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Search Results: 1 - 10 of 32718 matches for " Daniel;Dulley "
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Evaluation of early hospital discharge after allogeneic bone marrow transplantation for chronic myeloid leukemia
Nicolau, José Eduardo;Melo, Leila Maria Magalh?es Pessoa de;Sturaro, Daniel;Saboya, Rosaura;Dulley, Frederico Luiz;
Sao Paulo Medical Journal , 2007, DOI: 10.1590/S1516-31802007000300009
Abstract: context and objective: the increasing number of patients waiting for bone marrow transplantation in our service led to the implement of an early hospital discharge program with the intention of reducing the interval between diagnosis and transplantation. in this study we analyzed the results from early discharge, with outpatient care for patients with chronic myeloid leukemia who underwent allogeneic bone marrow transplantation. design and setting: retrospective study at the bone marrow transplantation unit of hospital das clínicas, faculdade de medicina da universidade de s?o paulo. methods: we compared clinical outcomes within 100 days post-transplantation, for 51 patients with chronic myeloid leukemia (cml) who received partially outpatient-based allogeneic hematopoietic stem cell transplantation, and the results were compared with a historical control group of 49 patients who received inpatient-based hematopoietic stem cell transplantation. results: there were significantly fewer days of hospitalization (p = 0.004), pseudomonas-positive cultures (p = 0.006) and nausea and vomiting of grade 2-3 (p < 0.001) in the outpatient group. there were no significant differences in mortality between the groups and no deaths occurred within the first 48 days post-transplantation in the outpatient group. conclusions: this partially outpatient-based hematopoietic stem cell transplantation program allowed an increased number of transplantations in our institution, in cases of cml and other diseases, since it reduced the median length of hospital stay without increasing morbidity and mortality.
Bussulfano e ciclofosfamida como condicionamento para o transplante de medula óssea da anemia aplástica grave
Dulley Frederico L.
Revista Brasileira de Hematologia e Hemoterapia , 2001,
Abstract:
Bussulfano e melfalano como regime de condicionamento para o transplante autogênico de células-tronco hematopoéticas na leucemia mielóide aguda em primeira remiss?o completa
Bueno, Nadjanara D.;Dulley, Frederico L.;Saboya, Rosaura;Amigo Filho, José U.;Piron-Ruiz, Lílian;Sturaro, Daniel;Chamone, Dalton A. F.;
Revista Brasileira de Hematologia e Hemoterapia , 2008, DOI: 10.1590/S1516-84842008000500005
Abstract: twenty-two consecutive patients with acute myeloid leukemia in first complete remission submitted to autologous hematopoietic stem cells transplantation conditioned with busulfan and melphalan were evaluated between 1993 and 2006. the overall survival, according to the kaplan-meier curve, was 57.5% at 36 months, with a "plateau" at 20 months after transplant. factors such as gender, french-american-british (fab) classification of acute myeloid leukemia, induction therapy, intensive consolidation, remission after the first cycle of induction and source of cells had no impact on survival. one patient with poor prognosis before the procedure died a year after transplantation. nine patients died, eight by relapse and one because of bleeding. death before 100 days occurred for two patients, one due to relapse and the other bleeding caused by refractory thrombocytopenia related to the procedure. in conclusion, the conditioning regiment with busulfan and melphalan is a valid option compared to the other conditioning regimens, with an excellent overall survival.
