ABSTRACT The novel coronavirus has swept across the world in 2020 and ushered a new era. In the current scenario, it is not clear how patients with myeloproliferative neoplasms (including chronic myelogenous leukemia) should be managed, considering the risk of therapy, the need for social distancing and the risk of untimely therapy discontinuation of delay. This guideline aims to give providers a sense of direction in order to better take care of patients and prioritize care.

ABSTRACT Splenic marginal zone lymphoma (SMZL) is a low-grade B-cell non-Hodgkin's lymphoma characterized by massive splenomegaly, moderate lymphocytosis with or without villous lymphocytes, rare involvement of peripheral lymph nodes and indolent clinical course. As a rare disease, with no randomized prospective trials, there is no standard of care for SMZL so far. Splenectomy has been done for many years as an attempt to control disease, but nowadays it has not been encouraged as first line because of new advances in therapy as rituximab, that are as effective with minimal toxicity. Facing these controversies, this review highlights advances in the literature regarding diagnosis, prognostic factors, treatment indications and therapeutic options.

OBJETIVOS: Identificar os principais achados fundoscópicos em pacientes portadores de anemia falciforme encaminhados a um Serviço Oftalmológico de Referência em Goiânia (GO). MÉTODOS: Foram realizados exames oftalmológicos em 50 pacientes (100 olhos) portadores de hemoglobinopatia falciforme para observar quais as alterações retinianas mais comuns nesse grupo. RESULTADOS: O tipo de hemoglobinopatia mais encontrado foi o SS, seguido pelas hemoglobinopatias SC, AS e Sthal. Dentro da amostra estudada, 22% apresentaram alterações retinianas. Destes 73% eram do sexo masculino. A alteração retinianas encontradas foram: "sea fan", "black sunburst", hemorragia vítrea e descolamento de retina. Em relação à classificação da retinopatia, 73% apresentaram a forma proliferativa, sendo vista nos tipos AS e SC e 27% apresentaram a forma não-proliferativa da retinopatia, sendo vista nos portadores do tipo SS. CONCLUSÃO: Foi observado elevado número de pacientes com alterações retinianas na amostra estudada, sendo o maior número em portadores da hemoglobinopatia SC, seguido dos grupos AS e SS. As alterações proliferativas foram as mais observadas. Hemorragia vítrea e descolamento de retina foram as manifestações proliferativas de maior prevalência e mostraram ser mais frequente em portadores da hemoglobinopatia SC na população estudada.

PURPOSE: To identify retinal manifestations in patients with sickle cell disease referred to a reference eye hospital in Goiânia (GO). METHODS: Ophthalmic evaluation was made in 50 patients (100 eyes) with sickle cell disease to evaluate the most common manifestations of this group. RESULTS: Hemoglobinopathy SS was the most commonly found, followed by hemoglobin SC, AS and Stahl. Twenty-two percent of the patients had retinal changes, of these 73% were male. Retinal changes observed were: "sea fan", "black sunburst", vitreous hemorrhage, and retinal detachment. In the classification of retinopathy, 73% had proliferative form, seen in the types AS and SC and 27% had non-proliferative retinopathy, seen in patients with SS type. CONCLUSIONS: We observed a large numbers of patients with retinal changes, most of them with hemoglobinopathy SC, followed by AS and SS groups. The proliferative changes were the most commonly observed. Vitreous hemorrhage and retinal detachment were the most prevalent manifestations in proliferative retinopathy and showed to be more common in patients with SC hemoglobinopathy in the studied population.

INTRODUÇÃO: A doença falciforme é a doença hereditária mais frequente no nosso país. O portador apresenta acometimentos físico, emocional e social, e sua qualidade de vida pode estar comprometida. OBJETIVO: Avaliar a qualidade de vida dos doentes falciformes em tratamento no Hospital das Clínicas da Universidade de Goiás. MÉTODO: Foram entrevistados 60 sujeitos entre 14 e 60 anos, doentes falciformes, em tratamento no Hospital das Clínicas. Aplicou-se o WHOQOL-Bref (instrumento avaliativo de qualidade de vida da Organização Mundial de Saúde - OMS), o questionário étnico-racial e o sociodemográfico. A significância foi definida por um erro padrão de 5% (p < 0,05). Os sujeitos eram do sexo feminino em 53,3% e solteiros em 71,7%. A média da idade foi de 27 anos e o nível educacional até o primeiro grau completo foi de 51,7%. RESULTADOS: A maioria considerou-se parda (46,7%) e a minoria, negra (11,7%). Apenas 6,7% disseram ser vítimas de preconceito devido à cor e 33,3% disseram ser vítimas de preconceito devido à doença. Os sujeitos relataram ligação entre doença e sua cor em 48,3%. A qualidade de vida foi avaliada negativa em 6,7% e, em 70%, positiva. Apresentaram satisfação negativa quanto à saúde 23,3% dos sujeitos e, em 48,3%, a satisfação foi positiva. Os escores do WHOQOL-Bref, de 0 a 100 foram: domínio físico (57,32), psicológico (66,03), social (69,86) e ambiental (52,76). CONCLUSÃO: Houve correlação significativa entre preconceito devido à doença e nível educacional, e entre idade e todos os domínios. A doença falciforme limita a vida do portador, com comprometimento da qualidade de vida. A doença está perdendo o caráter de "black related disease", coincidindo com a miscigenação racial brasileira.

INTRODUCTION: Sickle cell disease is the most common inherited disease in Brazil. Patients are known to suffer physical, emotional and social impairment and their quality of life may well be involved. METHOD: The quality of life of sickle cell disease patients treated in Hospital das Clínicas of the Universidade Federal de Goiás was evaluated. Sixty patients with ages ranging from 14 to 60 years old were interviewed. The WHOQOL-Bref (a quality of life validation instrument of the World Health Organization), and the ethnical-racial, and sociodemographic questionnaires were administered. A standard error of 5% (p-value < 0.05) was considered acceptable. RESULTS: The mean age of the participants was 27 years old, 53.3% of the patients were women, 71.7% were single and 51.7% had completed elementary school. The majority classified themselves as mulattos (46.7%) and the minority Blacks (11.7%). Only 6.7% considered themselves victims of racial discrimination because of their skin color but 33.3% considered themselves victims of discrimination due to sickle cell disease. The patients 48.3% reported an association between their disease and their skin color. The quality of life was considered bad by 6.7% and good by 70%. A total of 48.3% considered their lives to be satisfactory and 23.3% to be unsatisfactory. The scores obtained from the WHOQOL-Bref (from 0 to 100) were: 57.32 for physical, 66.03 for psychological, 69.86 for social and 52.76 for environmental domains. There were significant correlations of discrimination due to the disease with educational level and age with all the WHOQOL-Bref domains. CONCLUSION: Sickle cell disease significantly limits the quality of life of patients. Also, sickle cell disease, coinciding with the racial miscegenation, is losing its "black-related disease" character in Brazil.