Vergílio Antônio Rensi Colturato

Hospital Amaral Carvalho

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Nelson Hamerschlak

Hospital Israelita Albert Einstein

Adriana Seber

Universidade Federal de São Paulo

Carmem Bonfim

Hospital de Clínicas Universidade Federal do Paraná

Vaneuza Araújo Moreira Funke

Universidade Federal do Paraná

Afonso Celso Vigorito

Universidade Estadual de Campinas (UNICAMP)

Mair Pedro de Souza

Hospital Amaral Carvalho

Fernando Barroso Duarte

Hospital Universitário Walter Cantídio

Mary E.D. Flowers

Fred Hutch Cancer Center

Maria Cláudia Rodrigues Moreira

Instituto Nacional do Câncer

Anderson João Simione

Hospital Amaral Carvalho

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John Wiley & Sons (United States)

Hudson Institute

Universidade de São Paulo

Hospital Israelita Albert Einstein

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Hospital de Clínicas Universidade Federal do Paraná

Universidade Federal de São Paulo

Universidade Federal do Paraná

Hospital Amaral Carvalho

Hospital São Paulo

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Chronic graft-versus-host-disease treatment in Brazil: analyses of failure-free survival

Transplantation and Cellular Therapy (2023)

Afonso Celso Vigorito Eliana Cristina Martins Miranda Vergílio Antônio Rensi Colturato Vaneuza Araújo Moreira Funke Giancarlo Fatobene

Failure-free survival (FFS), defined as the absence of new systemic treatment, recurrence of original malignancy and mortality not associated with recurrence after allogeneic hematopoietic stem cell transplantation (HCT), is a robust clinical measure to interpret results of initial systemic treatment of chronic graft-versus-host disease (cGVHD). We evaluate FFS after initial treatment of cGVHD in a mixed-race cohort from a resource-constrained country. This retrospective study included 354 consecutive patients after their first HCT between January 2014 and August 2020, who received initial systemic treatment for moderate or severe cGVHD at 13 Brazilian centers. Cox regression models were used to identify risk factors for treatment failure. The overall median follow-up among survivors was 28 months (range 1-71) after initial treatment. FFS was 89% at 6 months, 71% at 1 year and 52% at 2 years. New systemic treatment was the major cause of failure. In multivariable models, prior grades II-IV acute GVHD, a National Institutes of Health severity score of 3 in liver, gastrointestinal tract or lung involvement, and onset of initial treatment of cGVHD within 12 months after transplantation were all associated with an increased risk of treatment failure. Our results could serve as a benchmark for the design of future clinical trials evaluating initial treatment of cGVHD in resource-constrained locations.

10.1016/j.jtct.2023.01.007

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Current use and outcomes of hematopoietic stem cell transplantation: Brazilian summary slides - 2023

JOURNAL OF BONE MARROW TRANSPLANTATION AND CELLULAR THERAPY (2023)

Anderson João Simione Heliz Regina A. Neves Cinthya Corrêa da Silva Paula Moreira da Silva Sabaini Bruna Letícia da Silva Santos Geraldo

The first hematopoietic stem cell transplantation (HSCT) program in Latin America started in 1979 at the federal university hospital in Curitiba, Paraná, Brazil. Over the years, the number of centers performing transplants in our country has increased tremendously, generating the need to know the results of this treatment modality. Understanding the HSCT scenario in Brazil is still challenging, since not all Brazilian centers report data to the Center for International Blood and Marrow Research (CIBMTR). Despite the improvement in the number of reporting centers over the past few years, infrastructure and trained data managers are still lacking. The partnership between the Brazilian Cellular Therapy and Bone Marrow Transplant Society (SBTMO) and the CIBMTR enabled the establishment of the Hematopoietic Stem Cell Transplantation Brazilian Registry (HSCTBR), using the CIBMTR Data Back to Center (DBtC) tool to retrieve Brazilian HSCT data in a standardized and organized way. Since then, it has been possible to gather country-level data on HSCT demographics and transplant outcomes. Between 2012 and 2022, complete information on 9,868 transplants were reported to the CIBMTR from 40 Brazilian transplant centers. The consolidation of the HSCTBR using CIBMTR infrastructure allowed the development and regular update of the Brazilian Summary Slides. Despite the differences in the number of cases and follow-up time, the results in this study were similar to those presented in the United States (US) Summary Slides. In this paper we present the 2023 SBTMO-CIBMTR Summary Slides prepared by the SBTMO data managers (GD-SBTMO).