O transplante de medula óssea na leucemia mielóide aguda: análise de 80 pacientes transplantados no complexo do Hospital das Clínicas da Faculdade de Medicina da Universidade de S?o Paulo
Bueno, Nadjanara D.;Saboya, Rosaura;Martins, Maria Cristina;Silva, Roberto L.;Chamone, Dalton A. F.;Rocha, Isamara F.;Sturaro, Daniel;Dulley, Frederico L.;
Revista Brasileira de Hematologia e Hemoterapia , 2004, DOI: 10.1590/S1516-84842004000200004
Abstract: the patients records of eighty consecutive patients with acute myeloid leukemia (aml) submitted to allogeneic (allo bmt) and autologous (auto bmt) bone marrow transplantation (bmt) between 1989 and 2001 were assessed. forty percent were alive in the end of the study; 37.9% of allogeneic patients and 45.4% of autologous. factors such as gender, the french-american-british aml classification, induction treatment, number of infused cells and the conditioning regiment did not have any impact in survival. patients with aml from m1 to m4, and who were consolidated with high doses of arabinoside had better a survival rate (p=0.0148). patients in their first complete remission also had better survival both with allogeneic and autologous bmt, with respective survival rates of 52.6% and 69.2%. acute graft-versus-host disease (gvhd) had an impact when it was compared the absence, grade i/ii with iii/iv giving a p-value of 0.0285. infection was the most frequent cause of death in allogeneic bmt. in autologous bmt relapse was the principal cause of death. toxicity related to the procedure occurred in 38.9% of patients who died in allogeneic bmt and 16.7% in autologous bmt. in univariant cox analyses for prognostic factors, the disease status and acute gvhd were significant, but this significance was lost in the multiple variant analyses (p-value = 0.069).
Transplante de medula óssea com doador familiar parcialmente compatível
Saboya, Rosaura;Dulley, Frederico L.;Ferreira, Euripedes;Sim?es, Belinda;
Revista Brasileira de Hematologia e Hemoterapia , 2010, DOI: 10.1590/S1516-84842010005000015
Abstract: myeloablative or non-myeloablative related allogeneic bone marrow transplantation is a curative treatment in some oncologic and hematologic diseases. unfortunately, only 25 to 30% of patients find a fully matched related donor. national and international donor programs are an option, however, much time is lost and patients can not wait because of their advance disease status or clinical deterioration. partially matched family donor allogeneic bone marrow transplantation may be an option. this article reviews the literature on this subject.
Transplante de células-tronco hematopoéticas em doen?as reumáticas. Parte 2: experiência brasileira e perspectivas futuras
Voltarelli, Júlio C.;Stracieri, Ana Beatriz P. L.;Oliveira, Maria Carolina B.;Godoi, Dannielle F.;Moraes, Daniela A.;Pieroni, Fabiano;Malmegrim, Kelen C. R.;Coutinho, Marina A.;Sim?es, Belinda P.;Massumoto, Celso;Hamerschlak, Nelson;Scheinberg, Morton;Ferreira, Eurípides;Coutinho, Mariana;Ostronoff, Maurício;Sturaro, Daniel;Dulley, Frederico;
Revista Brasileira de Reumatologia , 2005, DOI: 10.1590/S0482-50042005000500005
Abstract: in this review, we discuss the results of hematopoietic stem cell transplantation (hsct) for severe and refractory rheumatic diseases performed in brazil. we analyze preliminary results obtained in brazil with autologous hsct in anecdotal cases (n = 3) and in the cooperative protocol initiated in 2001 (n = 18). in 8 lupus nephritis patients there were 3 sustained remissions, 3 deaths, 1 mobilisation failure and 1 short follow-up; in 7 systemic sclerosis patients there were 3 sustained remissions after transplantation and 2 after mobilisation, 1 death before mobilisation and another after the first dose of the conditioning in an overlapping syndrome of sle and ssc, and between 2 patients with vasculitis there was 1 sustained remission in takayasu's arteritis and another in beh?et's disease. one patient with juvenile idiopathic arthritis was included in the protocol very recently. the follow-up of the patients varied from 0 to 48 months with a median of 29 months. we conclude the study with a discussion of future prospectives in developed countries, where randomized trials comparing transplantation with the best pharmacological therapy available have started recently, and in brazil, where several adaptations of existing protocols are required and the cost of transplantation is much lower than that of new biological therapies.
