Revista Brasileira De Hematologia E Hemoterapia Research Articles

Diffuse large B cell gastric lymphoma a rare disease: the effort to obtain scientific data in a multicenter, multinational retrospective trial.

The paper by Delamain et al., published in this issue ofthe Revista Brasileira de Hematologia e Hemoterapia (RBHH),addresses the main findings of DLBCGL in a multicenter retro-spective study with 104 patients from three countries, Brazil,Portugal and Italy. This kind of study is very important in rarediseasessincethemajorityoftherecommendationsarebasedondatafromcaseseries,ratherthanlargerandomizedtrials.

Five years of implementation of guidelines in hematology and transfusion medicine in Brazil.

In 2009, the Associacao Brasileira de Hematologia e Hemoterapia (ABHH) started to participate in an important mission proposed by the Associacao Medica Brasileira (AMB) and the Conselho Federal de Medicina named “Project Guidelines”. This project had already been adopted by some other specialties. It aims to determine diagnostic, monitoring, prevention and therapeutic practices according to the best scientific evidence available in the international literature. Some attempts had already been made within hematology, but without systematization or continuity. Thus the ABHH brought together a group of experts representative of the most important teaching and research institutions of Brazil and from the most varied areas of knowledge in hematology to discuss diverse issues. After training, this group prepared several guidelines from the results of systematic investigations of the literature. Seventeen priority themes, working groups and their coordinators were defined as were the start and end dates for each issue. It was decided that all the reports would be published in Portuguese in the journal of the Associacao Medica Brasileira (RAMB) and in English in the Revista Brasileira de Hematologia e Hemoterapia (RBHH). The working methodology included regular meetings between the group of researchers and those who were carrying out the systematic reviews of the literature. The most important questions were identified by experts of different fields within clinical hematology, pediatric hematology and transfusion medicine. The first set of guidelines, completed and published in 2012, was related to chronic myeloid leukemia,1 an

Goals, globalization and the impact factor of the journal.

Over the years, as editors of Revista Brasileira de Hematologia e Hemoterapia (RBHH), we have faced different issues. The irst of these, an observation that sometimes became a question, is about the purpose of the journal. To answer this question it is necessary to return to the journal’s origins in the 1980s. In those dificult times of discretion, Brazil was different and the Sociedade Brasileira de Hematologia e Hematologia (SBHH) was going through a period of restructuring and controversy about the role of hemotherapy in the country. In a irm and decisive action, remunerated blood donation was banned in Brazil. The SBHH had published a monthly newsletter since 1973 which aimed to promote the activities of the Executive Board of the society and informing everyone about what was going on in hematology and transfusion medicine across the country. At a time when there was little information, when for most it was dificult to access scientiic journals, it was said that for some corners of the country, this was the only accessible communication about hematology and transfusion medicine. An international congress of hematology was hosted by the city of Buenos Aires, Argentina, in 1984 when the Board of the SBHH, in a daring act involving four or ive people, modiied the format of the newsletter and launched instead a prototype of the scientiic journal that circulated during the event. At that point the primary objective and heresy of the creators was to move forward and to mark a scientiic position, a criticism that the SBHH received, in addition to attracting young people

