Hemotherapy Center Research Articles

Clinical and epidemiological profile of blood donors at Montes Claros Regional Blood Center, Southeastern Brazil

Objective: This study aims to analyze blood donation candidates' clinical and epidemiological profiles in Northern Minas Gerais, Brazil, from 2019 to 2022. Methods: We retrospectively searched clinical and epidemiological profiles in the donor data from Montes Claros’ Hemotherapy Center/ Hemominas Foundation from January 2019 to December 2022. Clinical and epidemiological variables were assessed using a blood bank database. Main Results: Of the 81,195 donation candidates, the majority were female, over 29 years old, repeat donors, and replacement donations. Among them, 18.96% were deemed ineligible, with the majority being female, over 29 years old, repeat donors, and replacement donations. Key causes of ineligibility included STD-risk behavior, anemia, hypertension, and Chagas disease. Women showed higher rates of anemia, hypotension, and Chagas disease, while men had more STD-risk behavior, hypertension, alcoholism, and drug use. Among eligible donors, 2.43% had serological ineligibility, notably for hepatitis B, syphilis, and hepatitis C. Conclusion: The frequency of female and repeat donors in Montes Claros was higher than the national average, with disparities in ineligibility between genders and a possible higher prevalence of syphilis and Chagas disease in the local population.

Impact of oral health conditions on the quality of life of children and adolescents with sickle cell anemia: A cross-sectional study.

Sickle cell anemia (SCA) is the most common hemoglobinopathy in Brazil and worldwide and is part of a group of chronic genetic diseases resulting from abnormalities in the structure of hemoglobin. To evaluate the impact of oral health conditions on the quality of life (QoL) of children and adolescents with SCA. This is a cross-sectional study with a sample of 76 children and adolescents aged 8-14 years. For inclusion, they were required to have a diagnosis of HbSS SCA in their medical records, without a pain crisis or any dental emergency in the last three months. The children and adolescents with SCA were from Hematology and Hemotherapy Center of Maranhão. Demographic characteristics, socioeconomic status, oral hygiene, caries, malocclusion, and oral health-related quality of life (OHRQoL) were assessed. OHRQoL was assessed using the Child Perceptions Questionnaire. Descriptive statistics, Student's t and Mann-Whitney tests were performed (α = 5%). Brown race was the most prevalent for both age groups (8-10 years-63.2% and 11-14 years-57.9%). Predominant monthly family income for both age groups was below $106. Visible plaque and gingival bleeding were higher in children aged 8-10 years. Dental caries significantly impacted the QoL of adolescents through the domain "oral symptom" (p = .031). Malocclusion significantly impacted the QoL of adolescents ("total score," p = .026; "social well-being", p = .045). Oral health impairment negatively affected the QoL of adolescents with SCA.

Prevalence of people with sickle cell disease and leg ulcers in Brazil: Socioeconomic and clinical overview.

ObjectiveTo identify the prevalence of people with leg ulcers resulting from sickle cell disease, as well as to describe the clinical, social, economic, and demographic conditions of these people.MethodDescriptive study, carried out at the Minas Gerais Hematology and Hemotherapy Center Foundation. The study population consisted of individuals over the age of 18 with a diagnosis of sickle cell disease in the State of Minas Gerais, Brazil. Data collection was performed from August 2019 to April 2020 through interviews. For the prevalence calculation, a census was taken of 5,379 people over the age of 18 with sickle cell disease, 77 of whom had active leg ulcers. Descriptive data analysis was performed using SPSS software (version 20.0, Chicago, IL, USA).ResultsThe prevalence of people with leg ulcers in Minas Gerais, Brazil was 1.4%. Of the 72 respondents, the average age was 39 years (range 18–64 years), 41.7% were single, 48.6% said they were black, 84.7% lived in their own house, 38.9% were retired, 61.1% had an income of one minimum wage. The median years of education was 10.5, 50% cited the church as a place for leisure activities, 79.2% denied smoking. Regarding pain, the median score was 3, the median baseline hemoglobin was 7.7 g/dL, and 91.7% had the HbSS genotype. The median age of the first ulcer was 18 years, 77.8% of active ulcers were recurrent, and 59.7% had only one active ulcer. The median time of existence of the ulcer was 3 years. The ulcer prevented 80.6% of people from doing some activity. Prejudice was experienced by 48.6% of the participants.ConclusionThe estimated prevalence of leg ulcers was lower than what it reported in the literature, however, the recurrence and the duration of ulcers were high. These findings bring reflection about the assistance to people with leg ulcer.