Bone transplantation

10.46765/2675-374x.2023v4n2p200

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Evaluation of pretransplant influenza vaccination in hematopoietic SCT: a randomized prospective study

Bone Marrow Transplantation (2015)

Aditya Ambati Lucy Santos Vilas Boas Per Ljungman Lucia Testa JM Oliveira

10.1038/bmt.2015.47

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Current use and outcomes of hematopoietic stem cell transplantation: The first Brazilian summary slides

JOURNAL OF BONE MARROW TRANSPLANTATION AND CELLULAR THERAPY (2021)

Anderson João Simione Heliz Regina A. Neves Cinthya Corrêa da Silva Bruna Letícia da Silva Santos Geraldo Marcelo C. Pasquini

Understanding the HSCT scenario in Brazil is challenging due to the lack of a national registry that allows the analysis of results. The partnership between the Brazilian Cellular Therapy and Bone Marrow Transplant Society (SBTMO) and the Center for International Blood and Marrow Research (CIBMTR) allowed the return of Brazilian data registered in the CIBMTR, through the Data Back to Center (DBtC), in a standardized and organized way. With this database it was possible to know the demographic data and the outcomes of transplants performed in Brazil. The spreadsheet was imported into the Power BI desktop, and functions and charts were created. Between 2008 and 2019, 7,264 transplants were reported to the CIBMTR from 24 Brazilian transplant centers. The partnership between SBTMO and CIBMTR, made the Brazilian registry possible and allowed the development of the first Brazilian Summary slides. Despite the difference in the number of cases and of follow-up time, the results in this study were similar to those presented in the US Summary Slides.

Bone transplantation

10.46765/2675-374x.2021v2n2p99

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Allogeneic Hematopoietic Stem Cell Transplantation for Children and Adolescents with Acute Myeloid Leukemia in Brazil: A Multicentric Retrospective Study

Cell Transplantation (2020)

Ana Luiza Rodrigues Carmem Bonfim Adriana Seber Vergílio Antônio Rensi Colturato Victor Gottardello Zecchin

The survival rates of children with high-risk acute myeloid leukemia (AML) treated with hematopoietic stem cell transplant (HSCT) range from 60% to 70% in high-income countries. The corresponding rate for Brazilian children with AML who undergo HSCT is unknown. We conducted a retrospective analysis of 114 children with AML who underwent HSCT between 2008 and 2012 at institutions participating in the Brazilian Pediatric Bone Marrow Transplant Working Group. At transplant, 38% of the children were in first complete remission (CR1), 37% were in CR2, and 25% were in CR3+ or had persistent disease. The donors included 49 matched-related, 59 matched-unrelated, and six haploidentical donors. The most frequent source of cells was bone marrow (69%), followed by the umbilical cord (19%) and peripheral blood (12%). The 4-year overall survival was 47% (95% confidence interval [CI] 30%-57%), and the 4-year progression-free survival was 40% (95% CI 30%-49%). Relapse occurred in 49 patients, at a median of 122 days after HSCT. There were 65 deaths: 40 related to AML, 19 to infection, and six to graft versus host disease. In conclusion, our study suggests that HSCT outcomes for children with AML in CR1 or CR2 are acceptable and that this should be considered in the overall treatment planning for children with AML in Brazil. Therapeutic standardization through the adoption of multicentric protocols and appropriate supportive care treatment will have a significant impact on the results of HSCT for AML in Brazil and possibly in other countries with limited resources.