The Guidelines Project: Brazilian guidelines for acute promyelocytic leukemia

The Guidelines Project of the Associacao Medica Brasileira (AMB) and of the Conselho Federal de Medicina (CFM) began in 2000 with specialist societies participating in the preparation of the texts. The guidelines are based on research and contain solid advice on the diagnosis, therapy, and prevention of diseases. Grounded in evidence-based medicine, they seek to answer specific or crucial questions regarding the disease. A review of the literature is performed and, using pre-established criteria, studies on the disease are selected and graded according to their characteristics and type. Randomized clinical trials and meta-analyses have the highest value (A). Second in importance are observational and clinical studies (B), then case reports and case series (C), and finally, publications of consensuses and opinions (D). Due to the methodology employed, current systematic reviews are clearly more relevant when compared to those written in the past. Historically, reviews were much more based on personal opinions and subject to the author's interest, that is, more concerned with the individual point of view and based on personal experience.1 The Associacao Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH) began to participate effectively in the development of the guidelines of the AMB in 2009, with contributions by several experts as shown in Table 1; previously, the collection was limited, with fewer themes. After 2012, guidelines on several diseases were completed and published in the Revista Brasileira de Hematologia e Hemoterapia (RBHH); chronic myelogenous leukemia,2 multiple myeloma,3 and diagnosis4 and treatment of immune thrombocytopenic purpura.5 It is also important to quote other systematic reviews published in the RBHH, such as preventive practices in longterm hematopoietic stem cell transplantation survivors, with the participation of experts from several different countries.6 The consensus of the Sociedade Brasileira de Transplante de Medula Ossea (SBTMO) produced the famous 'Pink Book'; this was rounded out with two publications on transplantation in acute myeloid leukemia7 and autoimmune diseases.8 Table 1 Guidelines published on hematological diseases. Acute promyelocytic leukemia (APL) has well-defined clinical, cytogenetic, and morphological characteristics; it encompasses 10% to 15% of all myeloid-type leukemias. Its molecular bases are well defined, with different variations influencing the treatment of patients.9 The results, as reported by the International Consortium on APL, established the treatment strategies and the conduct for the disease in developing countries.10,11 The guidelines for the diagnosis and treatment of APL12 are published in this issue of the RBHH, the first in 2014, thereby adding to those already published. Hopefully, this will stimulate other experts to continue this hard work, aiming to contribute to medical practice and to solidify the knowledge on the diagnoses and treatment of hematologic diseases.

The last issue of the year, a retrospective and a new perspective for the Revista Brasileira de Hematologia e Hemoterapia.

The last issue of the year, a retrospective and a new perspective for the Revista Brasileira de Hematologia e Hemoterapia.

The consequence of stacking by Brazilian journals

The consequence of stacking by Brazilian journals

Reviews and guidelines: Evidence of progress and a starting point for standardization and changes

Reviews and guidelines: Evidence of progress and a starting point for standardization and changes

I protest against the method used to evaluate scientific production used in Brazil

I protest against the method used to evaluate scientific production used in Brazil

Comment on: One window-period donation in two years of individual donor-nucleic acid test screening for hepatitis B, hepatitis C and human immunodeficiency virus

Since 1999 blood transfusion services around the world have been implementing nucleic acid amplification tests (NAAT) to screen for hepatitis C (HCV) RNA, human immunodeficiency virus (HIV) RNA and hepatitis B (HBV) DNA to improve the safety of the blood supply. Initially HCV RNA and HIV RNA NAAT screening was implemented and more recently HBV DNA NAAT screening commenced. In the beginning mini pools (MP) of 98 were used due to the manual complex systems available which were not suitable for high throughput because of the stringent laboratory requirements(1). Over the years the pool sizes have decreased to either 16 as used in the USA(2) or even smaller such as 6 as used by many European and Asian countries(3-5). South Africa, in 2005, was the first country in the world to implement individual donation (ID) screening for all three viruses of all donations(6). NAAT screening in parallel with serological screening has allowed the classification of HIV positive donations as window period, concordant and elite controller infections. HCV positive donations can be classified as window period, concordant and resolved infections and HBV positive donations can be classified as Window period, HBsAg only, acute concordant, occult and anti-HBc only infections. Since the implementation of NAAT for HBV DNA screening, vaccine breakthrough infections have also been recognized(7). The article in this issue of the Revista Brasileira de Hematologia e Hemoterapia (RBHH) entitled One window-period donation in two years of individual donor-nucleic acid test screening for hepatitis B, hepatitis C and human immunodeficiency virus by Levi et al. describes the first two years of screening for HIV RNA, HCV RNA and HBV DNA using ID NAAT in a small Brazilian blood center(8). From a total of 24,441 donations, no additional yield was obtained for HIV and HCV and they showed a 35% clearance rate for HCV and no elite controllers for HIV. The primary objective of the paper is to describe an unusual HBV yield case. This case tested HBsAg and anti-HBc negative and had an anti-HBs titer of 18 IU/mL. On follow up, the anti-HBs rose to 109 IU/mL, however in four samples over seven months no HBsAg or anti-HBc reactivity occurred. Sequencing confirmed the donation as a genotype A2 vaccine breakthrough infection. This is unusual as most documented breakthrough infections have been of the non-A2 genotype due to the vaccine comprising an A2 virus(7). The authors also showed 19 cases of HBsAg positive with no other HBV marker reactivity. It would be interesting to understand whether the authors viewed these donations as true or false infections in light of the investigations being done in the USA in the context of potentially removing HBsAg screening if HBV NAAT and anti-HBc screening is performed. Although this paper describes a small number of donations screened by ID-NAAT, if extrapolated to the larger Brazilian donor base and the prevalence and incidence is similar to that presented by Levi et al., then ID-NAAT could have a large impact on the safety of the blood supply particularly for HBV and HIV due to the high prevalence and incidence of the diseases, respectively.