The most common inadequacies in red blood cell requests at a reference center in Western Paraná state

IntroductionIn the current scenario, in which evidence-based medicine is almost obligatory, therapeutic approaches are increasingly being restricted to measures that are proven to bring benefits to the patient. Transfusion therapy follows the same concept. Even though it can be an essential support procedure in some situations, it must be carefully used, exclusively in situations in which the literature assures scientific support for its usage. Transfusion exposes patients to risks and complications, so it is necessary that we, as doctors, continue working to reduce possible mistakes involving the practice of this type of therapy. ObjectiveTo analyze if the red blood cell requests are properly made, analyzing the indication written on them (by the doctor, comparing them to the references in the actual literature. MethodIn this research, we have analyzed and reviewed the requests for red blood cell concentrates between August and September of 2018 received at the Hematology and Hemotherapy Center studied to find the most common mistakes made by requesters/doctors. ResultsA total of 397 of the 754 analyzed requests were evaluated as inadequate. Therefore, 1 out of every 2 transfusions performed did not have their requests properly completed in the city of Cascavel, Paraná. ConclusionsThe number of inappropriate requests was high during the studied period, especially when compared to studies available in the literature. The number of inadequacies suggests that the blood component requests and the subsequent evaluation by the transfusion agency needs to be better addressed in clinical practice.

Prevalence of Trypanosoma Cruzi Infection in Blood Donors.

ResumoFundamento A doença de Chagas (DC) é considerada um problema de saúde pública na América Latina. A região nordeste, principalmente o estado do Ceará, ainda representa grande preocupação em termos de risco de transmissão da doença.Objetivo Estimar a prevalência de T. cruzi em doadores de sangue do estado do Ceará.Métodos Trata-se um de estudo retrospectivo descritivo realizado no período de 2010 a 2015, a partir de dados registrados no sistema informatizado do Centro de Hematologia e Hemoterapia do Ceará (HEMOCE).Resultados Dos 763.731 potenciais doadores de sangue, 14.159 foram considerados impedidos de fazer a doação devido à sorologia, sendo que 1.982 (0,33%) o foram devido à positividade/inconclusão para doença de Chagas. Compareceram à Hemorrede para a repetição 425 indivíduos, sendo confirmados 28,2% (120/425) como impedidos de doar devido a DC.Conclusão Não houve redução significativa das sorologias positivas/inconclusivas no período entre 2010-2015, porém foi observada redução em relação a 1996/1997 no estado. A determinação da prevalência da doença de Chagas em bancos de sangue pode ser relevante como indicador do risco de transmissão transfusional em determinada região. Novos testes sorológicos para triagem com melhor acurácia são necessários, reduzindo o descarte desnecessário de bolsas de sangue, os custos para o Sistema Único de Saúde e a insegurança para os pacientes e familiares. (Arq Bras Cardiol. 2020; 115(6):1082-1091)

Implicações na continuidade do tratamento de doenças hematológicas durante a pandemia de COVID-19

Objetivo: descrever uma experiência vivenciada sobre a descontinuidade do tratamento de doenças hematológicas durante a pandemia de COVID-19, em um hemocentro do estado do Ceará. Método: Trata-se de um estudo descritivo, tipo relato de experiência, realizado no perí­odo de março de 2020. Resultados: relatamos a experiência dos atendimentos em consultas hematológicas, para que possamos dar continuidade ao serviço prestado aos pacientes que se tratam de distúrbios hematológicos. Deste modo, o Centro de Hematologia e Hemoterapia do Ceará buscou promover medidas preventivas para conter a transmissão da COVID-19 durante o atendimento dos pacientes. Deste modo, a pandemia provocada pelo novo coronaví­rus (SARS-CoV-2), ocasionou estado de alerta para os profissionais da saúde. Conclusão: As atividades práticas desenvolvidas pretenderam estabelecer uma maior proximidade entre o conhecimento teórico e o prático, oportunizando a construção cientí­fica. A pandemia provocada pelo novo coronaví­rus (SARS-CoV-2) traz grande preocupação para os profissionais da saúde, bem como para a população.

