Abstract Background There is little information on how different soil cover systems influence the residual effect of pre-emergent herbicides used in soybean cultivation in Brazil. Objective The objective was to compare the persistence of different pre-emergent herbicides in a Latosolic Dystrophic Red Nitosol soil in the presence or absence of black oat straw on the soil surface. Methods The herbicides used were chlorimuron-ethyl (40.0 g ai ha-1), diclosulam (70.1 g ai ha-1), flumioxazin (100.0 ai g ha-1) and saflufenacil (70.0 g ai ha-1). Soil samples were collected at 0, 5, 10, 15, 20, 32, 46 and 60 days after herbicide application. The bioavailability of the herbicides was evaluated in a greenhouse using cucumber plants as bioindicators. Results Rainfall was necessary for the herbicides to go through the straw layer and reach the soil. Using straw, the half-life times for chlorimuron, diclosulam, flumioxazin and saflufenacil were 42, 61, 49 and 26 days, while without straw, they were 23, 45, 8 and 10 days, respectively. Conclusion The presence of straw on the soil surface increased the persistence of herbicides in the soil.

ABSTRACT Chimeric antigen receptor T (CAR-T) cell therapy is a novel therapeutic modality for acute lymphoblastic leukemia (ALL) with robust outcomes in patients with refractory or relapsed disease. At the same time, CAR-T cell therapy is associated with unique and potentially fatal toxicities, such as cytokine release syndrome (CRS) and neurological toxicities (ICANS). This manuscript aims to provide a consensus of specialists in the fields of Hema- tology Oncology and Cellular Therapy to make recommendations on the current scenario of the use of CAR-T cells in patients with ALL.

Abstract Background: Substantial losses to crops can occur due to the presence of sourgrass in agroecosystems, which is promoted by its seed dispersal ability. Environmental factors can affect sourgrass germination and emergence. Objective: The objective of this study was to determine the effects of water restriction, salinity, and depth of sowing on the sourgrass germination and emergence processes. Methods: Experiments using sourgrass seeds were conducted under controlled conditions simulating osmotic and saline stress and seeding depths. The data collected was submitted to analysis of variance and adjusted to models by regression analysis. Results: Smaller osmotic potentials reduced germination, normal seedlings, and increased quiescence, with no germination occurring from -0.80 MPa. Salinity caused a decrease in germination from 20 mM NaCl, influencing the percentage of normal and abnormal seedlings and quiescent seeds. Seed depth influenced the emergence of seedlings, with the maximum percentage of emergence (83%) in the seeds placed on the substrate surface. The maximum depth from which sourgrass seedlings emerged was 7.6 cm. Conclusions: The results lead to the conclusion that the sourgrass germination process tolerates low osmotic potentials and salinity levels. Despite being small sized seeds, they can emerge from high depths. These characteristics justify its occurrence in several regions and agroecosystems, especially in perennial and no-till crops lacking soil cover.

RESUMO: Com o objetivo de avaliar a eficiência dos óleos essenciais de Citrus latifolia (limão taiti) e Cinnamomum zeylanicum (canela em casca) no controle dos fitopatógenos Penicillium sp. e Aspergillus sp. e na qualidade das sementes de feijão, foram conduzidos dois experimentos. No primeiro, avaliou-se o efeito dos óleos essenciais de C. latifolia e C. zeylanicum no desenvolvimento in vitro dos fungos Penicillium sp. e Aspergillus sp. e, no segundo, a influência dos óleos essenciais sobre a qualidade fisiológica e sanitária das sementes de feijão. As variáveis crescimento micelial, germinação de conídios e esporulação de Penicillium sp. e Aspergillus sp. foram aferidas no primeiro experimento, enquanto o teste de germinação de sementes, primeira contagem de germinação, índice de velocidade de germinação (IVG) e teste de sanidade de sementes de feijão foram aferidas no segundo. O óleo essencial (OE) de C. zeylanicum foi mais eficiente que C. latifolia no controle dos fungos Aspergillus sp. e Penicillium sp., mas diminuiu a qualidade fisiológica das sementes de feijão. A diversidade fúngica identificada no teste de sanidade de sementes foi composta por fungos dos gêneros Aspergillus, Penicillium, Cladosporium, Fusarium, Chaetomium e Rhizopus. Os resultados indicam o potencial do uso desses óleos essenciais no tratamento de sementes.