Comments on: alloimmunization screening after transfusion of red blood cells in a prospective study

A red blood cell (RBC) transfusion is a large-scale intravenous introduction of foreign tissue; this procedure provides a valuable opportunity to study human immunologic response to foreign antigens. Patients receiving RBC transfusions are at risk of forming alloantibodies against donor RBC antigens. The risk of alloimmunization is clinically important, but little is known about the factors governing this risk. In a novel mathematical model for RBC alloimmunization (Stochastic model, a random process) that excluded patients with sickle cell disease (SCD), it was calculated that approximately 13% of the transfusion recipient population are responders and at risk of forming RBC alloantibodies (the risk of forming alloantibodies is not the same as the incidence of alloantibodies)(1,2). The incidence of anti-RBC antibodies is not insignificant and varies widely according to the disease of the patient, history of transfusion, pregnancy and the antigen frequencies of patients versus donors in a geographic location. It is estimated at 1-2 percent in the general hospital population, 5 percent or more in multi-transfused patients and multiparous women and 20 percent or more in patients with transfusion-dependent diseases (e.g. sickle cell anemia, thalassemia, etc.)(3). Clinically, RBC alloimmunization can result in delays in patient care, hemolytic transfusion reactions, hemolytic disease of the fetus and newborn and possibly increased morbidity following organ transplantation(4,5). Anti-RBC antibody titers frequently drop below detectable levels, allowing units to be transfused with incompatible RBCs resulting in the restimulation of memory cells and an increase in antibody titers. With longer life expectancy and technological developments, the number of chronic degenerative diseases and more complex chirurgical procedures are increasing along with requests for more blood transfusions which consequently increase the probability of repeat transfusions. Many antibodies may not be detected at the time of a new transfusion event and so the transfusion recipient will be at risk for delayed hemolytic transfusion reactions. Given the clinical consequences, several retrospective studies have attempted to elucidate clinical and patient variables to help identify patients at increased risk for RBC alloimmunization. As the majority of studies report on the rate of alloimmunization in chronically transfused patients(6), Santos at al., in a retrospective study published in the Revista Brasileira de Hematologia e Hemoterapia (RBHH), demonstrated the importance of considering the incidence of clinically relevant antibodies in patients transfused in emergency situations(7). This issue of the RBHH includes an original and prospective analysis of patients in surgical and clinical emergency services - Alloimmunization screening after transfusion of red blood cells in a prospective study(8). The results demonstrated a high rate of alloimmunization within six months of the procedure (15/143 - 10.49%) in patients transfused with packed red blood cells; the titers of these antibodies decreased and disappeared within 15 months of transfusion in 60% of the alloimmunized individuals. Anti-K alloantibodies and those directed against antigens of the Rh system were the most common; the highest titer was 1:32 (anti-K) and there was an evident correlation with the number of transfusions. Due to the high incidence of RBC alloantibodies of clinical importance in patients transfused in surgical and clinical emergency services, the authors proposed to extend phenotyping of C, c, E, e and K antigens to all patients with planned surgeries or with acute clinical events that do not need emergency transfusions. This theme is controversial because preventing the formation of RBC antibodies is not practical for most patients and for many cases alloimmunization is not a serious problem. In addition, blood banking services face challenges with increased financial pressures amidst a growing demand. These financial pressures oblige modern blood banks to focus on improving efficiency. Thus, it is important to emphasize that donor phenotyping, when it is routinely performed using automated micro-assay techniques, often leads to a reduction in costs and a higher quality procedure. In the future the use of automated templates for large-scale phenotyping/genotyping will substantially increase transfusion safety(9). The author's proposal was realistic and will allow the prevention of RBC alloimmunization to be expanded one step further as phenotyping is already essential in women of child bearing age, for some patients at risk of serious hemolytic transfusion reactions and for patients with chronic transfusion requirements, e.g. patients with sickle cell anemia.