A Proposed Approach for Provenance Data Gathering

Data provenance focuses on the source of the data and on the identification of data sources and their transformations undergone over time. This paper proposes a generic method for collecting provenance data, and is a follow-up of a study carried out by the same authors in a Brazilian hemotherapy center. This method is based on the W3C’s Provenance Data Model (PROV-DM), and proposes a way to capture, store and analyze anemia-index provenance data by applying a scientific workflow, together with the management of provenance of knowledge. This is an exploratory, practical and deductive study carried out with real data from 197,551 candidates for blood donors, extracted from reports ranging from 2000 to 2018 provided by a Brazilian hemotherapy center. People identified with high anemia rates were quantified and tagged as not-suitable for blood donations. The inadequate candidates were quantified with the highest rate of anemia, and out of 1011 male candidates and 4039 female candidates, women had the highest levels of inadequate blood donations. At the end of this study, it can be concluded that the generic method for collecting data provenance proposed here can be applied in several areas of knowledge.

Impacto da pandemia COVID-19 na dinâmica do núcleo de hemoterapia de um hospital universitário

Objetivo: Descrever ameaças e oportunidades diante da pandemia de COVID-19 no Núcleo de Hemoterapia do Hospital Universitário Pedro Ernesto. Método: estudo descritivo com distribuição de frequência de candidatos í doação de sangue antes (2015-2019) e após declaração da pandemia COVID-19 (março/2020), e descrição de estratégias para manutenção do estoque de hemocomponentes. Resultados: houve redução de 25% no número de candidatos í doação entre os dias 2 e 16 de março de 2020. A implantação de diversas atividades de promoção í doação de sangue aumentou em 20% a média de doadores/dia em março/2020. Observou-se aumento de 24% no número de candidatos í doação em março/2020 (n=536) comparado a março/2019 (n=431). Conclusão: Diante de uma nova doença, de caráter pandêmico, temos mais perguntas que respostas. É necessário que mais centros compartilhem suas estratégias para a garantia de sangue em momentos de crise.

Recommendations for application and interpretation of the Blood Donor Satisfaction Questionnaire (BDSQ).

BackgroundThe level of satisfaction of donors with the blood donation system is an important factor which influences their intent to return for future donation. A 25-item questionnaire on the satisfaction of blood donors has been recently proposed to assess the donor satisfaction with the service provided by a blood bank. The objective of this study was to present a proposal for application and interpretation of a BDSQ considering a sample of blood donors of a Brazilian blood bank.MethodsA sample of 1019 blood donors at the Regional Hemotherapy Center of Franca, Brazil, answered the BDSQ. A top-box analysis was used to assess the associations between the variables characterizing the profiles of blood donors and their overall satisfaction with the service provided by the blood bank. We proposed the use of a performance-importance plot (PIP) for the interpretation of the 25 items of the BDSQ.ResultsOlder donors are more likely to report lower overall satisfaction with the service provided by the blood bank. PIP allows us to classify the items of BDSQ into long- and short-term improvement opportunities as well as into motivational and hygiene factors. Motivational factors (i.e. attributes that promote overall satisfaction when present) tend to be associated with the treatment offered by the blood bank staff. Donors seem to give more importance to the interpersonal aspects than to the physical structure of the service and other aspects of convenience.ConclusionsTop-box analysis and PIP proved to be efficient strategies to interpret the results of the BDSQ.

Immunohematological study of the first pediatric patient with the Bombay phenotype in Medellín, Colombia

The Bombay (Oh) phenotype is a rare phenotype in which red blood cells lack the H antigen as a result of a point mutation in the H gene. Oh patients are a challenge in transfusion medicine. We present a case of a pediatric patient with the Bombay phenotype who was carried to the emergency department of the Hospital Universitario San Vicente Fundación in Medellín, Colombia. The patient presented gastrointestinal hemorrhage and required transfusion therapy. Pretransfusion and molecular immunohematological analyses identified the Bombay phenotype. The patient was transfused with Oh red blood cells imported to Colombia from the Hematology and Hemotherapy Center of Ceará (Hemoce) in Fortaleza, Brazil. This first case of an Oh individual in Colombia highlights the need to look for donors with rare phenotypes to fulfill the transfusion requirements of the population.