Liposomal daunorubicin and dexamethasone as a treatment for multiple myeloma: the DD Protocol
Dulley, Frederico Luiz;Saboya, Rosaura;Hungria, Vania Tietsche de Moraes;Bueno, Nadjanara Dorna;Mello, Fernando Gomes de;Frota, Maria Tereza;Chiattone, Carlos Sergio;Barros, José Carlos;Mori, Nair Sumie;Sturaro, Daniel;Macedo, Maria Cristina Martins de Almeida;Silva, Roberto Luiz da;Melo, Leila Maria Magalh?es Pessoa de;Souza, Cármino Antonio;
Sao Paulo Medical Journal , 2005, DOI: 10.1590/S1516-31802005000600003
Abstract: context and objective: liposomal daunorubicin has been used to treat hematological malignancies, including multiple myeloma (mm). the goal was to evaluate efficacy, side-effects and toxicity of liposomal daunorubicin and dexamethasone ("dd protocol"). design and setting: prospective study at sírio-libanês, s?o camilo, brasil and alem?o oswaldo cruz hospitals. methods: twenty consecutive patients with active mm received four cycles of liposomal daunorubicin intravenously for two hours (25-30 mg/m2/day) on three consecutive days per month, with oral dexamethasone (10 mg every six hours) on four consecutive days three times a month. results: the male/female ratio was 1:1 and median age 60. nine patients were stage iia, ten iiia and one iiib. the median from diagnosis to starting dd was 13 months. all patients received four cycles, except one. fifteen had already received chemotherapy before dd. responses of > 50% reduction in serum monoclonal paraprotein were observed in six patients after first cycle (30%), six after second (30%) and four after third (20%), while four (20%) did not obtain this. initially, 17 patients (85%) had anemia: 12 (70%) achieved correction. progressive disease was observed in three patients (15%), while one had minimal response, four (20%) partial and 12 (60%) complete. hematological toxicity was acceptable: three patients (15%) had neutrophils < 1,000/mm3; none had thrombocytopenia. gastrointestinal toxicity was mild: nausea (10%), anorexia (15%) and no vomiting. conclusions: this treatment has mild toxicity and good response rate. it may therefore be feasible before autologous bone marrow transplantation.
Dry eye evaluation and immunohistochemical study of the conjunctiva and lacrimal gland of patients submitted to bone marrow transplantation
Cunha, Rosana Nogueira Pires da;Campos, Mauro;Dulley, Frederico Luis;Rojas, Bianca;Foster, Charles Stephen;
Arquivos Brasileiros de Oftalmologia , 2003, DOI: 10.1590/S0004-27492003000100004
Abstract: purpose: the primary ocular targets of chronic graft-versus-host disease (gvhd) are the lacrimal gland (lg) and the conjunctiva, and their involvement results in keratoconjunctivitis sicca (kcs). the purpose of the present study was to evaluate the frequency of signs and symptoms of kcs present in patients submitted to bmt, to identify the cellular phenotype of the conjunctival and lacrimal gland biopsies of these patients by immunohistochemistry and to correlate the findings with the presence of dry eye due to gvhd. methods: forty-seven patients were clinically classified into two groups: group i, with ocular gvhd, submitted to allogeneic bmt and group ii, without ocular gvhd, submitted to autologous and allogeneic bmt. thorough eye examination, including clinical lacrimal function tests and biopsies of the conjunctiva and of the lg were performed in the pre- and posttransplantation period. the biopsies were submitted to immunohistochemical analysis using a panel of monoclonal antibodies. results: of the 28 (82.4%) patients with chronic gvhd, 13 (46.4%) presented ocular gvhd. of the six patients without gvhd, one (16.7%) presented ocular gvhd. none of those submitted to autologous bmt presented ocular gvhd and 14 (41.2%) of 34 patients with allogeneic bmt presented ocular gvhd. all patients with ocular gvhd (group i) had symptoms and the most frequent were burning, foreign body sensation, blurred vision and dryness. the rose bengal test was one of the most sensitive in this study and slit lamp examination was very useful in the evaluation of corneal and conjunctival alterations, since these alterations were always present in patients with dry eye in our study. neither symptoms and signs of dry eye nor significant immunologic reaction was observed in the conjunctiva and in the lg of patients without ocular gvhd (group ii). there was an increase in the t lymphocyte population, of t helper lymphocyte (th/i) and t suppressor-cytotoxic lymphocyte (ts/c) subpopulation in
