Abstract This work describes the circulation over the continental slope and the São Paulo Plateau in the Santos Basin during the SANSED winter 2019 survey. The cruise consisted of four legs in the period between June, 11 and August, 03 2019. The observed circulation is dominated by the Atlantic southwestern boundary current regime and remotely-generated anticyclones and cyclones. The former is composed by the Brazil Current, the Intermediate Western Boundary Current and their mesoscale meanders; the latter are 300km vortical rings with origin in the eastern side of the South Atlantic Basin. A Lagrangian scheme applied over satellite altimeter maps indicate that the origin of these rings is primarily the Cape Basin of South Africa. The interaction between the boundary currents, their cyclonic meanders, and the anticyclonic rings is complex, and varies widely. During the SANSED winter 2019 survey period, three anticyclones interacted with the Brazil Current, instabilizing it, forming dipoles with the current cyclonic meanders, leading to their downstream propagation. Ancienter cyclonic eddies within Santos Basin may interfere with the propagation of the large anticyclones further south. In addition, the continuous arrival of remotely-originated anticyclones, the larger portion over the São Paulo Plateau presented a tendency of counter-clockwise circulation during the whole cruise period.

Abstract Coagulopathy and thrombosis associated with coronavirus disease 2019 (COVID-19) represent a major issue in the management of this disease. In the past months, clinical studies have demonstrated that COVID-19 patients present with a particular hypercoagulable state, in which a markedly increased D-dimer concomitant with increased levels of fibrinogen are observed. This hypercoagulable state leads to an increased risk of thrombosis, which seems to be higher among those patients with critical symptoms of COVID-19. The best therapeutic approach to prevent thrombotic events in COVID-19 has not been determined yet and several questions regarding thromboprophylaxis therapy, such as the time to initiate anticoagulation, type of anticoagulant and dose regimen, have emerged among physicians. To address these concerns, several medical societies have published position papers to provide the opinion of thrombosis experts on the management of coagulopathy and thrombosis associated with COVID-19. In line with this, the Latin America Cooperative Group of Hemostasis and Thrombosis (Grupo CLAHT) has constituted a panel of experts in thrombosis and hemostasis to discuss the available data on this topic. The aim of this review is to summarize the current evidence regarding hemostatic impairment and thrombotic risk in COVID-19 and to provide a carefully revised opinion of Latin American experts on the thromboprophylaxis and management of thrombotic events and coagulopathy in patients with suspected COVID-19.

Resumen La coagulopatía y la trombosis asociadas a la enfermedad por coronavirus 2019 (COVID-19) representan un problema importante en el manejo de esta enfermedad. Los estudios clínicos de los últimos meses han demostrado que los pacientes con COVID-19 presentan un estado de hipercoagulabilidad particular, en el que se observa un aumento notable del dímero D concomitante con niveles elevados de fibrinógeno. El estado de hipercoagulabilidad conduce a un mayor riesgo de trombosis, que parece ser mayor entre aquellos pacientes con síntomas críticos de COVID-19. El mejor enfoque terapéutico para prevenir los eventos trombóticos en esta nueva enfermedad aún no se ha determinado y han surgido varias preguntas con respecto a la tromboprofilaxia, como el momento adecuado para iniciar la anticoagulación, el tipo de anticoagulante y el régimen de dosis. Para abordar estas preocupaciones, varias sociedades médicas han publicado artículos de posición para brindar la opinión de expertos en trombosis sobre el manejo de la coagulopatía y trombosis asociadas a COVID-19. El Grupo Cooperativo Latinoamericano de Hemostasia y Trombosis (Grupo CLAHT) ha convocado a un panel de expertos en trombosis y hemostasia para discutir los datos disponibles sobre este tema. El objetivo de esta revisión es resumir la evidencia actual con respecto al deterioro hemostático y el riesgo trombótico en el COVID-19 y proporcionar una opinión cuidadosamente revisada de los expertos latinoamericanos sobre la tromboprofilaxis y el manejo de eventos trombóticos y coagulopatía en pacientes con sospecha de COVID-19.