Subjective Donor Deferral As a Tool for Increased Blood Transfusion Safety

Background: In blood transfusion services (BTS), selection of appropriate donor populations via clinical and serological screening is necessary to prevent transfusion-transmitted infections (TTIs). One of the strategies adopted by some Brazilian BTS is known as Subjective Donor Deferral (SDD), i.e., the rejection of a donation by the clinical triage interviewer based on subjective factors. Therefore, we aimed to evaluate if SDD has potential for increasing blood transfusion safety. Methods: We did a cross-sectional study involving blood donors who passed clinical triage from January 1, 2013, to December 31, 2015, in the Hematology and Hemotherapy Center of Ceara (Fortaleza, Brazil). Donor information was collected via the Blood Bank System (SBS) Web ISBT 128 database. They were evaluated for age, gender, education level, donation type and history, presence of confidential unit exclusion and/or SDD, and results of the standard serological screening (HIV, syphilis, human T-lymphotropic virus, and hepatitis B and C). Findings: 105,005 donors were included for analysis. Individuals subjectively deferred were 2.80 times more likely to have at least one reagent serology in the standard laboratory screening. Also, they were, respectively, 4.47, 5.69, and 6.14 times more likely to have positive syphilis, hepatitis B, and HIV screening. Interpretation: If positive infectious diseases markers rates correlate with the incidence of window period infections, implementation of SDD in clinical triage of blood donors may be an effective additional way to avoid TTIs, highlighting the importance of interviewer experience, perspicacity and face-to-face contact with the donor for blood safety assurance. Funding Statement: None received. Declaration of Interests: The authors declare they have no financial, personal, or professional conflicts of interests to disclose. Ethics Approval Statement: The study protocol was approved on 09 April 2018 by the Ethics Committee of the Center of Hematology and Hemotherapy of Ceara (Centro de Hematologia e Hemoterapia do Ceara; HEMOCE), number 8152.

Development of a blood donor satisfaction questionnaire (BDSQ).

ObjectiveTo develop a self-reporting questionnaire, namely the Blood Donor Satisfaction Questionnaire (BDSQ) in Brazilian Portuguese, to assess the blood donor satisfaction with the service provided by a blood bank.MethodThis study was carried out in three stages: 1) a preliminary version of the instrument was proposed, based on a revision of a previous questionnaire and consideration of the focus groups blood donor perceptions; 2) a content validation to assess the relevance of the items, clarity, domain structure and comprehensiveness of the satisfaction measurement, and; 3) a pre-test of the instrument using a sample of blood donors. All the stages of the research were performed at the Regional Hemotherapy Center in Franca, São Paulo, Brazil.ResultsThe 25-item BDSQ being proposed has an additional question on overall satisfaction. Responses to items are presented on a five-point scale, including a neutral answer. The BDSQ has three domains: accessibility and convenience, technical aspects, and interpersonal aspects.ConclusionThe application of the BDSQ has shown that it can be a useful tool in generating information for managers on specific aspects of blood bank services which need to be improved, monitored or maintained, aiming to provide a service which meets the blood donor expectations and makes him or her feel satisfied with the care received.

Exome Sequencing of Extreme Phenotypes Suggests Novel Candidate Genes As Modifiers of Leg Ulcer in Sickle Cell Anemia

