Made available in DSpace on 2014-12-17T14:16:28Z (GMT). No. of bitstreams: 1 RobertoCV_DISSERT.pdf: 2201581 bytes, checksum: a5ed04f6ae5794f328192fe513bdf03f (MD5) Previous issue date: 2010-02-24 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The acute myeloid leukemia (AML) is a disease in which malignant myeloblasts expand, build up and suppress normal hematopoietic activity would represent a major diagnostic challenge. With the advent of immunophenotyping by flow cytometry, the diagnosis of these tumors have become more faithful, facilitating the treatment and monitoring of patients. The objectives of this study: diagnosis and classification of AML based on immunophenotyping by flow cytometry with a panel of AcMo specific for acute leukemias, set the frequency of AML in samples from patients with acute leukemias sent to the Department of Hematology Blood Center of Rio Grande do Norte - HEMONORTE, establish standards of antigen expression for different subtypes of acute leukemia and its correlation with the newly diagnosed cases refractory to treatment and recurrence of the disease, standardization of methods for detection and labeling of surface antigens by flow cytometry and intracytoplasmic flow, and observe the frequency of acute leukemia with aberrant phenotypes rare. During the study, 351 were diagnosed acute leukemia, and 179 (51%) classified as AML and 172 (49%) and ALL, which were excluded from the present work. Of the 179 AML, 92 (51.4%) were female and 87 (48.6%) were male, with ages ranging from 3 to 95 years of ag, with higher incidence in individuals in the age group of 41 to 65. Splenomegaly was the clinical finding more present, a total of 147 cases (82.1%), followed by hepatomegaly present in 132 cases (73.7%). The hemorrhagic events were observed in 55 cases (30.7%). Lymphadenopathy in turn was detected in 20 of 179 cases (11.2%). In order to classify subtypes of AML, we used a large panel of monoclonal antibodies, obtaining the following results: AML M0, 02 (1.1%) AML M1, 40 (22.3) AML M2, 60 (33.5) AML M3, 22 (12.3%) AML M4, 10 (5.6) AML M5, 13 (7.3%) AML M6 06 (3.4%) and AML M7 01 (0.6%). We observed some cases with aberrant expression of some antigens such as CD7, CD4, CD19, CD3, CD5 and TdT, CD 7 was present in 30 (16.8%), CD4 in 5 (2.8%), the CD 3 in 5 (2.8%), the CD19 in 3 (1.7%), the CD5 in 3 (1.7%) and TDT was in 7 (3.9%) cases of AML .the CD8 and CD79a was present in only a 1 case. / A Leucemia Miel?ide Aguda (LMA) ? uma doen?a maligna em que os mieloblastos expandem-se, acumulam-se e suprimem a atividade hematopo?tica normal, constituindo um grande desafio diagn?stico. Com o advento da imunofenotipagem por citometria de fluxo, o diagn?stico dessas neoplasias se tornaram mais fi?is, facilitando o tratamento e o acompanhamento dos pacientes. Foram objetivos deste estudo: diagnosticar e classificar as LMA com base na imunofenotipagem por citometria de fluxo, com um painel de AcMo espec?fico para leucemias agudas; estabelecer a frequ?ncia de LMA nas amostras de pacientes com leucemias agudas encaminhadas ao Departamento de Hematologia do Hemocentro do Rio Grande do Norte HEMONORTE; estabelecer padr?es de express?o antig?nica para os diversos subtipos de leucemias agudas e a sua correla??o com os casos rec?m diagnosticados, refrat?rios ao tratamento e recorr?ncia da doen?a; padroniza??o dos m?todos de detec??o e marca??o de ant?genos de superf?cie e intracitoplasm?tico por citometria de fluxo; e observar a freq??ncia de leucemias agudas com fen?tipos aberrantes raros. Durante o estudo, foram diagnosticados 351 leucemias agudas, sendo 179 (51%) classificadas como LMA e 172 (49%) como LLA, as quais foram exclu?das do presente trabalho. Das 179 LMA, 92 (51,4%) eram do sexo feminino e 87 (48,6%) do sexo masculino, com faixa et?ria variando de 3 a 95 anos de idade, com maior incid?ncia em indiv?duos na faixa et?ria de 41 a 65 anos. A esplenomegalia foi o achado cl?nico mais presente, perfazendo um total de 147 casos (82,1%), seguida da hepatomegalia presente em 132 casos (73,7%). Os fen?menos hemorragicos foram observado em 55 casos ( 30,7%). A linfoadenopatia por sua vez foi constatada em 20 dos 179 casos (11,2%). Para classifica??o dos subtipos de LMA foi utilizado um painel amplo de anticorpos monoclonais, obtendo os seguintes resultados: LMA M0, 02 (1.1%) LMA M1, 40 (22.3) LMA M2, 60 (33.5) LMA M3, 22 (12.3%) LMA M4, 10 (5.6) LMA M5, 13 (7.3%) LMA M6 06 (3.4%) e LMA M7 01 (0.6%). Foram observados alguns casos com express?o aberrante de alguns ant?genos tais como CD7, CD4, CD19, CD3, CD5 e TdT, O CD7 esteve presente em 30 (16,8%) , o CD4 em 5 (2,8%), o CD 3 em 5 (2,8%), o CD19 em 3 (1,7%), o CD5 em 3 (1,7%) e o TDT esteve em 7 (3,9%) casos de LMA diagnosticados.O CD8 e o CD79a esteve presente em apenas um 1 caso.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-01-04T19:56:36Z No. of bitstreams: 1 AndreaLucianaAraujoDaCunha_TESE.pdf: 62271689 bytes, checksum: f3e505d6758068c74606405cf05b2b9c (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-01-05T19:52:34Z (GMT) No. of bitstreams: 1 AndreaLucianaAraujoDaCunha_TESE.pdf: 62271689 bytes, checksum: f3e505d6758068c74606405cf05b2b9c (MD5) / Made available in DSpace on 2016-01-05T19:52:34Z (GMT). No. of bitstreams: 1 AndreaLucianaAraujoDaCunha_TESE.pdf: 62271689 bytes, checksum: f3e505d6758068c74606405cf05b2b9c (MD5) Previous issue date: 2013-08-30 / Despite the advances in the cure rate for acute myeloid leukemia, a considerable number of patients die from their disease due to the occurrence of multidrug resistance (MDR). Overexpression of the transporter proteins P-glycoprotein (Pgp) and multidrug resistance-associated protein (MRP) confer resistance to the treatment these leukemias. OBJECTIVE: To analyze the expression of the Gpp and MRP1 in patients with AML by flow cytometry (FC) and to determine the correlation between expression and demographic and also clinical and laboratorial variables. METHODS: Bone marrow and peripheral blood samples from 346 patients with a diagnosis of AML were assessed for the expression of Pgp and MRP1 by FC. RESULTS: The expression of Pgp and MRP1 was found in 111 (32.1%) and 133 (38.4%) patients, respectively, with greater prevalence in older patients and lower in adolescents, observing also a high incidence in patients with refractory disease, recurrence and secondary in comparison with the cases of de novo AML. Regarding the laboratory findings, we observed a higher correlation statistically significant between the expression of Pgp and MRP1 in AML CD34+ and FAB AML M7, M5A and M2 and lower the M3 subtype, not observed statistically significant correlation between the phenotype MDR and other laboratory data such with hemoglobin, leukocyte count, platelet count, aberrant expression of lymphoid antigens (CD2, CD7 and CD19) and clinical signs related to the disease. CONCLUSIONS: The results showed that the detection of MDR phenotype by flow cytometry can be a molecular marker for prognosis independent patients diagnosed with AML.