudos Soroepidemiológicos , Adulto Jovem
3.
Spinal Cord ; 56(10): 949-954, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29789706

RESUMO

STUDY DESIGN: Multicenter retrospective study. OBJECTIVES: The aim was to determine the frequency and magnetic resonance imaging (MRI) features of short-segment transverse myelitis (STM) in patients with neuromyelitis optica spectrum disorders (NMOSD) during a myelitis attack. SETTING: Latin American diagnostic centres (Neuroimmunology Unit). A multicenter study from Argentina, Brazil and Venezuela was performed. METHODS: Seventy-six patients with NMOSD were included. We analyzed 346 attacks and reviewed spinal cord MRIs performed within 30 days from spinal attack onset. Sagittal and axial characteristics on cervical and thoracic MRI (1.5 tesla) were observed. Demographics, clinical, serological, and disability data were collected. RESULTS: Among the 76 patients with NMOSD, isolated STM was observed in 8% (n = 6), multisegmental lesions (longitudinally extensive transverse myelitis (LETM) + STM) in 28% (n = 21; 13 had at least one STM), LETM in 42% (n = 32), and normal spinal MRI in 22% (n = 17). However, isolated STM was increased by 10% in patients with NMOSD with spinal lesions (6 out of 59) with mean attacks of 2.5 (±0.83) and last follow-up expanded disability status scale (EDSS) of 3.1 (±2.63). Positive aquaporin 4 antibodies (AQP4-ab) were found in 50%. Upper-cervical lesion was most frequently observed (5 out of 6). Myelitis was preceded by ON in all isolated patients with STM. Only one had a positive gadolinium lesion and none of these had asymptomatic spinal cord lesion. CONCLUSION: Isolated STM does not exclude NMOSD diagnosis. Therefore, APQ4-ab testing could be useful during a myelitis attack with STM.


Assuntos
Neuromielite Óptica/diagnóstico por imagem , Medula Espinal/diagnóstico por imagem , Adulto , Vértebras Cervicais , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Vértebras Torácicas
4.
Medicina (B Aires) ; 73(1): 9-16, 2013.
Artigo em Espanhol | MEDLINE | ID: mdl-23335699

RESUMO

Multiparameter flow cytometry (MFC) has become the preferred method for the lineage assignment and maturational analysis of malignant cells in acute leukemias. Multiparametric immunophenotyping analysis allows the detection of aberrant antigen expression and the analysis of heterogeneity and clonality of malignant cells in leukemias. Our objectives were to analyze the membrane antigen expression and to evaluate if the aberrant phenotypes occurrence in blasts cells of patients with acute leukemia is useful in monitoring the response to the treatment. We have retrospectively analyzed the MFC data of 364 samples sent to our laboratory in a 7 years period. For this purpose we have used a large panel of monoclonal antibodies against lymphoid, myeloid and precursors antigens. From the 364 analyzed samples, 60.2% showed a phenotype compatible with acute myeloid leukemia (AML), 28.8% with B lymphoblastic leukemia (B-LLA), 6.6% with T lymphoblastic leukemia (T-LLA) and 4.4% with rare leukemias. Aberrant phenotypes were found in 86% of the samples. The aberrant phenotypes identified were:1) lineage infidelity AML (54%), B-ALL (40%), T-ALL (29%); 2) absence of antigen expression: AML (21%), B-ALL (35%), T-ALL (70%); 3) altered antigen expression: AML (67%), B-ALL (66%),T-ALL (84%); 4) asynchronous expression: AML (26%), B-ALL (37%) and 5) ectopic phenotype: T-ALL (96%). Multiparameter flow cytometry of acute leukemias allowed identification of aberrant phenotypes in the majority of our patients, that are helpful for monitoring treatment response.