Abstract We present postmortem evidence of invasive pulmonary aspergillosis (IPA) in a patient with severe COVID-19. Autopsies of COVID-19 confirmed cases were performed. The patient died despite antimicrobials, mechanical ventilation, and vasopressor support. Histopathology and peripheral blood galactomannan antigen testing confirmed IPA. Aspergillus penicillioides infection was confirmed by nucleotide sequencing and BLAST analysis. Further reports are needed to assess the occurrence and frequency of IPA in SARS-CoV-2 infections, and how they interact clinically.

ABSTRACT Objective: The association between coronary artery disease (CAD) and thyroid function remains controversial. We evaluated the thyroid function and graduated well-defined CAD as confirmed by quantitative coronary angiography (CA). Subjects and methods: We evaluated the serum TSH, free thyroxine, free triiodothyronine and thyroid antibody levels in 300 consecutive patients (age 61.6 ± 9.9 years and 54% were male) undergoing CAD diagnosis as confirmed by CA. Plaques with ≥ 50% stenosis being indicative of obstructive CAD, and patients were divided into groups according to main epicardial coronary arteries with plaques (0, 1, 2, 3). Lipid profiles and a homeostasis model assessment (HOMA-IR) were determined. Results: Serum median (25% and 75% percentile) TSH levels in patients with group 2 and 3 (2.25; 1.66-3.12 mU/L and 4.99; 4.38-23.60 mU/L, respectively) had significantly higher TSH concentrations (p < 0.0001) than the group 0 (1.82; 1.35-2.51 mU/L). Furthermore, patients of group 3 had higher TSH concentration (p < 0.0001) than those of group 1 (1.60; 0.89-2.68 mU/L). Group 3 were older (64 ± 8.5 vs. 59 ± 9.5, p = 0.001), had more patients with dyslipidemia (84% versus 58%, p < 0.001), male (54% versus 44%, p = 0.01), hypertension (100% versus 86%, p < 0.001), and smoking (61% versus 33%, p < 0.001) than group 0. Multivariate stepwise logistic analysis showed TSH, age, HbA1c, and HOMA-IR were the CAD associated variables. Conclusions: In this cohort, elevated TSH levels in the high normal range or above are associated with the presence and severity of CAD besides may represent a weak CAD risk factor.

ABSTRACT The effects of the hexanic extracts of the fruits and flowers of Clusia fluminensis Planch. & Triana, Clusiaceae, as well as their main constituents, the triterpene lanosterol and the benzophenone clusianone, were evaluated on hemipterans Dysdercus peruvianus and Oncopeltus fasciatus. The topical treatments of insects with the hexanic extracts significantly affected the survival of O. fasciatus, but not that of D. peruvianus. Concomitantly, extracts delayed the development of both hemipterans. Moreover, isolated lanosterol significantly reduced both the survival and development of O. fasciatus and D. peruvianus, while clusianone only reduce the survival of D. peruvianus and marginally inhibited the development of both insects. The results show the specific activity of lanosterol and clusianone against the two evaluated insect species and indicate the potential of compounds derived from C. fluminensis for the development of specific biopesticides for the control of agricultural pests. Subsequent work will examine the mode of action of lanosterol and clusianone isolates from C. fluminensis.

RESUMOObjetivando avaliar o efeito da irrigação sobre a qualidade da fibra do algodoeiro, experimento foi conduzido no município de Barbalha, CE, no período de julho a dezembro de 2010. Os tratamentos consistiram da combinação fatorial de duas cultivares de algodoeiro herbáceo (BRS Aroeira e BRS Araripe) e de cinco lâminas de irrigação (260,93; 418,93; 514,21; 711,81 e 894,68 mm). Utilizou-se o delineamento em blocos casualizados dispostos em faixas, com quatro repetições. Foi utilizado um sistema de irrigação por aspersão em linha sendo a lâmina controle (711,81 mm) aplicada em função da evapotranspiração da cultura. As variáveis analisadas foram: percentagem de fibra, comprimento, uniformidade, índice de fibras curtas, resistência, alongamento à ruptura, índice micronaire, maturidade, grau de amarelamento, reflectância e índice de fiabilidade. As lâminas de irrigação influenciaram o comprimento, o índice de fibras curtas, a resistência, o micronaire, a maturidade e a reflectância da fibra. As cultivares influenciaram a porcentagem, o comprimento e a cor da fibra (grau de amarelamento). A cultivar BRS Araripe obteve a melhor qualidade de fibra com a lâmina de irrigação de 514,21 mm e a BRS Aroeira com a de 418,93 mm.

