Biological diversity variations of pediatric acute leukemia in Brazil: contribution of immunophenotypic profiles to epidemiological studies

Pombo‐de‐Oliveira, Maria S.; Córdoba, José Carlos; Alencar, Dora Maria; Campos, Maria Martha; Carriço, Kadma; Dobbin, Jane; Dorea, Maria Dolores Fonseca; Ferreira, Regina; Mendonça, Núbia; Magalhães, Isis Quezado

doi:10.1590/s1516-84842005000100007

Cited by 2 publications

(6 citation statements)

References 21 publications

(22 reference statements)

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“…A higher number of ALL, in the age group of 0–10 years and B subtype is shown here and corroborates with other studies which describe it as the most common epidemiological pattern, however, the etiological factor was not analyzed in our study [10,11,15,22,25,40,41].…”

Section: Discussionsupporting

confidence: 92%

Acute lymphoid and myeloid leukemia in a Brazilian Amazon population: Epidemiology and predictors of comorbidity and deaths

et al. 2019

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Introduction Leukemia is the most common cancer in children and has the highest rates of incidence in industrialized countries, followed by developing countries. This epidemiologic profile can mainly be attributed to the availability of diagnostic resources. In Brazil, leukemia diagnosis is a challenge due to financial viability, lack of hemovigilance services in isolated regions and the vast size of the territory. Its incidence in the state of Amazonas has been increasing since 2010. Therefore, this study aims to describe the epidemiological pattern and spatial distribution of patients with acute lymphoid leukemia and acute myeloid leukemia in Amazonas and identify the predictors of comorbidity and death. Materials and methods A retrospective cross-sectional study was carried out based on patients’ data which was obtained from the database of a referral center for the period of 2005 to 2015. Variables included age, gender, ethnicity, civil status, schooling, income, location of residence, subtype of leukemia, comorbidities, and date of death. The spatial distribution was performed using QGIS v.2.18. Stata software was used for univariable and multivariable logistic regression to evaluate the association between both comorbidities and death for all characteristic groups of ALL and AML. Results The group that was studied was composed of 577 ALL and 266 AML patients. For both, most patients were male, with a schooling period of 1–4 years, received<1 minimum wage, and lived mostly in Manaus, followed by the municipality of Tefé. There was no association between the development of comorbidities and analyzed variables in patients with ALL. AML patients that were >60 years old and with family history of the disease had the highest risk of developing comorbidities (OR = 5.06, p = 0.038; OR = 2.44, p = 0.041, respectively). Furthermore, patients with ALL and in the 41-50-year age group had a higher risk of death (OR = 31.12; p = 0.001). No association between death and explanatory variables were found in patients with AML. In addition, significant difference was observed in time to death (chi2 = 4,098.32, p = 0.000), with 50% of patients with AML dying within two years after diagnosis, whereas in ALL, this percentual of death only is reached in approximately 5 years. Conclusion Our study describes the data of patients with acute leukemia in Amazonas, a remote region in the north of Brazil. In addition, it highlights the importance of hemovigilance in an Amazon region state, while focusing on peripheral areas which don't have prevention, diagnosis and treatment tools for this disease.

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Section: Discussionsupporting

confidence: 92%

Acute lymphoid and myeloid leukemia in a Brazilian Amazon population: Epidemiology and predictors of comorbidity and deaths

et al. 2019

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“…25 Another factor associated with increased frequency of T-ALL is ethnic origin, since the T phenotype has been shown to be more frequent among nonwhites. 13 Taking into consideration that the state of Maranhão is the second poorest in Brazil, 26 and that the population is predominantly nonwhite, 27 this may explain the high incidence of T-ALL found in the present investigation.…”

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confidence: 73%

“…In a study involving children from the states of Rio de Janeiro and Bahia and the Federal District, the ratio of males to females was 1.2:1. 13 In the state of Pernambuco, this ratio was 1.7:1, 20 while in Ribeirão Preto (city in the state of São Paulo), it was 1.8:1 for all subtypes of ALL,…”

Section: Discussionmentioning

confidence: 97%

“…[9][10][11] Analysis of the incidence of leukemia subtypes across the world has revealed important variations in relation to geographical distribution, sex, age, ethnicity and socioeconomic status, thus suggesting that several etiological factors exist. 12,13 Therefore, further studies on the frequencies of different subtypes of acute leukemias are of great importance, especially in regions with different socioeconomic characteristics such as the northeast of Brazil, where such data are scarce.…”

Section: Introductionmentioning

confidence: 99%

“…In the population of Maranhão, the children presented a higher frequency of T-ALL (27%) than what is generally described in the literature (7.3% to 16%). 13 …”

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confidence: 99%

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Immunophenotypic characterization of acute leukemia at a public oncology reference center in Maranhão, northeastern Brazil

et al. 2011

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CONTEXT AND OBJECTIVES: The incidence of acute leukemia (AL) subtypes varies according to geographical distribution. The aim here was to determine the incidence of morphological and immunophenotypic AL subtypes in the state of Maranhão, Brazil, and to correlate the expression of aberrant phenotypes in children with acute lymphoblastic leukemia (ALL) with prognostic factors. DESIGN AND SETTING: Single prospective cohort study at a public oncology reference center in Maranhão. METHODS: Seventy AL cases were diagnosed between September 2008 and January 2010. For the diagnosis, complete blood cell counts, myelograms (at diagnosis and at the end of the induction phase), cytochemical analysis and immunophenotyping were performed. RESULTS: Among adult patients (n = 22), the incidence of AL types was: ALL (22.7%) and acute myeloid leukemia (AML) (77.3%). The subtype AML M0 occurred most frequently (29.4%). In children (n = 48), the types were: AML (18.7%), most frequently subtype AML M4 (33.4%); biphenotypic acute leukemia (BAL) (4.2%); and ALL (77.1%), including the subtypes B-ALL (72.9%) and T-ALL (27.1%). Among the children with ALL, there were no statistically significant differences between patients with and without aberrant phenotypes, in relation to hematological parameters and treatment response. CONCLUSION: This work demonstrates that the frequencies of AML M0 cases among adults and T-ALL cases among children in Maranhão were high. This suggests that there may be differences in AML subtype incidence, as seen with ALL subtypes, in different regions of Brazil. No association was found between the expression of aberrant phenotypes and prognostic factors, in children with ALL. -T (27,1%). Na LLA, em crianças, não se encontrou diferença estatisticamente significante entre pacientes com e sem fenótipos aberrantes, em relação aos parâmetros hematológicos e resposta ao tratamento. CONCLUSÃO: Esta pesquisa demonstra elevada frequência de casos de LMA M0 em adultos, bem como das LLA-T em crianças no Maranhão, sugerindo que podem haver diferenças na incidência dos subtipos das LMA, assim como dos subtipos de LLA, em diferentes regiões do Brasil. Não foi encontrada associação entre a expressão de fenótipos aberrantes e fatores prognósticos em crianças com LLA.

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Biological diversity variations of pediatric acute leukemia in Brazil: contribution of immunophenotypic profiles to epidemiological studies

Cited by 2 publications

References 21 publications

Acute lymphoid and myeloid leukemia in a Brazilian Amazon population: Epidemiology and predictors of comorbidity and deaths

Acute lymphoid and myeloid leukemia in a Brazilian Amazon population: Epidemiology and predictors of comorbidity and deaths

Immunophenotypic characterization of acute leukemia at a public oncology reference center in Maranhão, northeastern Brazil

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