Assuntos
Antígenos CD/análise , Imunofenotipagem/métodos , Leucemia/imunologia , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina , Linhagem da Célula/imunologia , Feminino , Citometria de Fluxo/métodos , Humanos , Leucemia/genética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
5.
Adv Rheumatol ; 61(1): 46, 2021 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-34238387

RESUMO

BACKGROUND: Infections are a major cause of morbidity and mortality in systemic lupus (SLE). Vaccination would be an effective method to reduce infection rate. Coverage for influenza and pneumococcus appears to be low in Latin America. The objective of this study was to evaluate vaccination coverage for influenza and pneumococcus in Latin America, causes of non-vaccination and to compare it with European patients. METHODS: A survey was conducted through social networks targeting Latin American lupus patients. A self-report was used to assess the demographics, risk factors for pneumonia, vaccination status, and causes of non-vaccination. The same method was used for European patients. We used binary logistic regression to identify factors associated with pneumococcal and influenza vaccination. RESULTS: There were 1130 participants from Latin America. Among them, 97% were women with an average of 37.9 years (SD: 11.3) and 46.5% had more than 7 years of disease duration. Two or more risk factors for pneumonia were found in 64.9%. Coverage for influenza and pneumococcal was 42.7 and 25% respectively, being lower than in Europe. Tetanus coverage was the most important predictor for receiving influenza and pneumococcal vaccination. Lack of prescription was the most common cause of non-application (64.6%). CONCLUSIONS: Vaccination coverage for influenza and pneumonia is low in Latin America, especially compared to Europe. It is necessary to make specialists aware of their role in vaccine control and to implement measures to improve coordination between them and general practitioners.


Assuntos
Vacinas contra Influenza , Lúpus Eritematoso Sistêmico , Vacinas Pneumocócicas , Cobertura Vacinal , Adulto , Estudos Transversais , Feminino , Humanos , Vacinas contra Influenza/administração & dosagem , América Latina/epidemiologia , Lúpus Eritematoso Sistêmico/epidemiologia , Masculino , Pessoa de Meia-Idade , Vacinas Pneumocócicas/administração & dosagem , Cobertura Vacinal/estatística & dados numéricos
6.
Mult Scler Relat Disord ; 19: 73-78, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29156226

RESUMO

BACKGROUND: Brain magnetic resonance imaging (BMRI) lesions were classically not reported in neuromyelitis optica (NMO). However, BMRI lesions are not uncommon in NMO spectrum disorder (NMOSD) patients. OBJECTIVE: To report BMRI characteristic abnormalities (location and configuration) in NMOSD patients at presentation. METHODS: Medical records and BMRI characteristics of 79 patients with NMOSD (during the first documented attack) in Argentina, Brazil and Venezuela were reviewed retrospectively. RESULTS: BMRI abnormalities were observed in 81.02% of NMOSD patients at presentation. Forty-two patients (53.1%) showed typical-NMOSD abnormalities. We found BMRI abnormalities at presentation in the brainstem/cerebellum (n = 26; 32.9%), optic chiasm (n = 16; 20.2%), area postrema (n = 13; 16.4%), thalamus/hypothalamus (n = 11; 13.9%), corpus callosum (n = 11; 13.9%), periependymal-third ventricle (n = 9; 11.3%), corticospinal tract (n = 7; 8.8%), hemispheric white matter (n = 1; 1.2%) and nonspecific areas (n = 49; 62.03%). Asymptomatic BMRI lesions were more common. The frequency of brain MRI abnormalities did not differ between patients who were positive and negative for aquaporin 4 antibodies at presentation. CONCLUSION: Typical brain MRI abnormalities are frequent in NMOSD at disease onset.


Assuntos
Aquaporina 4/imunologia , Autoanticorpos/sangue , Encéfalo/patologia , Neuromielite Óptica/sangue , Neuromielite Óptica/patologia , Adulto , Argentina , Encéfalo/diagnóstico por imagem , Tronco Encefálico/diagnóstico por imagem , Tronco Encefálico/patologia , Brasil , Cerebelo/diagnóstico por imagem , Cerebelo/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuromielite Óptica/diagnóstico por imagem , Estudos Retrospectivos , Venezuela , Adulto Jovem
7.
Clin Neurol Neurosurg ; 163: 149-155, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29102871