Background: Despite resulting from homozygosity of a single mutation at position 6 of the beta-globin locus, the clinical aspects of sickle cell anemia (SCA) are very heterogeneous. Leg ulcer is one of the many resulting complications, exerting a quite negative impact in the quality of life of patients and is related to the severity of the disease. The pathogenesis of such complication is complex and still not well explained. Objective: Seeking for novel genes associated with leg ulcer in SCA, we proposed exome sequencing of extreme phenotypes in a sample of the Brazilian population. Methods: Our sample consisted of 40 unrelated patients with SCA from the Hematology and Hemotherapy Center of the University of Campinas (Unicamp), Campinas, SP, Brazil. The cohort was composed by 20 patients who didn't have leg ulcer, with ages varying from 40 to 61 years (it is unusual the appearance of this disorder at such age) and 20 patients with chronic leg ulcer. DNA was collected from peripheral blood leukocytes and submitted to exome sequencing. Capture and enrichment were performed with the Nextera Rapid Capture Exome kit (Illumina) and samples were loaded in the Illumina HiSeq2500. The bioinformatics process was based on the GATK Pipeline and manual filters in vcftools and excel. Briefly, we prioritized the variants according to some conditions, like score quality, depth, Hardy-Weinberg equilibrium and minor allele frequency greater than 0.1. Subsequently, through PLINK, we selected the variants with p value less than 0.05 from Fisher association test. The annotation was made through wAnnovar. We excluded the synonymous variants, remaining with 244 variants at this point. Finally, the deleterious variants were selected, in addition to those not classified by SIFT, PolyPhen2 and FATHMM. Twenty-one variants remained, all of them in genes beyond the usual set of a priori biological candidate genes for this phenotype. We picked up 6 variants with the lowest p values: rs4857302 (CRYBG3), rs3782489 (KRT77), rs11800462 (TNFRSF25), rs13428956 (FOXD4L1), rs201853154 (UBTFL1) and rs11454536 (VWDE). We suggest that these variants and their genes could potentially be related to the development of leg ulcer in SCA. However, they should all be validated in other populations for confirmation. DisclosuresNo relevant conflicts of interest to declare.

Anemia as the cause of clinical inability of candidates to blood donation for a hemotherapy and hematology center in the state of Maranhão, Brazil

Objective: To evaluate anemia as a cause of clinical disability in blood donors in the state of Maranhão- Brazil. Methods: This study addresses a time series of prevalence of anemia among blood donor candidates. Secondary data were collected from the Information System of the Blood Center of Maranhão. Donor candidates were treated between 2001 and 2010. Statistical analysis was performed with Epi Info version 6.04d. Results: The proportion of clinical disability was 16.8% (n = 1,672) and 63.27% (n = 6,198) consisted of men. Considering the unfit group, anemia was the second most frequent cause with 16.68% (n = 16,729). In men, drug use was the most frequent cause of inability (90.94%, n = 650) and anemia was the last cause with 28.76% (n = 458). In women, anemia was the major cause of clinical inability (71.24%, p = 0.000). Conclusion: Anemia is an important cause of inability, and in women it is the first one.

Enamel defects and tooth eruption disturbances in children with sickle cell anemia.

Sickle cell anemia, a genetic disease caused by a mutation in the beta-globin gene, can present oral manifestations such as delayed tooth eruption and hypomineralized enamel and dentin. The aim of the present study was to evaluate the prevalence and severity of developmental defects of enamel (DDE) and delayed tooth eruption in children with sickle cell anemia. The sample comprised 56 male and female children with sickle cell anemia aged 6 to 12 years and treated at the Hematology and Hemotherapy Center of Pernambuco, Brazil. The data were collected according to the WHO criteria for DDE and tooth eruption. The prevalence of DDE was 58.2% and increased with age, affecting 43.8% of children aged 6 to 8 years and 66.7% of those aged 10 to 12 years (p>0.05; Pearson's chi-square test). There was no significant association between DDE and sex; the most prevalent type of DDE was diffuse opacity (6.2%). Tooth eruption was delayed in 18 children (32.1%). The delay increased with age and was detected in 11.8% of children aged 6 to 8 years, in 20.0% of those aged 8 to 10 years and in 54.2% of those aged 10 to 12 years (p<0.05; Pearson's chi-square test). Delayed tooth eruption was higher in males (36.7%, p>0.05). The prevalence of DDE was high, increased with age and was similar between sexes, while delayed eruption was higher in males and showed a significant association with age.