ABSTRACT: With the objective to evaluate the efficiency of essential oils of Citrus latifolia (Tahiti lemon) and Cinnamomum zeylanicum (cinnamon bark) in the control of plant pathogens Penicillium sp. and Aspergillus sp. and the quality of the bean seeds, two experiments were conducted. In the first one, the effect of essential oils of C. latifolia and C. zeylanicum was evaluated in vitro development of the fungi Penicillium sp. and Aspergillus sp. and, in the second one, the influence of essential oils on the physiological and sanitary quality of bean seeds. The variables mycelial growth, conidial germination and sporulation of Penicillium sp. and Aspergillus sp. were measured in the first experiment, while the seed germination test, first count of germination, germination speed index (GSI) and sanity test of bean seeds were measured in the second. The essential oil (EO) of C. zeylanicum was more efficient than C. latifolia in the control of Aspergillus sp. and Penicillium sp., but decreased the physiological quality of the beans seeds. The fungal diversity identified in the seed health test was composed by fungi of the genera Aspergillus, Penicillium, Cladosporium, Fusarium, Chaetomium and Rhizopus. The results indicate the potential of the use of these EOs in the seeds treatment.

Resumo: Objetivou-se avaliar os tratamentos com produtos alternativos na repelência do caruncho do feijão e na qualidade fisiológica de sementes de Phaseolus vulgaris. Utilizou-se delineamento experimental inteiramente casualizado, com quatro repetições, em esquema bifatorial (10x4). Os 10 tratamentos foram: Piper nigrum, diatomáceas e caulim (4 g/kg de semente); Cinnamomum zeylanicum, Citrus sinensis e cinza de Eucalyptus sp. (1% do peso de semente); óleo de Azadirachta indica (3 mL/kg de semente); Gastoxin (6 g/t semente); garrafa pet; testemunha; e quatro períodos de armazenamento (0, 25, 50 e 75 dias). Foram avaliadas as variáveis umidade, germinação, velocidade de emergência, tempo médio de emergência, peso de mil sementes, sementes infestadas e repelência. Os tratamentos com caulim e A. indica foram repelentes no início do tratamento, porém perderam a eficácia ao final do armazenamento. Os produtos a base de C. zeylanicum e Eucalyptus sp. não foram repelentes no início do tratamento, porém o foram no final do armazenamento. Já os produtos a base de C. sinensis e diatomáceas foram repelentes tanto no início quanto no final do armazenamento. Os tratamentos com diatomáceas, caulim, P. nigrum, C. zeylanicum, Eucalyptus sp., A. indica e a embalagem pet são eficientes em reduzir a infestação do caruncho sem impactar negativamente na qualidade fisiológica das sementes.

Abstract: The objectives of this study were to evaluate treatments with alternative products for repelling bean weevils, and to assess their influence on the physiological quality of Phaseolus vulgaris seeds. The experiment was carried out in a completely randomized design, with four replications, in a two-factorial scheme (10x4). It comprised 10 treatments: Piper nigrum, diatomaceous earth and kaolin (4 g/kg of seed); Cinnamomum zeylanicum, Citrus sinensis and Eucalyptus sp. (1% of the seed weight); Azadirachta indica oil (3 mL/kg of seed); Gastoxin (6 g/t of seed); PET container; control; and the storage times of 0, 25, 50, and 75 days. The variables seed moisture content, germination, emergence speed, mean emergence time, weight of one thousand seeds, seed infestation, and repellency were evaluated. The treatments with kaolin and A. indica had a repellent effect at first, but they lost effectiveness by the end of the storage period. The products based on C. zeylanicum and Eucalyptus sp. did not have such impact during early periods of storage, albeit repellency grew with time. On the other hand, C. sinensis and diatom-based products were repellents, both at the beginning and at the end of storage. The treatments with diatomaceous earth, kaolin, P. nigrum, C. zeylanicum, Eucalyptus sp., A. indica, and PET container all proved to be effective in reducing bean weevil infestation, without negatively impacting the physiological quality of the seeds.