RESUMO

OBJECTIVE: To report the impact of multiple sclerosis (MS) on patients' quality of life (QoL) compared to systemic lupus erythematosus (SLE) using the 36-Item Short Form (SF-36) health questionnaire in Argentina. PATIENTS AND METHODS: Cross-sectional study. All consecutive MS patients, SLE and healthy controls (HC) were included. Demographics, clinical and radiological aspects, EDSS and SF-36 were assessed. RESULTS: A total of 191 subjects were included (MS=74, SLE=30 and HC=87). When we compared, using 2 standard deviations below the normal mean, the SF-36 subscales scores between MS and SLE, we found that MS patients experienced significant deterioration in general health (p<0.0001), vitality (p=0.009), current health (p<0.0001) and previous year health perception (p=0.003). Additional evaluated areas did not show significant differences. MS patients scored significantly lower in all categories compared to HC, except for bodily pain. An inverse correlation between EDSS and SF-36 total (R2=0.59, ß -11.08, p<0.0001) and subscale scores was observed after applying regression analysis. CONCLUSION: MS behaves as a systemic disease from the functional point of view. Patient-reported QoL scales scores provide comprehensive additional prognostic information beyond the EDSS score. Therefore, adding the SF-36 questionnaire in clinical practice might be useful for the assessment and follow-up of MS patients.


Assuntos
Lúpus Eritematoso Sistêmico/diagnóstico , Esclerose Múltipla/diagnóstico , Qualidade de Vida , Inquéritos e Questionários , Adulto , Estudos Transversais , Diagnóstico Diferencial , Feminino , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico por imagem , Masculino , Índice de Gravidade de Doença
8.
J Neurol Sci ; 373: 134-137, 2017 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-28131170

RESUMO

BACKGROUND: Longitudinally extensive transverse myelitis (LETM) is a frequent manifestation of neuromyelitis optica spectrum disorder (NMOSD). However, it can also occur in other immune-mediated diseases of the central nervous system (CNS). Positive aquoporin-4 antibodies (AQP4-ab) predict higher relapse rate after LETM. OBJECTIVE: To assess clinical and brain/spinal cord magnetic resonance imaging (MRI) features of LETM immune-mediated at onset and to compare AQP4-ab negative (N-LETM) with AQP4-ab positive (P-LETM) patients. METHODS: Thirty LETM patients remitted for consideration of inflammatory CNS diseases were included. Demographics, clinical, serological, disability and neuroimaging features at onset we reviewed retrospectively and divided into two groups according to serological status. AQP4-ab were tested using indirect immunofluorescence. RESULTS: Twenty-one patients were N-LETM. We did not find significant differences between both groups as regards gender, age at onset, dysfunction (motor, sensory, bladder/bowel) or disability. However, recurrences (p=0.04) of myelitis and number of relapses (p=0.03) were associated to P-LETM. N-LETM was associated with normal brain MRI (p=0.04) at onset. AQP4-ab positive were only observed in NMOSD patients. N-LETM (24%) and P-LETM (56%) patients had relapses of optic neuritis (ON) during the follow-up. CONCLUSION: LETM at onset is a heterogeneous syndrome with similar clinical and neuroimaging features between both groups. N-LETM displayed a lower relapse rate of myelitis and ON.


Assuntos
Mielite Transversa/imunologia , Neuromielite Óptica/imunologia , Adulto , Aquaporina 4/imunologia , Autoanticorpos/sangue , Encéfalo/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Masculino , Mielite Transversa/diagnóstico por imagem , Mielite Transversa/etiologia , Mielite Transversa/terapia , Neuromielite Óptica/complicações , Neuromielite Óptica/diagnóstico por imagem , Neuromielite Óptica/terapia , Recidiva , Estudos Retrospectivos , Índice de Gravidade de Doença
9.
Adv Rheumatol ; 61: 46, 2021. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1284983