Comments on: frequency of human platelet antigens in oncohematological patients with thrombocytopenia and the probability of incompatibility to platelet transfusions

Comments on: frequency of human platelet antigens in oncohematological patients with thrombocytopenia and the probability of incompatibility to platelet transfusions

Animal models of human nutritional diseases: a short overview

The long history of animal experimentation describes the use of a series of methods that not only include the use of whole animals but isolated organs, isolated tissues, tissue cultures, isolated cells, subcellular components, modeling and structure-activity relationships. Data from government reports, from medical research council reports and from scientific publications point to the extent to which these methods are used. A study of the revolution of therapeutics and of the recent decline in drug innovation, raises the question as to whether the trend away from experimentation on the whole organism may have gone too far(1). Several factors were very important in the discovery of essential nutrients including the recognition that certain diseases are directly associated to diet. Subsequently, the development of suitable animal models investigated animals that have specific requirements for the nutrient in question, the use of bioassay procedures to first produce and then ameliorate one or more of the symptoms related to deficiency and the development of defined purified diets that could be made singly deficient in a nutritional entity. Generally, the diet-disease association preceded both isolation of the nutrient per se as well as the establishment of nutrient function(2,3). The STZ-diabetes model is widely used to investigate diabetic peripheral neuropathies by transmission electron microscopy (TEM). Morphological alterations of the vestibulocochlear nerve in experimental diabetes are being described for the first time and such information corroborates to a better understanding of the changes in hearing observed in diabetic patients(4). The nutritional status of animals can change these results, as can the cellular composition and emerging inflammatory reactions. Leukocyte counts can easily be studied by TEM and with the advancing age of mice the results may be different. There are several forms of causing undernourishment in animals with the most common being protein malnutrition caused by the ingestion of small quantities of milk protein - casein (about 8%), as described in the original article by Viana et al. published in this issue of the Revista Brasileira de Hematologia eHemoterapia(5). This scientific paper shows the importance of physical training on the physiological adaptation of leukocytes in situations of neonatal malnutrition. Currently many experiments are underway to try to reconcile animal research to effectively and ethically extrapolate the results to humans.

Results and goals

Results and goals

The journal's performance in 2011

At the close of the year and of Volume 33 of the Revista Brasileira de Hematologia e Hemoterapia (RBHH) several significant changes deserve reflection and considerations. The first change this year was that the journal was printed in English. There was almost unanimous agreement about this decision. Even so, one or two colleagues contacted me and said they believed that this measure was inapt and even unpatriotic. This theme has been debated for some time, even among journal editors at events of the Associacao Brasileira de Editores Cientificos (ABEC). Since 2002, in its instructions for authors, the RBHH has stated that it is a bilingual journal; papers in Portuguese or English would be published and so the choice of language has always depended on the author. The times have changed and in recent years the country changed with greater participation in the global scientific market as was reported in previous issues.(1) Concurrently the academic pressure for authors' visibility has increased and the Qualis scientific journal classification system of the Coordenacao de Apoio aos Profissionais do Ensino Superior (CAPES) implanted four years ago was a fatal blow for many national journals and authors, alike.(2,3) Editorial staff felt that their work was devalued and the authors were discouraged because their contributions were given low scores with a direct impact on the productivity factor of professors and researchers. Since then the quest for visibility has become a mantra of all editors and the pursuit of the internationalization of journals has become a national goal. At this point ABEC and the Associacao Medica Brasileira (AMB) issued clear signals that it is essential to implement changes. Among which is the internationalization of the editorial board, with the participation of foreign experts in journals; this is one of the main demands for journals to become indexed to the Institute for Scientific Information Web of Knowledge/Journal Citation Reports (ISI/JCR) and PubMed/Medline electronic databases. And at this time both printed and electronic journals need to be edited in English. Thus, recent publications and events such as those of the Fundacao de Amparo a Pesquisas do Estado de Sao Paulo (FAPESP) and of the Scientific Electronic Library Online (SciELO) have been stimulating journals to publish in English on the grounds that English should be considered technical, frank and the most important or even the only international language. FAPESP recommends, albeit inexplicitly, that English be used for national publications if the objective is to reach international audiences. Publish, be read and cited or perish. This is the key. So today, on filling out disclosure documents, such as requests for financial support for the journal there is always the question of whether the journal is published in English. So the RBHH started to be printed in English, and because of this it was indexed in PubMed Central (PMC) of the National Institutes of Health, an auspicious achievement in 2011. Volume 33 will be indexed in PMC in full thereby providing international visibility to all authors. Another accomplishment this year was a 20% increase in submissions, a fact that comforts us as it shows that the changes have been accepted not only in respect to our attempts at internationalization but also in respect to measures implemented on the quality of print and the scientific rigor used in the evaluation of submissions. So, in line with policies of the Associacao Brasileira de Hematologia e Hemoterapia (ABHH) and affiliated societies [Sociedade Brasileira de Transplante de Medula Ossea (SBTMO), Associacao Italo-Brasileira de Hematologia (AIBE) and Sociedade Brasileira de Oncologia Pediatrica (SOBOPE)] the RBHH is becoming internationalized and fulfilling its role as representative of the Brazilian hematology community with the aim of becoming an alternative for the international scientific communities.