ABSTRACTAiming to evaluate the effect of irrigation depths on fiber quality of upland cotton, an experiment was conducted from July to December 2010 in Barbalha-CE, Brazil. The treatments consisted of a factorial combination of two upland cotton cultivars (BRS Aroeira and BRS Araripe) and five irrigation depths (260.93, 418.93, 514.21, 711.81 and 894.68 mm), arranged in a split-plot design with four replicates. A line-source sprinkler irrigation system was used and irrigation depth in the control treatment was calculated according to the crop evapotranspiration. The analysed fiber quality variables were: fiber percentage, length, uniformity, short-fiber index, resistance, elongation at rupture, micronaire index, maturity, degree of yellowing, reflectance degree and count strength product (CSP) index. The irrigation depths influenced fiber length, short-fiber index, strength, micronaire index, maturity and reflectance degree. The cultivars influenced fiber percentage, length and color (degree of yellowing). The best results of fiber quality were found with irrigation depths of 514.21 and 418.93 mm for the upland cotton cultivars BRS Araripe and BRS Aroeira, respectively.

RESUMO O cumaru (Amburana cearensis (Allem.) A. C. Smith) é uma espécie nativa do semiárido brasileiro que apresenta múltiplas utilidades como madeira de boa qualidade e contém princípio ativo que pode ser utilizado nas indústrias alimentícias, de perfume e na produção de medicamentos. É, também, planta forrageira e melífera. As respostas do cumaru à adubação orgânica e cobertura morta do solo, insumos oriundos e ciclados dentro do próprio agroecossistema, são ainda pouco conhecidas. Para isto, um experimento foi montado visando estudar o comportamento das mudas em um sistema agroflorestal (em consórcio com milho e feijão), testando-se diferentes níveis de matéria orgânica (0, 15 e 30 L de esterco na cova), com e sem cobertura morta no solo. Avaliou-se a altura de plantas, diâmetro caulinar, número de folhas, área foliar e sobrevivência das plantas no campo após um ano de plantio. O cumaru, no sistema agroflorestal estudado, mostrou-se indiferente ao uso de cobertura morta e adaptado às condições de baixa matéria orgânica no solo, obtendo-se o maior crescimento na ausência de matéria orgânica (esterco).

ABSTRACT Amburana cearensis (Allem.) A. C. Smith is a Brazilian semiarid region native plant. It presents good quality wood, contains an active ingredient that can be used for food, perfume and medicine production and it is also a forage and a melifera plant. The responses of the studied species to organic fertilizer and mulch, inputs produced and cycled within its ecosystem are still unknown. For this, an experiment was conducted to study the behavior of seedlings in an agroforestry system intercropped with maize and beans, testing different levels of organic matter (0, 15 and 30 L of manure) with and without soil mulch. It was evaluated the plant height, stem diameter, leaf number, leaf area and the survival of plants in the field one year after planting. The performance of A. cearensis was indifferent to the use of mulch and well adapted to low soil organic matter conditions, obtaining the largest growth in the absence of organic matter.

