ABSTRACT Background: Hematopoietic stem cell transplantation is a curative treatment for many patients with hematological disorders. Donor–recipient genetic disparity, especially involving the human leukocyte antigen system is a critical factor for transplant outcome. Objective: To evaluate retrospectively donor characteristics and correlations with the occurrence of acute and chronic graft-versus-host disease, disease-free survival and overall survival in a Brazilian population submitted to allogeneic hematopoietic stem cell transplantation between 1994 and 2012 in a single center. Results: Three hundred and forty-seven consecutive transplantations were included. Related transplants (81.2%) were significantly more common than unrelated transplants (18.7%); donor and recipient median ages were 34 (range: 1–61) and 33 (range: 3–65) years respectively with donor HLAs being matched for 333 (95.9%) patients. Donor gender, cytomegalovirus status and ABO incompatibility did not influence the five-year overall survival. In univariate analyses, overall survival was negatively influenced by the presence of acute graft-versus-host disease (33% vs. 47%, respectively; p-value = 0.04), unrelated transplant (41.5% vs. 50.9%, respectively; p-value = 0.045) and donors aged over 40 years (41% vs. 52%, respectively; p-value = 0.03). Older donors were associated with a higher rate of acute (52% vs. 65.8%; p-value = 0.03) and chronic graft-versus-host disease (60% vs. 43%, respectively; p-value = 0.015). In multivariate analyses, acute graft-versus-host disease [relative risk (RR): 1.8; 95% confidence interval (CI): 1.1–29; p-value = 0.008] and older donors (RR: 1.6; 95% CI 1.11–2.24; p-value = 0.013) were associated with higher transplant-related mortality. Conclusions: In transplant patients, to have a donor older than 40 years of age seems to significantly increase the incidence of acute and chronic graft-versus-host disease and transplant-related mortality with no impact on disease-free survival and overall survival. In spite of the rather small cohort of patients, these findings are similar to what is described in the literature suggesting that a younger donor should be chosen whenever possible.

Background: Cyclosporine and tacrolimus are limited by a narrow therapeutic window. Maintaining immunosuppressive drugs at desired levels may be difficult. Pharmaceutical care emerges as a philosophy of practice that enhances medication use and leads to a better control of serum concentration. Objective: This study aims to evaluate the impact of pharmaceutical care in the maintaining of proper serum levels of immunosuppressive medications in patients who have undergone allo-HSCT. Methods: The study had a quasi-experimental design that included a comparison group. The service model used was pharmacotherapy follow-up, according to an adaptation of the Dader method. The pharmacist consultation was carried out at a day-hospital or at the outpatient hematology clinic as needed. The intervention group consisted of 22 patients seen by a clinical pharmacist. The control group consisted of 44 patients that received standard care. This study aims to evaluate the impact of pharmaceutical care on keeping patient serum levels of cyclosporine and tacrolimus within the desired range. Results: Control group displayed 65% of the proper serum levels of immunosuppressive agents. While In intervention group, the figure was 82% (p = 0.004). Conclusion: The role of the pharmacist in the multidisciplinary team may contribute to a greater success in attaining the patients' therapeutic targets with regard to the use of immunosuppressant.

A conversão de biomassas agroindustriais em bioetanol com consequente valorização de rejeitos e resíduos, tem sido objeto de estudos de várias pesquisas realizadas no Brasil e no mundo. Neste trabalho foi avaliada a potencialidade do uso da polpa e da casca da banana (Musa cavendishii ), tanto in natura como previamente hidrolisada por ácido e enzimas, como substrato da fermentação alcoólica. Os rendimentos médios em bioetanol (em base úmida de biomassa) obtidos com a polpa (0,48 ± 0,05 g g-1) e com a casca (0,34 ± 0,11 g g-1), ambos in natura, possibilitaram a eficiência do processo de conversão, da ordem de 95% do rendimento teórico. A produtividade máxima alcançada em bioetanol foi de 3,0 ± 0,7 g L-1 h-1 com o uso da polpa e de 1,32 ± 0,03 g L-1 h-1 com a casca. Nas condições operacionais avaliadas o pretratamento dos resíduos com ácido sulfúrico não é recomendado para a produção de bioetanol.

The conversion of agroindustrial biomasses in bioethanol with consequent enrichment of wastes has been the object of various research projects conducted in Brazil and around the world. This study evaluated the potential of the Musa cavendishii banana pulp and peels using in natural state and also waste previously hydrolyzed by acid and enzimes, as substrate of alcoholic fermentation. The mean bioethanol yields (on wet biomass base), obtained with the pulp (0.48 ± 0.05 g g-1) and with the peels (0.34 ± 0.11 g g-1), both in natural state, enabled a conversion process efficiency to the order of 95% of theoretical yield. Maximum value reached in bioethanol was 3.0 ± 0.7 g L-1 h-1 with pulp and 1.32 ± 0.03 g L-1 h-1 with peels. Under the evaluated operating conditions, the pre-treatment of wastes with sulfuric acid is not recommended for bioethanol production.