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Acute Lymphoblastic Leukemia is a very aggressive malignant disorder of lymphoid cells in adults, with recurrence (30 to 60% of the cases) after the initial treatment. Until this moment, there is no gold standard therapy for the treatment of adult patients with acute relapsed/refractory lymphoblastic leukemia. In this case report, we describe two cases of relapsed leukemia: one of lymphocytic leukemia B and one of trilineage leukemia, which presented a satisfactory response to treatment with Bortezomib associated with Vincristine, Dexamethasone, and Bendamustine. [ABSTRACT FROM AUTHOR]

• In pre-hematopoietic stem cell transplantation (HSCT) treated and untreated patients, there is no difference in survival. • The type of pre-HSCT treatment has a significant difference in overall survival. • Hypomethylating agents and chemotherapy in pre-HSCT treatment improve myelodysplastic syndrome survival. It has been suggested that bridging therapy with intensive chemotherapy and/or hypomethylating agents followed by hematopoietic stem cell transplantation (HSCT) can be valuable in the treatment of patients with myelodysplastic syndromes (MDS). However, the influence of this approach on HSCT outcomes remains poorly defined. Therefore, our objective was to investigate the influence of treatment before HSCT in patients with MDS. We retrospectively analyzed data from the Latin American registry of 258 patients from 17 Latin American centers who underwent HSCT from 1988 to 2019. Our data showed that there was pre-HSCT. We detected no significant difference regarding the impact on overall survival of treated and untreated patients before HSCT. Despite these data, the type of previous treatment among treated patients showed a significant difference in overall survival. Treatment with hypomethylating agents together with pre-HSCT chemotherapy seems to result in better survival of the studied population. These data correspond to the first results obtained through cooperative work between various centers in Latin America comparing the different approaches to patients and reflecting their reality and challenges. Therefore, the selection of pretransplant bridge therapy should be analyzed and focus given primarily to those approaches that result in better survival of patients with MDS. [ABSTRACT FROM AUTHOR]

Several factors may interfere with the response to hematopoietic stem cell transplantation (HSCT) in myelodysplastic syndrome (MDS). To evaluate the effect of cell source and type of conditioning on HSCT outcome in MDS. We analyzed data from 258 MDS patients from the Latin American transplant registry in Brazil and Uruguay from 1988 to 2019. The statistics were performed on SPSS v.23.1, considering significant p < 0.05. A predominance of males (56.2%) and Caucasian individuals (84.5%) was observed. The most frequent age group was 51 to 60 years (2 -79 years) (26%). When stratified according to the Prognosis Scoring System (IPSS-R), 0.78% were classified as very low risk, 11.2% as low risk, 24% as intermediate risk, 21.3% as high risk and 4.7% as very high risk. A total of 38% of patients could not be classified according to the IPSS-R due to lack of data, such as cytogenetics. In myeloablative conditioning (MAC) (78.7%) the regimens were (bulssulfan/fludarabine, bulssulfan/cyclophosphamide, with or without total body irradiation (ICT)). Reduced intensity (RIC) (15.9%) was (bulssulfan/fludarabine, bulssulfan/cyclosphosphamide at reduced doses, with or without ICT and FluMel). The cell source was bone marrow (BM) (52.7%), peripheral blood (PB) (45.3%) and cord blood (2%). Major post-HSCT complications included acute (37.2%) and chronic (28.7%) graft versus host disease (GVHD). Regarding the possible predictors of acute, chronic GvHD and death, there was an association between type of cell source and the death outcome (p = 0.0336). Moreover, there was a significant association between acute GvHD and conditioning regimen (p = 0.0127) and cell source (p = 0.0004). There was also an association of chronic GvHD with the conditioning regimen (p <0.0001) and donor type (p = 0.0246). In binary logistic regression analysis, MAC was 2.81 times more likely to develop acute GVHD than RIC (OR: 2.81; 95%CI:1.1-7.15; p = 0.031). MAC was also 7.35 times more likely to develop chronic GVHD than RIC (OR: 0.14; 95%CI:0.03-0.6; p = 0.008). The type of donor showed no influence on the outcome acute, chronic GVHD and death after HSCT. Cell source type was a significant predictor of death in patients. BM was 2.09 times more likely to death than PB (OR:2.09; 95%CI:1.25-3.51; p = 0.005) Overall survival was higher with PB (p = 0.0478). The overall survival at 6 years was 51.33%. The results demonstrate the impact of conditioning and cell source on the HSCT outcome and reinforce the need for an appropriate assessment for better conduction results optimization. [ABSTRACT FROM AUTHOR]

Introduction Although there are 70 TCs in Brazil, the HCT data reporting (DR) for a local database has not been made feasible yet; beyond that, the number of Brazilian TCs reporting for any international research database (IRD) is still small. Reporting HCT data for an IRD generates scientific information, enabling medical professionals to understand and analyze the HCT results among the TCs worldwide. This TC performed 670 HCTs (autologous and allogeneic) along 13 years. In January 2017, we started to submit data to the CIBMTR (Center for International Blood & Marrow Transplant Research). So far, 154 forms have been reported: 110 Transplant Essential Data (TED) forms and 44 Comprehensive Report Forms (CRF). The main challenges faced in the beginning were the following: understanding the data flow and identifying the data to be reported, taking part in online trainings (all offered in English language), seting up the DM team and implementing a process to help data collection. This TC's DM team consists of 2 nurses and 1 secretary working on part-time basis and partially focused on data management. DM collects data from patient's medical files, organize, scan and store data, and report follow-up and current HCT data on the FormsNet3 platform. Objective Show how this TC is structured to report data for an IRD. Introduce the strategies developed to cope with the challenges arisen along the process. Suggest alternatives to enhance the quality of the data collection. Methods Development of forms for each disease, both pre-transplantation and post-discharge. Development of auxiliary charts for the classification of disease, disease status, Karnofsky scale, degree of toxicities and graft versus host disease (all available in hard copy and e-file, rapidly and easily accessed from any device). Presentation meeting to introduce CIBMTR and sensitize the multiprofessional team to the impact of data registry on the researches, collaborating with the global scientific community to HCT advances. Creation of an exclusive e-mail to receive exams and other information about the patients involved in the project. Participation of the DM nurses in the weekly multiprofessional meeting and in the daily medical visit to the inpatients. Participation in local and international events addressed to DMs. Conclusion The events addressed to DMs are opportunities to share and exchange both experience and knowledge with DMs from other TCs worldwide and, consequently, improve DR. Additionally, the DM nurses participation in the hospital visits adds value to the data registry for it is an opportunity to check and detail information. Despite all the strategies developed, the data collection is still time consuming because part of the medical team are not fully sensitized to the importance of filling out the forms properly. However, the delay in reporting to CIBMTR is also due to the fact of DMs are not full time dedicated to the project. [ABSTRACT FROM AUTHOR]