The evolution of the "Revista Brasileira de Hematologia e Hemoterapia" to meet the challenges of a new era

The evolution of the "Revista Brasileira de Hematologia e Hemoterapia" to meet the challenges of a new era

The Revista Brasileira de Hematologia e Hemoterapia now and discussion on the new classification of brazilian journals

The Revista Brasileira de Hematologia e Hemoterapia (RBHH) is now the official organ of the Sociedade Brasileira de Oncologia Pediatrica (Brazilian Society of Pediatric Oncology - SOBOPE). With this, SOBOPE will assist us to achieve our objectives to develop and internationalize the journal. The question regarding the Qualis classification of CAPES remains a matter of widespread debate and controversy. A recent event of FAPESP/SciELO, highlighted the progress of Brazil in respect to global scientific production as we had already discussed in issue no 3 of the RBHH this year.(1) In an atmosphere of jingoism, several editors presented measures they adopted for their journals to be included in the Thomson Reuters/ISI/JCR database, the most prestigious among all existing databases and the one responsible for calculating the famous Impact Factor. The measures used are all basically the same and already known to most participants. They include professionalization of the journal, publishing in English to increase international visibility and massive investment to improve the quality of content, in addition to trivial details, such as care with the frequency and quality of printing. With this, in few years, Brazil now has 89 scientific journals in all fields of the Thomson Reuters/ISI/JCR database. Several aspects were mentioned and a presentation by the representative of the University of Granada, Spain responsible for SCImago, emphasized the importance of Brazil and suggested adopting different approaches within the editorial market such as partnerships especially between scientific groups in Brazil and other countries in order to produce material with greater appeal and international impact. Examples of the influence of international publishers as well as criticism of the current Qualis classification were presented by another speaker(2-4) (Table 1). Table 1 Qualis classification of scientific journals With the approach of the publication of the new Qualis classification, representatives of SciELO and FAPESP suggested that some journals will be reclassified in higher positions than the old classification; those chosen would receive good financial support over a fiveyear period but this was not explained well. They mentioned that three journals from each of the three medical categories (Medicine 1, 2 and 3) would be indicated. Others suggested that it would only be two in each area. The criteria would be the existing parameters such as the impact factor, possibly using SCImago and the inclusion in SciELO which are criteria of the old classification system. Thus, the discussion is on the agenda. For this reason the Brazilian Medical Association met with all medical journal editors to discuss the new classification and the parameters that will be employed. Without much information, one of the area coordinators reported that Capes had asked him to indicate three journals, pure and simply. He also informed us that the nominees may even be promoted to classification A1 even with an impact factor lower than that stipulated by the old classification. At this point the meeting came to an end as the discussion became general with different opinions on various aspects; one conclusion was reached that if this measure were adopted there would be major discouragement for all the excluded journals. The RBHH, since the new classification was established, has been feeling the impact and thus has been trying to adapt to the new situation with much effort to improve.(5) The journal has invested in human resources and professionalism, which can be seen from the first edition of this volume. At this moment the RBHH advocates a comprehensive policy to stimulate national journals and does not agree with the support by sector for a few journals. However, we also know of the distinctive position of the RBHH in the world in relation to the other journals of this specialty and of course with evolution, our journal will become an even stronger representative of South America and of Latin countries as an alternative for developing countries to publish their scientific production.