Cord blood

10.1177/0963689720949175

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Transplante de células-tronco hematopoéticas em crianças e adolescentes com leucemia aguda: experiência de duas instituições brasileiras

Revista Brasileira de Hematologia e Hemoterapia (2010)

Juliane Morando Marcos Augusto Mauad Sérgio Costa Fortier Flávia Zattar Piazera Mair Pedro de Souza

10.1590/s1516-84842010005000093

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Clinical validation of a 10-color flow cytometry panel to detect measurable residual disease in acute myeloid leukemia

Leukemia Research (2024)

Maura Rosane Valério Ikoma Alef Rafael Severino J. Tosi Camila Marques Bertolucci Yeda Midori Nakamura Cuoco

Minimal Residual Disease

10.1016/j.leukres.2024.107482

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Ethnic Variation in Chronic Graft-Versus-Host Disease (cGVHD) Manifestations

Biology of Blood and Marrow Transplantation (2013)

Maria Elvira Pizzigatti Corrêa Eliana Cristina Martins Miranda Afonso Celso Vigorito Luís Fernando S. Bouzas Vaneuza Araújo Moreira Funke

Risk of acute GVHD varies among different ethnic population. Thus, we evaluated potential differences in cGVHD manifestations in two ethnic distinct cohorts. The study included a Brazilian cohort diagnosed with cGVHD by 2005 NIH criteria who were enrolled in a prospective multicenter longitudinal study at 5 centers in Brazil and compared with a North American cohort reported by the cGVHD consortium (Arai S. et al. Blood 2011). Pts. were assessed using standardized clinical data forms every 3 months (124 visits). Any elevation of liver function tests was scored as cGVHD. The Brazilian study cohort included 36 pts. with a median age of 44 (13-64) years and 21 (58%) were male. At study enrollment, 24 (67%) had classic cGVHD, and 12 (33%) pts. had overlap subtype (with feature of both acute and chronic). Distribution of organ involvement attributed to cGVHD for the Brazilian and the North American cohorts at study enrollment is shown in the Figure. Liver severity scores at study enrollment was mild in 10 (34%), moderate in 12 (40%) and severe in 8 (26%) pts. among Brazilian cohort, and it was mild in 113 (76%), moderated in 36 (24%) and none severe in the North American cohort. Overall, cGVHD global severity at study enrollment was calculated from reported data as mild in 2 (5.5%), moderate in 17 (47%) and severe in 17 (47%) of Brazilian cohort compared to 32 (10%), 175 (59%) and 91(31%) in the North American cohort, respectively. Similar to North American cohort, distribution of global severity was similar in the Brazilian cohort across 22 incident (enrollment < 3 months of cGVHD diagnosis) and 14 prevalent cases (enrollment 3 or 6 months after cGVHD diagnosis) and, between pts. with classic and overlap cGVHD. Prevalence of organs involvement at study enrollment was significant different between the two population. Compared to the North American cohort, the Brazilian cohort had higher rates of liver involvement (83% vs. 50%; p < .001) and lower rate of lung (8% vs. 50%; p < .001), respectively. The cause for the high incidence and severity scores in the liver among the Brazilian cohort is unknown, but we speculated potential contributors. For instance, 100% of Brazilian cohort was CMV positive and pre-emptive treatment for CMV reactivation is not used after day 100 posttransplant, thus reactivation of CMV may have contributed to the elevation of liver function tests. Moreover, it is not standard practice in Brazil to add ursodiol to treat elevation of liver tests attributed to GVHD, thus allowing for further potential increase in liver severity score. The lower rates of lung in the Brazilian cohort may reflect non-standardization of pulmonary function test in Brazil. In conclusion, prevalence of organ manifestations in cGVHD varied between the two ethnic distinct cohort studied. Attention should be taken into consideration when evaluating prognosis and outcomes in cGVHD in different ethnic population.

10.1016/j.bbmt.2012.11.483

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Citations (0)

Allogeneic Hematopoietic Cell Transplantation in Elderly Patients in a Latin American Country: Analysis of 11 Years of Data from the Brazilian Registry SBTMO/CIBMTR

Transplantation and Cellular Therapy (2024)

Fernando Barroso Duarte Yhasmine Delles Oliveira Garcia Nelson Hamerschlak Vaneuza Araújo Moreira Funke Maria Cláudia Rodrigues Moreira

10.1016/j.jtct.2024.12.003

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Paradoxes of hematology: When the old disappears and the new does not arrive

Revista Brasileira de Hematologia e Hemoterapia (2017)

Ângelo Maiolino Belinda Pinto Simões Cláudio Galvão de Castro Dimas Tadeu Covas Gustavo dos Santos Fernandes

Hematology

10.1016/j.bjhh.2017.01.001

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Citations (2)