Genotyping of Dombrock and Lutheran blood group systems in blood donors from the southwestern region of the state of Paraná, Southern Brazil

BackgroundLutheran and Dombrock are two blood group systems with low immunogenic antigens; they can cause mild-to-moderate transfusion reactions. For both, immunophenotyping is not performed in the pretransfusion routine in Brazil. In addition, the distribution of their antigenic frequencies is an important marker of ethnicity. Thus, the goal of this study was to carry out the genotyping of the LU*01, LU*02, DO*01 and DO*02 alleles of the Lutheran and Dombrock blood group systems in blood donors from the southwestern region of the state of Paraná, Southern Brazil. MethodGenotyping was performed for 251 blood donors by specific allele-polymerase chain reaction. The genotype and allele frequencies were obtained through direct counting and compared with other Brazilian populations using the chi-square test with Yates correction. ResultsThe distribution of genotype frequencies for LU were 0.4% for LU*01/LU*01, 6.8% for LU*01/LU*02 and 92.8% for LU*02/LU*02 and for DO, they were 19.9% for DO*01/DO*01, 44.6% for DO*01/DO*02 and 35.5% for DO*02/DO*02. The allele and genotype frequencies of LU and DO were similar to those expected for Caucasians, but the DO*01/DO*01 genotype frequency was different to other Brazilian populations. The rare LU*01/LU*01 genotype was found in a loyal blood donor. ConclusionThe genotyping techniques allowed the evaluation of the LU*01, LU*02, DO*01 and DO*02 alleles in blood donors registered in the Hemotherapy Center of the southwestern region of Paraná, Southern Brazil, and contributed to a genotyped blood donor database.

Seroprevalence of Chikungunya virus in blood donors from Northern and Southeastern Brazil

BackgroundChikungunya virus, an arbovirus that belongs to the Alphavirus genus of the Togaviridae family, causes a febrile illness accompanied by rash and arthralgia. It is estimated that during outbreaks, the prevalence of Chikungunya virus RNA in viremic blood donations varies between 0.4 and 2.1%; therefore, this virus may be transmitted by transfusion. In Brazil, Chikungunya virus has been claimed to cause extensive outbreaks, however, the seroprevalence of anti-Chikungunya virus IgG among Brazilian blood donors is unknown. MethodsEight hundred and ninety-seven blood samples were collected from volunteer blood donors in two distant localities long after the Chikungunya virus first appeared in Brazil. In 2015, 442 samples were collected from the Hemotherapy Service of Macapá, Amapá in the northern Brazilian Amazon. To evaluate the dissemination course of the virus in Brazil, in 2016, 455 blood samples were collected from the southeastern region (Blood Center of Ribeirão Preto, Ribeirão Preto, São Paulo). All samples were tested for the presence of anti-Chikungunya virus IgG and viral RNA. ResultsOne sample (0.2%) obtained from the Hemotherapy Center of Macapá tested positive for anti-Chikungunya virus IgG and no sample from the Blood Center of Ribeirão Preto was seroreactive to anti-Chikungunya virus IgG. All blood donations were Chikungunya virus RNA negative. ConclusionsThis study, performed during 2015–2016, indicates that the transfusion risk of Chikungunya virus in this period was low. However, due to the constant advance of this virus in Brazil, further studies during outbreaks are needed to evaluate the presence of Chikungunya virus RNA in blood donations and the respective transfusion-transmission risk.

T28. Neuropathies in haemophylics: Preliminary evaluation of four cases and literature review

Peripheral neuropathy is an uncommon complication in patients with hemophilia, usually characterized by mononeuropathies, caused by hematoma and compartmental syndrome. The femoral nerve is the most affected, but several other locations have been described. The purpose of this article is to describe four cases of peripheral nerve injury in hemophiliacs comparing with data from the literature. This is a descriptive study, carried out by reviewing the medical record of four hemophiliac patients diagnosed with peripheral nerve injury, performed at a hematology and hemotherapy center in the state of Ceara, Brazil. The literature review was performed on the PubMed platform. All four patients underwent imaging and electromyography studies. The data collected were compared with those of the literature. The first case involves a male patient, twenty-nine years old, with a massive hematoma encapsulated in the right thigh (pseudotumor), and associated with paresthesia and a sensory and motor NCS evidencing sciatic nerve involvement. The second case refers to a male patient, forty-seven years old, with chronic hemophilic arthropathy at the right elbow, presenting with tactile-painful hypoesthesia at the medial border of the hand and the fifth finger. The study of nerve conduction revealed ulnar neuropathy at the elbow. In this case, the probable pathophysiology involves the stretching of the ulnar nerve by the pronounced valgus of the elbow. The last two patients were a man of forty-two and a boy of sixteen, both with left iliopsoas hematoma, accompanied by paresthesia in the anterior and lateral aspect of the thigh. The evaluation of the sensory e motor NCS revealed the involvement of the sensory branch of the femoral nerve (saphenous) and acute denervation in quadriceps muscle on needle EMG. Even in a limited sample, the four reported cases are in accordance with the literature data. The main publications on the subject indicate the nerves of the lower limbs as the most affected ones, predominating the femoral nerve, followed by the sciatic nerve.