Neste trabalho foi avaliada a influência de exsudados radiculares e de extrato aquoso da parte aérea de Ambrosia artemisiifolia na germinação, no vigor de sementes e no crescimento inicial de milho e soja. Foram realizados dois ensaios, o primeiro em esquema fatorial (2x2), milho e soja com e sem exsudato radicular, e o segundo em esquema fatorial (2x4), milho e soja nas concentrações de 0, 25, 50 e 75 % de extrato aquoso de parte aérea de A. artemisiifolia. O exsudato radicular de A. artemisiifolia afetou negativamente o vigor de sementes de milho, mas não a germinação. O exsudato radicular de A. artemisiifolia não influenciou a germinação nem o vigor de sementes de soja. A cultura do milho apresentou maior sensibilidade que a soja ao exsudato radicular. O extrato aquoso da parte aérea de A. artemisiifolia afetou negativamente o vigor de sementes de milho e o vigor e a germinação de sementes de soja, sendo a soja mais sensível aos efeitos alelopáticos do extrato. O extrato aquoso da parte aérea de A. artemisiifolia apresentou teor de fenóis totais de 11,13 mg g-1 de biomassa seca da parte aérea, o que pode ser considerado um valor alto quando comparado ao de outras infestantes.

In this work, the influence of root exudates and aqueous extract from Ambrosia artemisiifolia shoots on germination, seed vigor and initial development of corn and soybean were evaluated. Two experiments were carried out in a factorial scheme (2x2), corn and soybean with and without root exudate, and the second in a factorial scheme (2x4), corn and soybean at concentrations of 0, 25, 50 and 75% of aqueous extract of A. artemisiifolia shoots. The root exudate of A. artemisiifolia negatively affected the vigor of maize seeds, but not germination. The root exudate of A. artemisiifolia did not influence the germination and vigor of soybean seeds. The corn crop was more sensitive than soybean to root exudate. The aqueous extract from A. artemisiifolia shoots negatively affected the vigor of maize seeds and the vigor and germination of soybean seeds, being the soybean crop more sensitive to the allelopathic effects of the extract. The aqueous extract from A. artemisiifolia shoots presented total phenol content of 11.13 mg g-1 of the dry mass, which can be considered a high value when compared to other weeds.

Acute promyelocytic leukemia is potentially a highly curable type of leukemia that usually presents with pancytopenia, coagulopathies and bleeding. We describe a case of an unusual presentation of acute promyelocytic leukemia. A 53 year-old male was admitted complaining of pain and weakness in his legs. He presented at examination a spastic paraparesis with a sensitive level at the eighth thoracic medullar (T8) segment. Magnetic resonance imaging showed a posterolateral extradural mass from T6 through T8 segments with medullar compression. A complete blood count showed anemia, thrombocytopenia and the presence of promyelocytes and blasts. Marrow examination was compatible with the diagnosis of acute promyelocytic leukemia by cytogenetics and polymerase chain reaction for the PML-RARα gene. He was treated with all-trans-retinoic acid therapy plus daunorubicin and presented an all-trans-retinoic acid syndrome. Despite hematological remission, the patient presented neurologic deterioration and had to be treated with radiotherapy (total dose 3000 cGy) of the extradural lesion. The patient evolved with severe sepsis and died without any recovery from his neurologic deficit. Extramedullary infiltration is a very rare complication in acute promyelocytic leukemia. Most cases are related to relapse after initial treatment with all-trans-retinoic acid. The skin and the central nervous system are the most frequently involved sites. This is possibly the first case reported of this condition in which the patient had a symptomatic extradural mass.

This is a case study with a qualitative approach carried out to discuss the experience of a family facing a bone marrow transplant, and the nursing care based on the Calgary Model of Family Assessment and Intervention. Data were collected in June 2005, through interviews with the subjects, concomitant with the development of the genogram and eco-map during hospitalization in the Transplant Unit of Hospital das Clinicas, Federal University of Minas Gerais. It was found that the family re-organized itself to face the emerging health situation, with the support of the multidisciplinary transplant team, especially the care of nurses. The study allowed understanding how this family takes care, identifies potential problems and efforts to share responsibility in a situation of insecurity and suffering with an unfavorable prognosis. However, it was concluded that it is vital that the nursing team act as a facilitator in the search for their own solutions.