Countries emerging as major scientific powers

The last issue emphasized the changes taking place in the Revista Brasileira de Hematologia e Hemoterapia (RBHH) and discussed the reasons that the Associacao Brasileira de Hematologia e Hemoterapia (ABHH) and her two sister societies decided to internationalize the journal.(1-3) It was pointed out that one of the primary reasons for this was the new Qualis classification by the Brazilian further education council (Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior - Capes). In several articles, editors of many Brazilian journals voiced their unanimous disagreement at the use of just the Thomson-Reuters impact factor in the preparation of this new classification.(4,5) The impact factor has long been used inappropriately to assess the productivity of individual researchers and professors and consequently in academic decisions related to promotion. Thus, several reports exorcise the Thomson-Reuters impact factor and recommend that other indices, such as those of SCImago and SciELO, should also be used in the classification of scientific journals.(6,7) This is justified and so the objective of the Brazilian editors was to valorize national production and Brazilian journals. In June, Crossref Quarterly, the e-letter of one of the institutions that attribute Digital Object Identifiers (DOIs) to scientific publications on the internet, reported on the Brazilian evolution over the last two years in respect to the number of requests for DOIs.(8) Crossref cites Brazil because of the recent increase in membership; the RBHH is one of these new members. Another article from the Royal Society entitled Knowledge, Networks and Nations: Global scientific collaboration in the 21st century identifies the new emerging countries of great scientific power led by China and including Brazil and also throws light on the growing scientific production of countries that are not normally mentioned such as Iran, Turkey and Tunisia.(9) China is now the second highest producer of scholarship articles worldwide and the fourth in medicine.(10) Eleven years ago it was the nineteenth in the ranking of SCImago in medicine, that is, behind Brazil which was the seventeenth (Table 1). China's contribution has accompanied its intense economic progress that has been observed over the last fifteen years. Table 1 Scientific publications in medicine - 1996 to 2010(10) Albeit not so evident, a similar evolution has happened number giving a larger slice of the share in these years (Figure 1). Today, both in general publications and in medicine, we are in the thirteenth position according to the SCImago Journal Rank (SJR - Table 1). Figure 1 Evolution of scientific production in Brazil between 1996 and 2010(10) And how is the production of Hematology? Table 2 is the cumulated publications from 1996 to 2010. In 2009 and 2010 there was intense and comparable production in Italy, the UK and Germany; these countries produced the highest number of articles after the USA. Between 1999 and 2009 China climbed from the twenty-fifth place to the seventh place giving it an aggregate position of thirteenth in 2010 (Table 2). Table 2 Scientific publications in hematology – 1996 to 2010(10) In the same period, Brazil moved from twenty-fourth to fourteenth position and its aggregate position for 1996 to 2010 is eighteenth. This is important but it is even more significant if we look at the production of Brazil in 2010 when it is in the twelfth position and not so far behind countries such as Australia and Spain (Table 3). Table 3 Scientific publications in hematology – 2010(10) However we can improve as is clear on comparing the percentage of production in hematology in respect to the overall production of documents in Medicine. Table 4 is a simple comparison of evolution of randomly chosen years of the countries that lead aggregate ranking in Hematology as well as China and Brazil. What is observed is that every year the percentage contribution of the USA and Italy in the field of hematology compared to its overall scientific production in medicine is higher than China and Brazil which shows we can and should improve. Table 4 Percentage of publications in hematology compared to the overall scientific publications in medicine of each country in 1999, 2004, 2009, cumulative of 2006 and 2009 and the year of highest productivity(10) At this point we should emphasize that the RBHH has an important role in the evolution of hematology in Brazil; it is publishing most of the citable and cited documents which make up the score of the ranking of the SJR. These data can be challenged or considered irrelevant, but should be viewed as a stimulus; an encouragement to continue with changes to transform the Revista Brasileira de Hematologia e Hemoterapia.

The AIBE and the new phase of the RBHH

The Associacao Italo-Brasileira de Hematologia (Italian-Brazilian Association of Hematology - AIBE) was founded on 04/02/2004 in the city of Genoa, Italy. The primary objectives of the AIBE are to promote the integration of the hematology service of both countries through an exchange of healthcare professionals and the development of research of common interest. Since its inception, the AIBE chose the Revista Brasileira de Hematologia e Hemoterapia (RBHH) as its official vehicle for the publication of scientific articles. For us, it is a great pleasure to participate in this new phase of the journal, its internationalization. The AIBE can be a powerful tool in this process, as publishing the journal in English and its future indexing by Pubmed will increase, without any doubt whatsoever, the interest of colleagues and Italian researchers in publishing their articles in the journal. It is important to note that at present Italy is ranked second in the world in the number of scientific publications in the field of hematology. The Italian members, who helped found the AIBE are also in the leadership and participate in several cooperative groups that develop highly important research protocols. Today, cooperation and multicenter studies are of fundamental importance in the development of medical science and Italy has a long tradition and has advanced greatly in recent years in the development of these studies. The AIBE and the RBHH are partners in this process and we believe that there will be a great synergy in actions that undoubtedly will lead to great steps forward for both.