RESUMO

Abstract Background: Infections are a major cause of morbidity and mortality in systemic lupus (SLE). Vaccination would be an effective method to reduce infection rate. Coverage for influenza and pneumococcus appears to be low in Latin America. The objective of this study was to evaluate vaccination coverage for influenza and pneumococcus in Latin America, causes of non-vaccination and to compare it with European patients. Methods: A survey was conducted through social networks targeting Latin American lupus patients. A self-report was used to assess the demographics, risk factors for pneumonia, vaccination status, and causes of non-vaccination. The same method was used for European patients. We used binary logistic regression to identify factors associated with pneumococcal and influenza vaccination. Results: There were 1130 participants from Latin America. Among them, 97% were women with an average of 37.9 years (SD: 11.3) and 46.5% had more than 7 years of disease duration. Two or more risk factors for pneumonia were found in 64.9%. Coverage for influenza and pneumococcal was 42.7 and 25% respectively, being lower than in Europe. Tetanus coverage was the most important predictor for receiving influenza and pneumococcal vaccination. Lack of prescription was the most common cause of non-application (64.6%). Conclusions: Vaccination coverage for influenza and pneumonia is low in Latin America, especially compared to Europe. It is necessary to make specialists aware of their role in vaccine control and to implement measures to improve coordination between them and general practitioners.

10.
Spinal Cord Ser Cases ; 2: 16005, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28053749

RESUMO

Myelopathy is one of the neuropsychiatric lupus syndromes. In this article, an original series of related lupus myelitis is reported and analyzed. We employed a retrospective chart review and identified all patients who were admitted to a general hospital in Buenos Aires, Argentina, with SLE and myelitis during the period 2007-2014. Five patients were observed, all women. The mean age was 25.4 years (19-39). In three of five cases, myelitis was one of the initial SLE manifestations. The SLE Disease Activity Index was variable (3/5 with high activity). Time to nadir ranged from 6 to 72 h. All had severe impairment, with motor deficit, sensory level and urinary retention. Magnetic resonance imaging was abnormal in all cases, 3/5 presented a longitudinally extensive myelitis. Serum analysis revealed positive antinuclear antibodies at a high titer in all patients, 4/5 had low complement levels and 3/5 had anti-phospholipids positive. The treatment (methylprednisolone and, in some cases, cyclophosphamide, anticoagulation and/or plasmapheresis) produced partial improvement or no benefits. One patient died due to sepsis. The others showed significant disability at 6 months (European Database for Multiple Sclerosis grading scale=6-8). In view of these results, myelitis associated with lupus shows heterogeneity of the clinical, radiological and serological features. In our experience, the cases were severe and with poor response to treatment. Further studies are required to understand this disease and establish a more efficient treatment.

11.
Medicina (B.Aires) ; 73(1): 9-16, feb. 2013. tab
Artigo em Espanhol | LILACS | ID: lil-672020

RESUMO

La citometría de flujo multiparamétrica es el método de elección para la caracterización inmunofenotípica de las células hematopoyéticas clonales presentes en los distintos procesos leucémicos agudos. El objetivo fue analizar la expresión de antígenos de membrana y evaluar la presencia de fenotipos aberrantes en los blastos de pacientes con diagnóstico de leucemia aguda, que permiten el monitoreo de la respuesta al tratamiento. Se revisaron los inmunofenotipos de 364 muestras de pacientes adultos derivadas a nuestro laboratorio en un período de 7 años. El inmunofenotipo se realizó por citometría de flujo con un amplio panel de anticuerpos monoclonales con el que se evaluó la expresión de antígenos de linaje linfoide, mieloide y también antígenos de maduración. De las 364 muestras estudiadas, 60.2% presentaron un fenotipo compatible con leucemia mieloide aguda (LMA), 28.8% con leucemia linfoblástica B (LLA-B), 6.6% con leucemia linfoblástica T (LLA-T) y 4.4% con leucemias agudas poco frecuentes. La presencia de fenotipos aberrantes se observó en 89% de los casos, los fenotipos aberrantes identificados fueron: 1) infidelidad de linaje: LMA (54%), LLA-B (40%), LLA-T (29%); 2) ausencia de expresión antigénica: LMA (21%), LLA-B (35%), LLA-T (70%); 3) alteración de la expresión antigénica: LMA (67%), LLA-B (66%), LLA-T (84%); 4) asincronismo madurativo: LMA (26%), LLA-B (37%) y 5) fenotipo ectópico: LLA-T 96%). El análisis por citometría de flujo multiparamétrica de las leucemias agudas permitió la identificación de fenotipos aberrantes en la mayoría de nuestros pacientes, que son de utilidad para el monitoreo de la respuesta al tratamiento.