Se trata de un estudio de caso en el abordaje cualitativo con el fin de discutir la experiencia de una familia frente a un trasplante de médula ósea y los cuidados de enfermería basados en el Modelo Calgary de Evaluación e Intervención de Familia. Los datos fueron recolectados en junio de 2005, a través de entrevistas con los sujetos, concomitante a la elaboración del genograma y ecomapa durante la hospitalización en la Unidad de Trasplantes del Hospital de las Clínicas, Universidad Federal de Minas Gerais. Observamos que la familia se reorganizó al enfrentar la situación de salud emergente, teniendo como apoyo el equipo multidisciplinario del trasplante, en especial la atención del enfermero. El estudio permitió comprender cómo esta familia cuida, identifica potencial, dificultades y esfuerzos para compartir responsabilidades delante de una situación de inseguridad, sufrimiento con pronóstico poco favorable, pero es vital que la enfermería sea facilitadora de la búsquela y encuentro de sus propias soluciones.

No presente artigo trata-se de um estudo de caso de abordagem qualitativa feito com o objetivo de discutir a experiência de uma família em relação a um transplante de medula óssea e à assistência de enfermagem fundamentada no Modelo Calgary de Avaliação e Intervenção de Família. Os dados foram coletados em junho de 2005, por meio de entrevistas com os sujeitos, concomitantemente à elaboração do genograma e ecomapa durante a hospitalização na Unidade de Transplante do Hospital das Clínicas da Universidade Federal de Minas Gerais. Observou-se que a família se reorganizou para enfrentar a situação de saúde emergente, tendo como apoio a equipe multidisciplinar do transplante, em especial, o cuidado do enfermeiro. O estudo possibilitou compreender como esta família cuida, identifica potencial e dificuldades e envida esforços para partilhar responsabilidades diante de uma situação de insegurança e sofrimento ante um prognóstico pouco favorável, mas que é vital a enfermagem facilitar a busca e encontro de suas próprias soluções.

OBJECTIVE: This study aimed to examine the association between different inflammatory markers and specific clinical endpoints in patients with febrile neutropenia. METHOD: We prospectively evaluated the expression of procalcitonin (PCT), interleukin 8 (IL-8), induced protein-10, tumor necrosis factor alpha (TNF-a), two soluble TNF-a receptors (sTNF-R I and sTNF-R II), monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1 alpha, and eotaxin in 37 episodes of febrile neutropenia occurring in 31 hospitalized adult onco-hematologic patients. Peripheral blood samples were collected in the morning at inclusion (day of fever onset) and on days 1, 3, and 7 after the onset of fever. Approximately 2-3 ml of plasma was obtained from each blood sample and stored at -80°C. RESULTS: The sTNF-R II level at inclusion (day 1), the PCT level on the day of fever onset, and the change (day 3 - day 1) in the IL-8 and eotaxin levels were significantly higher in patients who died during the 28-day follow-up. A requirement for early adjustment of antimicrobial treatment was associated with higher day 3 levels of IL-8, sTNF-R II, PCT, and MCP-1. CONCLUSION: Procalcitonin, sTNF-R II, IL-8, MCP-1, and eotaxin could potentially be used to assess the risk of death and the requirement for early adjustment of antimicrobial treatment in febrile, neutropenic onco-hematologic patients. The levels of the other markers showed no association with any of the evaluated endpoints.