Brazilian Society of Pediatric Oncology - SOBOPE

The history of pediatric oncology in Brazil is strongly linked to the history of the Sociedade Brasileira de Oncologia Pediatrica (SOBOPE). In the seventies two of our most prestigious pediatric oncologists, Waldir Veiga Pereira and Vicente Odone Filho, decided to go to Memphis, USA to learn about the most recent advances in pediatric hematology and Oncology. It was there they met Rhomes Joao Amim Aur. Rhomes Aur is a pioneer in pediatric hematology and oncology; the most important award in Brazilian pediatric oncology is named after him. Saint Jude Children's Hospital has a strong connection with Brazil. Since he moved to Memphis, Raul Ribeiro has continuously provided opportunities by helping Brazilian pediatric oncologists and institutions. Silvia Brandalise also visited Dr. Odone in Saint Jude. There they talked about acute lymphoblastic leukemia and a few years later in 1980, she met Milton Ruiz, Celso Carlos Campos Guerra and Rhomes Aur in Santos to discuss the first Brazilian protocol for acute lymphoblastic leukemia. The Brazilian society of pediatric oncology was founded in 1981 by a group of physicians led by Virgilio Carvalho Pinto. The founders were committed to change the dismal prognosis of children and adolescents with cancer. At that time diagnosis was practically a death sentence; few hospitals could offer a proper treatment. At the same time Beatriz de Camargo started the Wilms' tumor study group.(1) Alois Bianchi, the first head of the Pediatric Oncology Department at the A C Camargo Hospital, was the second president of SOBOPE. With Nubia Mendonca, one of the founders and most active pediatric oncologists in Brazil, the meetings of SOBOPE became routine. She officially established the Brazilian cooperative groups. After Nubia, Waldir Pereira, Silvia Brandalise, Fernando Werneck and Jose Roberto Resende contributed to the growth of SOBOPE making it a more prestigious Society. Ten years ago, with effort of one of our former presidents, Sidnei Epelman, SOBOPE started a data management center, a Computerized Data Center. This center and the cooperative groups continued to develop with Sonia Vianna. Renato Melaragno, another former President, created a strong partnership with the Instituto Ronald Mc Donald. All these collaborative studies resulted in National and International publications. The osteosarcoma study by Dr Petrilli demonstrated the Brazilian reality as opposed to the reality of other countries in respect to the size of tumors and metastasis.(2) The Ewing Sarcoma Study, led by Brunetto(3) highlighted a new combination of drugs. More recent projects are using an efficient on-line data collection system. With this quicker and more efficient system, data analysis will correct protocols in relation to toxicity. The Ewing Sarcoma protocol, like the osteosarcoma study, was developed in partnership with GALOP (the Latin American Group of Pediatric Oncology), showing that it is possible to work in harmony with other countries. The last Brazilian study of acute lymphoblastic leukemia showed new maintenance therapy.(4) The cooperative group of germ cell tumors by Luiz Fernando Lopes also published their results;(5) This group has a strong partnership with other international institutions that present data at international meetings. The Brazilian Committee of Pediatric Bone Marrow Transplantation, in a joint effort between SOBOPE and theSociedade Brasileira de Transplante de Medula Ossea (SBTMO), also published a consensus.(6) This consensus, organized by the SBTMO, was developed not only with international data, but with our local experience and publications. We cannot forget Celia Gianotti, who is internationally recognized because of her important work with the campaign for early diagnosis of retinoblastoma in Brazil.(7,8) The National Cancer Institute is making every effort to know about the reality of pediatric cancer in Brazil.(9) We should not need to use data from other countries to infer the situation here in Brazil; a few years ago, we had no idea about the numbers of new cases. SOBOPE is happy about this opportunity to join the Revista Brasileira de Hematologia e Hemoterapia (RBHH). We are very thankful to ABHH who kindly opened this door to us. This partnership will certainly further improve the quality of the RBHH. It is important to remember that the RBHH is the only scientific journal in the area of hematology in the southern hemisphere. SOBOPE is now one of the few societies of pediatric oncology that has the honor of participating in an official journal.