Multiparameter flow cytometry (MFC) has become the preferred method for the lineage assignment and maturational analysis of malignant cells in acute leukemias. Multiparametric immunophenotyping analysis allows the detection of aberrant antigen expression and the analysis of heterogeneity and clonality of malignant cells in leukemias. Our objectives were to analyze the membrane antigen expression and to evaluate if the aberrant phenotypes occurrence in blasts cells of patients with acute leukemia is useful in monitoring the response to the treatment. We have retrospectively analyzed the MFC data of 364 samples sent to our laboratory in a 7 years period. For this purpose we have used a large panel of monoclonal antibodies against lymphoid, myeloid and precursors antigens. From the 364 analyzed samples, 60.2% showe d a phenotype compatible with acute myeloid leukemia (AML), 28.8% with B lymphoblastic leukemia (B-LLA), 6.6% with T lymphoblastic leukemia (T-LLA) and 4.4% with rare leukemias. Aberrant phenotypes were found in 86% of the samples. The aberrant phenotypes identified were:1) lineage infidelity AML (54%), B-ALL (40%), T-ALL (29%); 2) absence of antigen expression: AML (21%), B-ALL (35%), T-ALL (70%); 3) altered antigen expression: AML (67%), B-ALL (66%),T-ALL (84%); 4) asynchronous expression: AML (26%), B-ALL (37%) and 5) ectopic phenotype: T-ALL (96%). Multiparameter flow cytometry of acute leukemias allowed identification of aberrant phenotypes in the majority of our patients, that are helpful for monitoring treatment response.


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Antígenos CD/análise , Imunofenotipagem/métodos , Leucemia/imunologia , Doença Aguda , Argentina , Linhagem da Célula/imunologia , Citometria de Fluxo/métodos , Leucemia/genética , Estudos Retrospectivos
12.
Medicina (B.Aires) ; 73(1): 9-16, feb. 2013. tab
Artigo em Espanhol | BINACIS | ID: bin-131133

RESUMO

La citometría de flujo multiparamétrica es el método de elección para la caracterización inmunofenotípica de las células hematopoyéticas clonales presentes en los distintos procesos leucémicos agudos. El objetivo fue analizar la expresión de antígenos de membrana y evaluar la presencia de fenotipos aberrantes en los blastos de pacientes con diagnóstico de leucemia aguda, que permiten el monitoreo de la respuesta al tratamiento. Se revisaron los inmunofenotipos de 364 muestras de pacientes adultos derivadas a nuestro laboratorio en un período de 7 años. El inmunofenotipo se realizó por citometría de flujo con un amplio panel de anticuerpos monoclonales con el que se evaluó la expresión de antígenos de linaje linfoide, mieloide y también antígenos de maduración. De las 364 muestras estudiadas, 60.2% presentaron un fenotipo compatible con leucemia mieloide aguda (LMA), 28.8% con leucemia linfoblástica B (LLA-B), 6.6% con leucemia linfoblástica T (LLA-T) y 4.4% con leucemias agudas poco frecuentes. La presencia de fenotipos aberrantes se observó en 89% de los casos, los fenotipos aberrantes identificados fueron: 1) infidelidad de linaje: LMA (54%), LLA-B (40%), LLA-T (29%); 2) ausencia de expresión antigénica: LMA (21%), LLA-B (35%), LLA-T (70%); 3) alteración de la expresión antigénica: LMA (67%), LLA-B (66%), LLA-T (84%); 4) asincronismo madurativo: LMA (26%), LLA-B (37%) y 5) fenotipo ectópico: LLA-T 96%). El análisis por citometría de flujo multiparamétrica de las leucemias agudas permitió la identificación de fenotipos aberrantes en la mayoría de nuestros pacientes, que son de utilidad para el monitoreo de la respuesta al tratamiento.(AU)