BACKGROUND: Infection/reactivation of cytomegalovirus is a major cause of morbidity and mortality in immunocompromised transplant patients. It has already been observed in kidney and liver transplantation patients that cytomegalovirus disease is accompanied by significant increases in circulating CD8+CD38+ T lymphocytes. There are no reports that study CD8+CD38+ T lymphocytes to monitor/diagnose cytomegalovirus disease in hematopoietic stem cell transplantation patients. OBJECTIVE: The aim of this study was to evaluate some cellular activation markers on circulating mononuclear cells (CD38 and HLA-DR) in patients submitted to hematopoietic stem cell transplantation and to establish any correlation with cytomegalovirus disease as diagnosed by antigenemia. METHODS: Blood samples of 15 transplant patients were analyzed by flow cytometry using anti-CD3, anti-CD4, anti-CD8, anti-CD38, CD16, CD56 and anti-HLA-DR monoclonal antibodies and the results were evaluated in respect to cytomegalovirus antigenemia measured by indirect immunofluorescence. Minitab for Windows was used for statistical analysis and a p-value < 0.05 was considered significant. RESULTS: Patients with positive antigenemia did not show any significant increase in the percentages of cells expressing the CD38 or HLADR activation markers when compared to patients with negative antigenemia. On the contrary, all patients showed high percentages of these cells independent of the presence of cytomegalovirus disease. CONCLUSIONS: This study suggests that the investigation of these lymphocyte sub-populations in patients submitted to hematopoietic stem cell transplantation does not seem to contribute to the early identification of cytomegalovirus disease.

As complicações pulmonares constituem importante causa de morbidade e mortalidade após o transplante de células-tronco hematopoiéticas (TCTH) ocorrendo em cerca de 30 a 60% dos receptores. O avanço na profilaxia e tratamento de complicações infecciosas tem aumentado de forma significativa a parcela de complicações pulmonares não infecciosas. O diagnóstico e o tratamento precoce destas complicações podem mudar o prognóstico dos receptores de transplante de células-tronco hematopoéticas. O objectivo deste estudo é rever as principais complicações não infecciosas associadas ao TCTH desde a realização do primeiro transplante de medula óssea em 1957. Foi realizada uma revisão sistemática da literatura utilizando-se a estratégia PICO para a construção das perguntas. Os descritores transplante de células-tronco hematopoiéticas, complicações pulmonares não infecciosas, revisão sistemática, em português e seus correspondentes em inglês, foram utilizados para acesso às seguintes bases de dados: MEDLINE, EBM, EMBASE, COCRANE LIBRARY, LILACS e SciELO. Nesta revisão foram identificados 263 trabalhos. Destes, 30 foram seleccionados para serem analisados na íntegra. As complicações pulmonares não infecciosas mais frequentemente descritas foram: bronquiolite obliterante, bronquiolite obliterante com pneumonia em organização, edema pulmonar, síndroma da pneumonia idiopática, síndroma da toxicidade pulmonar por droga, hemorragia alveolar difusa, síndroma do enxerto e trombo citolítico pulmonar.

Pulmonary complications are important cause of mortality and morbidity after hematopoietic stem cell transplantation, in 30% to 60% of the patients. Improvements in prophylaxis and treatment of infectious complications have been increasing the rate of non-infectious complications. Early diagnosis and treatment of those complications can significantly change the evolution of hematopoietic stem cell transplantation receptors. The objective of this study is to review the most frequent non-infection complications associated to hematopoietic stem cell transplantation since the first bone marrow transplantation performed in 1957. A systematic literature review was performed, using the PICO strategy to ask the questions. The descriptors hematopoietic stem cell transplantation, non-infectious pulmonary complications, systematic review, in portuguese and their english correspondents, were used to access the following databases: MEDLINE, EBM, Embase, Cocrane Library, LILACS and SciELO. In this review, 263 studies were identified, from which 31 were selected for full analyzis. The non-infection pulmonary complications most frequently found were: bronchiolitis obliterans, bronchiolitis obliterans organizing pneumonia, pulmonary edema, idiopathic pneumonia syndrome, delayed pulmonary toxicity syndrome, diffuse alveolar hemorrhage, engrafment syndrome and pulmonary cytolitic thrombi.