Conduziu-se um experimento em um viveiro visando estudar os efeitos da irrigação, da adubação orgânica e da cobertura morta no solo, sobre o crescimento das mudas de cumaru (Amburana cearensis), planta nativa de múltiplas utilidades. Cinco quantidades de água foram aplicadas no solo, determinadas em função da evapotranspiração (0,25; 0,50; 0,75; 1,00; 1,25 ET); três níveis de esterco de boi no solo, como fração do volume total do solo (0,25; 0,50; 0,75) e presença e ausência de cobertura morta. O delineamento experimental foi em blocos casualizados, com quatro repetições. Aos 147 dias após a semeadura, observou-se que, com exceção da altura das plantas, afetada pela cobertura do solo, nenhuma das variáveis estudadas foi afetada significativamente pelos tratamentos utilizados. O cumaru parece adaptar-se às condições adversas de água e matéria orgânica no solo. A presença de cobertura morta no solo além de aumentar a altura das mudas significou uma economia de 41% da água de irrigação utilizada.

An experiment with 'cumaru' (Amburana cearensis), semi-arid native tree of multiple uses, was conducted under semi controlled conditions aiming to study the effects of irrigation, organic matter fertilization and mulching on the seedling growth. Five water regimes, based on the water evapotranspiration, (0.25; 0.50; 0.75; 1.00 and 1.25 ET); three levels of manure application, as fraction of the total volume of the soil (0.25; 0.50 and 0.75) with and without mulching were studied. The experimental design was a factorial in randomized blocks and four replicates. One hundred and forty seven days after sowing, it was observed that with the exception of the plant height none of the studied variables were affected by the treatments. It seems that the 'cumaru' is a highly adapted plant to soil water stress and organic matter. The presence of mulching besides increasing the seedling height presented a 41% irrigation water economy.

Este estudo avaliou a frequência de cardiopatia chagásica crônica (CCC) em 37 pacientes autóctones da Amazônia com disfunção sistólica ventricular esquerda sem etiologia definida. Foram diagnosticados três casos com frequência de 8,1% no grupo estudado.

This study assessed the frequency of chronic chagasic cardiopathy (CCC) in 37 autochthonus patients from Amazon region with left ventricular systolic dysfunction of undefined etiology. Three cases were diagnosed in the studied sample, with an 8.1% frequency.

Este estudio evaluó la frecuencia de cardiopatía chagásica crónica (CCC) en 37 pacientes autóctonos de la Amazonía con disfunción sistólica ventricular izquierda sin etiología definida. Se diagnosticaron tres casos con frecuencia del 8,1% en el grupo estudiado.

Otomicose é uma infecção fúngica do conduto auditivo externo com poucos estudos sobre sua real frequência no Brasil. OBJETIVO: Avaliar a frequência e características das otomicoses em pacientes com suspeita clínica de otite externa. DESENHO DO ESTUDO: Estudo retrospectivo com corte transversal (2000-2006). MATERIAL E MÉTODOS: 103 pacientes foram atendidos para diagnóstico micológico (exame microscópico direto e cultivo). RESULTADOS: Otomicoses foram diagnosticadas em 19,4% dos pacientes. A idade desses pacientes variou de 2 a 66 anos (média de 23,5 anos) e 60% das otomicoses foram observadas em mulheres entre 2 a 20 anos de idade. Otite crônica, antibioticoterapia prévia e ausência de cerume foram os fatores predisponentes e prurido otológico, otalgia, otorreia e hipoacusia os sintomas relatados pelos pacientes. As espécies mais frequentemente isoladas foram C. albicans (30%), C. parapsilosis (20%), A. niger (20%), A. flavus (10%), A. fumigatus (5%), C. tropicalis (5%), Trichosporon asahii (5%) e Scedosporium apiospermum (5%). CONCLUSÃO: Otomicose é endêmica em João Pessoa - PB. O acompanhamento clínico e o diagnóstico micológico são importantes uma vez que a sintomatologia de otomicose não é específica.

