OBJECTIVES: The outcomes of refractory and relapsed acute myeloid leukemia (AML) patients in developing countries are underreported, even though the similar classic regimens are widely used. METHODS: We conducted a retrospective comparison of “MEC” (mitoxantrone, etoposide, and cytarabine) and “FLAG-IDA” (fludarabine, cytarabine, idarubicin, and filgrastim) in adults with first relapse or refractory AML. RESULTS: In total, 60 patients were included, of which 28 patients received MEC and 32 received FLAG-IDA. A complete response (CR) rate of 48.3% was observed. Of the included patients, 16 (27%) died before undergoing bone marrow assessment. No statiscally significant difference in CR rate was found between the two protocols (p=0.447). The median survival in the total cohort was 4 months, with a 3-year overall survival (OS) rate of 9.7%. In a multivariable model including age, fms-like tyrosine kinase 3 (FLT3) status, and stem-cell transplantation (SCT), only the last two indicators remained significant: FLT3-ITD mutation (hazard ratio [HR]=4.6, p<0.001) and SCT (HR=0.43, p=0.01). CONCLUSION: In our analysis, there were no significant differences between the chosen regimens. High rates of early toxicity were found, emphasizing the role of supportive care and judicious selection of patients who are eligible for intensive salvage therapy in this setting. The FLT3-ITD mutation and SCT remained significant factors for survival in our study, in line with the results of previous studies.

Resumo: Estudou-se o tecido germinativo ovariano do peixe Melanotaenia boesemani. Por meio de análises morfológicas das gônadas, realizadas após a confecção de lâminas histológicas elaboradas em parafina e coradas com hematoxilina-eosina, foram descritos os tipos celulares encontrados e realizada a classificação do estádio de maturidade dos peixes. Macroscopicamente, foi identificado que a referida espécie possui ovário único, arredondado e, na fase observada, amarelado, localizado na parte látero-anterior da cavidade celomática. As fêmeas analisadas foram classificadas na escala de desenvolvimento gonadal como maduro/em reprodução. A presença de folículos vazios e marcas de desova nas lamelas ovulígeras mostrou-se evidente. Nos ovócitos vitelogênicos deste peixe, foi constatada a presença de filamentos de adesão ovocitária ancorados à zona pelúcida. Os ovários apresentaram aspecto morfológico geral semelhante ao de outros peixes teleósteos. Seu tipo de desova foi classificado como intermitente e o padrão de desenvolvimento de ovócitos, como assincrônico.

Abstract: The germinal ovarian tissue of the fish Melanotaenia boesemani was studied. By means of morphological analyses of the gonads, performed after the manufacture of histological slides made of paraffin and stained with hematoxylin-eosin, the cell types found were described and the rank of the maturity stage of the fishes was executed. Macroscopically was found that the species has only one ovary, rounded and in the observed phase yellowish, located in the lateral front part of the coelomic cavity. The observed females were classified in the gonadal development scale as mature/in reproduction. The presence of empty follicles and spawning marks on ovigerous lamellae proved to be evident. In vitellogenic oocytes of this fish, the presence of filaments of oocyte adhesion anchored to the pellucida zona was found. The ovaries showed general morphological appearance similar to that of other teleost fishes. Its spawning type was classified as intermittent and the pattern of development of oocytes as asynchronous.