As leucemias agudas são doenças com alta morbimortalidade para as quais o transplante alogênico de medula óssea é uma opção terapêutica eficaz. Neste artigo, relatamos a experiência de um centro brasileiro com pacientes apresentando leucemia aguda que receberam um enxerto de medula óssea ou células-tronco periféricas de um doador familiar HLA idêntico no período de julho de 1995 a dezembro de 2005. Foi realizado um estudo de coorte retrospectivo, analisando dados de 125 pacientes com mediana de idade de 28,7 anos. Oitenta e um pacientes (64,8%) apresentavam leucemia mieloide aguda; 38 (30,4%), leucemia linfoide aguda; e seis (4,8%), leucemia bifenotípica. Trinta e dois pacientes encontravam-se em primeira remissão completa, 23 em segunda remissão e 70 com doença avançada (refratários, recidivados ou além da segunda remissão). A sobrevida global estimada em 10 anos foi de 22,9%. Em relação à situação clínica do paciente no momento do transplante, a sobrevida global em dez anos foi de 56,3% para pacientes em primeira remissão, 38% para os pacientes em segunda remissão, e 3,7% para os pacientes com doença avançada. Considerando-se os pacientes transplantados em primeira e segunda remissão, a evolução foi semelhante aos dados disponíveis na literatura. Entretanto, os resultados dos pacientes transplantados em fase avançada foram ruins, devendo-se discutir o papel do transplante para este grupo.

Acute leukemias are a group of diseases with high morbimortality. Allogeneic bone marrow transplantation is an efficacious therapeutic option for their treatment. We report the experience of a Brazilian center in respect to acute leukemia patients who received a bone marrow or peripheral blood allograft from a HLA-matched sibling from July 1995 to December 2005. Data were retrospectively collected. The median age of the 125 patients included in the study was 28.7 years. Eighty-one patients presented with acute myeloid leukemia, 38 with acute lymphocytic leukemia and six patients with biphenotypic leukemia. Thirty-two patients were in first complete remission, while 23 were in second remission and 70 were transplanted in an advanced disease stage (refractory, relapsed, or beyond second remission). Overall expected survival at 10 years was 22.9%; the expected survival was 56.3%, 38%, and 3.7% for patients in first remission, second remission and for patients with advanced disease, respectively. In conclusion, the evolution of patients transplanted in first or second remission was similar to other published studies. On the contrary, patients with advanced disease showed a dismal prognosis. The role of allogeneic transplantation in this group of patients should be further discussed.

Investigou-se o efeito das coberturas de inverno centeio, aveia, azevém, ervilhaca e nabo forrageiro (e suas associações), em sistema de plantio direto, sobre a cobertura do solo e a produção de biomassa das coberturas de inverno, sobre a biomassa de plantas espontâneas de verão, no período crítico de competição, e sobre a produtividade do feijão, cv Guará. O experimento foi instalado em delineamento experimental constituído por blocos ao acaso com quatro repetições. Observaram-se as maiores percentagens de cobertura do solo no inverno, com os tratamentos centeio + ervilhaca, centeio + ervilhaca + nabo forrageiro e aveia + ervilhaca; a produção de biomassa de cobertura foi maior com centeio + ervilhaca + nabo forrageiro. O efeito de supressão observado foi maior no monocultivo de azevém e no consórcio de centeio + ervilhaca + nabo forrageiro, porém não foi detectada correlação da biomassa de cobertura com a supressão de plantas espontâneas de verão. Os melhores rendimentos de feijão foram obtidos com o monocultivo de azevém, monocultivo de aveia e combinação centeio + ervilhaca, que atingiram 1.950, 1.730 e 1.790 kg ha-1, respectivamente. O azevém e a aveia em monocultivo apresentaram os menores custos com sementes e as maiores receitas, ou seja, os maiores retornos por unidade monetária investida.

The effect of the winter cover crops rye, oat, ryegrass, vetch and fodder radish (and their mixtures) in no-tillage systems was investigated on soil cover, cover crop biomass and summer weed biomass during the critical competition stage with common bean. Bean yield was also evaluated. The experimental design was randomized complete blocks and four repetitions. The highest soil cover during winter was observed in the treatments rye + vetch, rye + vetch + fodder radish and oat + vetch. The highest values of cover crops biomass production were observed in the treatments rye + vetch + fodder radish. Weed suppression was higher in the ryegrass monoculture and in the rye + vetch + fodder radish association, and there was no correlation between cover crop biomass and summer weed suppression; the best bean yields were achieved with the following treatments: ryegrass in monoculture, oat in monoculture and rye + vetch, producing 1,950, 1,730 e 1,790 kg ha-1 respectively. The monocultures of ryegrass and oat showed the lowest costs with seeds and the highest economic returns.