Characteristics of follicular and mantle cell lymphoma in Brazil: prognostic impact of clinical parameters and treatment conditions in two hospitals

ObjectiveFollicular and mantle cell lymphoma are low-grade B-cell malignancies that lack good responses to chemoimmunotherapy. This study aimed to assess retrospectively clinicopathological features and to determine independent prognostic factors for follicular and mantle cell lymphoma patients treated at two Brazilian medical centers: the Hematology and Hemotherapy Center of the Universidade Estadual de Campinas (Unicamp), a public university hospital, and AC. Camargo Cancer Center, a specialized cancer center. MethodsTwo hundred and twenty-seven follicular and 112 mantle cell lymphoma cases were diagnosed between 1999 and 2016. Archived paraffin blocks were retrieved and reviewed. Corresponding demographics and clinical data were recovered from medical charts. Outcome analyses considered both overall and event-free survival. ResultsFor follicular lymphoma treated with the R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, prednisone) and R-CVP (rituximab, cyclophosphamide, vincristine sulfate, prednisone) regimens, both B-symptoms (p-value<0.01 for overall and event-free survival) and high-risk Follicular Lymphoma International Prognostic Index (p-value<0.01 for overall survival) were independently associated to worse prognosis. Maintenance with rituximab improved the prognosis (p-value<0.01 for overall survival). For mantle cell lymphoma, B-symptoms (p-value=0.03 for overall survival and event-free survival) and bone marrow infiltration (p-value=0.01 for overall survival) independently predicted reduced survival, and rituximab at induction increased both event-free and overall survival (p-value<0.01 in both analyses). Combinations of these deleterious features could identify extremely poor prognostic subgroups. The administration of rituximab was more frequent in the AC. Camargo Cancer Center, which was the institution associated with better overall survival for both neoplasias. ConclusionThis study represents the largest cohort of follicular and mantle cell lymphoma in South America thus far. Some easily assessable clinical variables were able to predict prognosis and should be considered in low-income centers. In addition, the underuse of rituximab in the Brazilian public health system should be reconsidered in future health policies.

Epidemiological profile of blood donors diagnosed with syphilis in the State of Piauí, Northeastern Brazil

Syphilis is a sexually transmitted disease caused by Treponema pallidum. In the State of Piauí, Northeastern Brazil, the units of the Hematology and Hemotherapy Center of Piauí (HEMOPI) receive blood donations to maintain the stock of blood and its derivatives. This study aimed to obtain epidemiological data on the frequency of syphilis in blood donors in the State of Piauí, from 2008 to 2013. This is a descriptive retrospective research based on secondary data with quantitative and exploratory analysis, in which the variables age, gender, school level, marital status, occupation, and municipality where the participants reside were recorded, analyzing the prevalence of syphilis in donors. A total of 233,927 volunteer donations were considered, of which 4,118 were positive for syphilis. The prevalence (1.76%) was analyzed using the ELISA technique, and it was relatively low among blood donations in comparison to other states. The most frequent donations were made by students in the Municipality of Teresina, downtown, and there was a statistically significant association for men, age group of 40-49 years, incomplete elementary school and married marital status. Therefore, it was concluded that the prevalence of syphilis in the State of Piauí is lower than in other states and that updated epidemiological data on the presence of syphilis in blood samples from blood donors has been generated.