Células-tronco hematopoéticas: utilidades e perspectivas
Silva Junior, Francisco C. da;Odongo, Fatuma C. A.;Dulley, Frederico L.;
Revista Brasileira de Hematologia e Hemoterapia , 2009, DOI: 10.1590/S1516-84842009005000032
Abstract: hematopoietic stem cells (hsc) are cells capable of self-renewal and differentiation into specialized blood tissue and immune system cells. in medicine, their importance is evidenced by their routine use in the treatment of onco-hematological and immunologic diseases. the difficulty of finding compatible bone marrow donors has motivated the search for alternative sources of hsc, notably placental/umbilical cord blood (pucb). the number of pucb units stored worldwide has been increasing since 1990. in 2004, the brasilcord network was created, establishing a national network of pucb banks with the aim of increasing the chances of finding donors and expanding the number of pucb banks in the country. despite the small volume collected and the greater amount of time required for the regeneration of the hematopoietic tissue, the blood concentration of hsc in pucb is higher, their use as a source for hsc for transplantation presents a lower risk of causing graft versus host disease and they are more easily obtained compared to hsc originating from the bone marrow.
Dry eye evaluation and immunohistochemical study of the conjunctiva and lacrimal gland of patients submitted to bone marrow transplantation
Cunha Rosana Nogueira Pires da,Campos Mauro,Dulley Frederico Luis,Rojas Bianca
Arquivos Brasileiros de Oftalmologia , 2003,
Abstract: PURPOSE: The primary ocular targets of chronic graft-versus-host disease (GVHD) are the lacrimal gland (LG) and the conjunctiva, and their involvement results in keratoconjunctivitis sicca (KCS). The purpose of the present study was to evaluate the frequency of signs and symptoms of KCS present in patients submitted to BMT, to identify the cellular phenotype of the conjunctival and lacrimal gland biopsies of these patients by immunohistochemistry and to correlate the findings with the presence of dry eye due to GVHD. METHODS: Forty-seven patients were clinically classified into two groups: Group I, with ocular GVHD, submitted to allogeneic BMT and Group II, without ocular GVHD, submitted to autologous and allogeneic BMT. Thorough eye examination, including clinical lacrimal function tests and biopsies of the conjunctiva and of the LG were performed in the pre- and posttransplantation period. The biopsies were submitted to immunohistochemical analysis using a panel of monoclonal antibodies. RESULTS: Of the 28 (82.4%) patients with chronic GVHD, 13 (46.4%) presented ocular GVHD. Of the six patients without GVHD, one (16.7%) presented ocular GVHD. None of those submitted to autologous BMT presented ocular GVHD and 14 (41.2%) of 34 patients with allogeneic BMT presented ocular GVHD. All patients with ocular GVHD (Group I) had symptoms and the most frequent were burning, foreign body sensation, blurred vision and dryness. The rose bengal test was one of the most sensitive in this study and slit lamp examination was very useful in the evaluation of corneal and conjunctival alterations, since these alterations were always present in patients with dry eye in our study. Neither symptoms and signs of dry eye nor significant immunologic reaction was observed in the conjunctiva and in the LG of patients without ocular GVHD (Group II). There was an increase in the T lymphocyte population, of T helper lymphocyte (Th/i) and T suppressor-cytotoxic lymphocyte (Ts/c) subpopulation in the conjunctiva and in the LG of patients with ocular GVHD after the transplantation. CONCLUSIONS: Patients submitted to allogeneic BMT may develop ocular GHVD characterized by KCS. The immunohistochemical study of the conjunctiva and lacrimal gland biopsies of these patients suggested that these tissues are the target of the T cell mediated immunological reaction.
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