Dados do Registro Internacional de Transplante de Medula Óssea, International Bone Marrow Transplant Registry (IBMTR) contribuem para o progresso do transplante de medula óssea (TMO) em todo o mundo. Neste artigo relatamos a experiência brasileira em leucemia mielóide aguda e comparamos os resultados do TMO com os dados internacionais. Foi realizado um estudo retrospectivo com dados de tratamento de LMA com o TMO de 16 instituições brasileiras. A análise estatística dos transplantes da modalidade autogênica (TMO auto) e alogênica (TMO alo) foi realizada com o método de Kaplan-Meier e log-rank. Todos os valores de p foram bicaudados. Foram avaliados os dados de 731 pacientes (205 TMO auto e 526 TMO alo). A mediana de sobrevida global dos pacientes submetidos ao TMO auto foi superior à dos submetidos ao TMO alo (1.035 vs 466 dias, p=0,0012). A origem das células-tronco (OCT) no TMO alo em 73% dos pacientes foi de medula óssea (CTMO), em 23% de sangue periférico (CTSP) e em 4% de cordão umbilical. No TMO auto, a OCT foi 63% de CTSP, 22% CTMO e 15% de ambas as fontes. A OCT não teve impacto na sobrevida global (SG). Não houve diferença na SG também entre os pacientes segundo a classificação FAB no TMO alo, mas os pacientes com LMA M3 com o TMO auto tiveram SG longa. Como esperado, a principal causa de óbito entre os pacientes do TMO auto foi relacionada à recidiva de doença (60%), enquanto no TMO alo as principais causas foram a doença enxerto versus hospedeiro e infecções (38%). Em ambos os grupos foi observada SG mais longa nos pacientes tratados em primeira remissão completa (1RC) quando comparados aos de segunda remissão (2RC) e outras fases (p<0,0001), tendo sido observado SG mais longa nos pacientes com LMA de novo quando comparados aos de LMA secundária. No TMO alo a SG foi mais longa com doadores aparentados (538 versus 93 dias p=0,001). A SG foi mais curta nos pacientes que utilizaram irradiação corpórea total no regime de condicionamento (p=0,0001). No TMO alo foram observados mais pacientes com doença avançada (60%) enquanto no grupo de TMO auto 24% eram da morfologia M3, o que pode explicar a diferença de SG entre os grupos. O resultado do estudo está em concordância com os dados do IBMTR. Considerando a natureza do estudo, retrospectivo e multicêntrico, os resultados devem ser analisados com cautela.

Data from the International Bone Marrow Transplant Registry (IBMTR) contribute for the improvement of Bone Marrow Transplant (BMT) worldwide. We studied the Brazilian experience in BMT for AML to compare this with international data. We performed a retrospective study by sending questionnaires to 16 BMT centers regarding clinical and treatment variables. Statistical analyses concerning autologous BMT (autoBMT) and allogeneic BMT (alloBMT) were performed using the Kaplan-Meier method and the log-rank test. All p-values were two-tailed. We collected data from 731 patients (205 autoBMT and 526 alloBMT). Median overall survival (OS) for autoBMT patients was longer than alloBMT patients (1035 vs. 466 days, p=0.0012). AlloBMT stem cell source (SCS): 73% bone marrow stem cell (BMSC), 23% peripheral blood stem cells (PBSC) and 4% umbilical cord blood. Among the autoBMT patients, the SCS was 63% PBSC, 22% BMSC and 15% both. The SCS did not impact on OS. There was no difference in OS between different FAB classifications in the alloBMT group, but in the autoBMT the M3 patients had longer survival. As expected, the main cause of mortality among autoBMT patients was related to disease relapse (60%), while in the alloBMT, to infection (38%). In both groups we found longer OS in first complete remission (1CR) compared to second (2CR) and other (p<0.0001), and longer OS in de novo AML than in secondary. In the alloBMT group we found more patients with advanced disease (60%), while in the autoBMT group, we found more M3 patients (24%), which could explain the difference in OS. Most of our results are in accordance with IBMTR data. One should consider the fact that this is a retrospective study and our findings should be analysed with caution.