Multiparameter flow cytometry (MFC) has become the preferred method for the lineage assignment and maturational analysis of malignant cells in acute leukemias. Multiparametric immunophenotyping analysis allows the detection of aberrant antigen expression and the analysis of heterogeneity and clonality of malignant cells in leukemias. Our objectives were to analyze the membrane antigen expression and to evaluate if the aberrant phenotypes occurrence in blasts cells of patients with acute leukemia is useful in monitoring the response to the treatment. We have retrospectively analyzed the MFC data of 364 samples sent to our laboratory in a 7 years period. For this purpose we have used a large panel of monoclonal antibodies against lymphoid, myeloid and precursors antigens. From the 364 analyzed samples, 60.2% showe d a phenotype compatible with acute myeloid leukemia (AML), 28.8% with B lymphoblastic leukemia (B-LLA), 6.6% with T lymphoblastic leukemia (T-LLA) and 4.4% with rare leukemias. Aberrant phenotypes were found in 86% of the samples. The aberrant phenotypes identified were:1) lineage infidelity AML (54%), B-ALL (40%), T-ALL (29%); 2) absence of antigen expression: AML (21%), B-ALL (35%), T-ALL (70%); 3) altered antigen expression: AML (67%), B-ALL (66%),T-ALL (84%); 4) asynchronous expression: AML (26%), B-ALL (37%) and 5) ectopic phenotype: T-ALL (96%). Multiparameter flow cytometry of acute leukemias allowed identification of aberrant phenotypes in the majority of our patients, that are helpful for monitoring treatment response.(AU)


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Antígenos CD/análise , Imunofenotipagem/métodos , Leucemia/imunologia , Doença Aguda , Argentina , Linhagem da Célula/imunologia , Citometria de Fluxo/métodos , Leucemia/genética , Estudos Retrospectivos
13.
Medicina (B Aires) ; 73(1): 9-16, 2013.
Artigo em Espanhol | BINACIS | ID: bin-133230

RESUMO

Multiparameter flow cytometry (MFC) has become the preferred method for the lineage assignment and maturational analysis of malignant cells in acute leukemias. Multiparametric immunophenotyping analysis allows the detection of aberrant antigen expression and the analysis of heterogeneity and clonality of malignant cells in leukemias. Our objectives were to analyze the membrane antigen expression and to evaluate if the aberrant phenotypes occurrence in blasts cells of patients with acute leukemia is useful in monitoring the response to the treatment. We have retrospectively analyzed the MFC data of 364 samples sent to our laboratory in a 7 years period. For this purpose we have used a large panel of monoclonal antibodies against lymphoid, myeloid and precursors antigens. From the 364 analyzed samples, 60.2


showed a phenotype compatible with acute myeloid leukemia (AML), 28.8


with B lymphoblastic leukemia (B-LLA), 6.6


with T lymphoblastic leukemia (T-LLA) and 4.4


with rare leukemias. Aberrant phenotypes were found in 86


of the samples. The aberrant phenotypes identified were:1) lineage infidelity AML (54


), B-ALL (40


), T-ALL (29


); 2) absence of antigen expression: AML (21


), B-ALL (35


), T-ALL (70


); 3) altered antigen expression: AML (67


), B-ALL (66


),T-ALL (84


); 4) asynchronous expression: AML (26


), B-ALL (37


) and 5) ectopic phenotype: T-ALL (96


). Multiparameter flow cytometry of acute leukemias allowed identification of aberrant phenotypes in the majority of our patients, that are helpful for monitoring treatment response.


Assuntos
Antígenos CD/análise , Imunofenotipagem/métodos , Leucemia/imunologia , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina , Linhagem da Célula/imunologia , Feminino , Citometria de Fluxo/métodos , Humanos , Leucemia/genética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
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