Otomycosis is a fungal infection of the external ear canal with only a few studies about its real frequence in Brazil. AIM: to evaluate otomycosis frequence and characteristics in patients with clinical suspicion of external otitis. STUDY DESIGN: Retrospective study with transversal cohort (2000-2006). MATERIALS AND METHODS:103 patients were assigned to mycological diagnosis (direct microscopic examination and culture). RESULTS: Otomycosis was diagnosed in 19.4% of the patients. Patient age varied from 2 to 66 years (an average of 23.5 years of age), and 60% of otomycosis cases were seen in women between 2 to 20 years of age. Chronic otitis, previous antibiotic therapy and the lack of cerumen were predisposing factors; itching, otalgia, otorrhea and hypoacusis were the symptoms reported by the patients. The most frequently isolated species were C. albicans (30%), C. parapsilosis (20%), A. niger (20%), A. flavus (10%), A. fumigatus (5%), C. tropicalis (5%), Trichosporon asahii (5%) and Scedosporium apiospermum (5%). CONCLUSIONS: Otomycosis is endemic in João Pessoa-PB. Clinical exam and mycological studies are important for diagnostic purposes because otomycosis symptoms are not specific.

A hiperplasia angiolinfoide (Hale e doença de Kimura são duas entidades que podem se manifestar como nódulos, placas ou pápulas, de localização predominante em face, região retroauricular e cervical. São causas raras de eosinofilia e ainda há muita discussão em torno de suas etiopatogenias. Para alguns autores trata-se de duas patologias distintas enquanto para outros são manifestações diferentes da mesma doença. O presente artigo relata o caso de um paciente asiático que apresentava história de prurido generalizado há um ano, acompanhado de pápulas em membros e nódulo de aproximadamente 5 cm de diâmetro em região retroauricular direita com aumento progressivo. O hemograma apresentava leucocitose às custas de eosinofilia. Os achados sugerem uma superposição entre as duas patologias, pois clinicamente são sugestivos de doença de Kimura, mas a histopatologia e imuno-histoquímica confirmaram a origem endotelial da lesão, sendo compatível com Hale. Os autores destacam a raridade do caso como causa de eosinofilia, assim como alertam para a dificuldade do diagnóstico e da diferenciação entre as duas patologias.

Angiolymphoid hyperplasia (Hale) and Kimura disease are two entities that can manifest as subcutaneous nodules, plaques, or papules, and the predominant localization is face, retroauricular and cervical region. They are rare causes of eosinophilia and there is discussion regarding their etiopathogenesis. Some authors propose that these two diseases are truly individual, but others say that they are separate points on a single spectrum. This article is a case report of an asian patient that showed a one year duration of generalized pruritus, with papules on the limbs and a 5 centimeter nodule on the right retroauricular region with slow progression of the size. The hemogram showed leucocitosis with eosinophilia. These findings suggest an overlap between these two diseases, they are clinically suggestive of Kimura disease diagnosis, but the histopathology with HE and immunohistochemistry confirmed the endothelial origin of the lesion that was compatible with Hale. The authors emphasize the rarity of the case as the cause of eosinophilia, also alert for the challenge of the diagnosis and distinction between these two diseases.

As síndromes mielodisplásicas (SMD) são um grupo heterogêneo de doenças malignas das células-tronco hematopoéticas, classificadas segundo a Organização Mundial da Saúde (OMS) em: anemia refratária, anemia refratária com sideroblastos em anel, citopenia refratária com displasia de multilinhagens, anemia refratária com excesso de blastos, síndrome mielodisplásica inclassificável e sindrome mielodisplásica associada com anormalidade isolada do cromossomo 5q(del). Na anemia refratária com sideroblastos em anel observam-se hiperplasia e displasia eritróide com presença de 15% ou mais de sideroblastos em anel. Utilizamos neste estudo a coloração de Perls em esfregaços de medula óssea de pacientes com idade superior a 40 anos e que apresentavam uma ou mais citopenias no sangue periférico associada a anemia. Por tratar-se de técnica de manejo fácil e ágil sugerimos seu emprego em esfregaços de aspirado de medula óssea de pacientes que apresentem os achados laboratoriais acima, pois, dentre os casos analisados 18,7% apresentavam mais que 10 grânulos sideróticos circundando a terça parte ou mais do núcleo do precursor eritróide (sideroblasto em anel), sugerindo ao hematologista um possível diagnóstico de Síndrome Mielodisplásica com Sideroblastos em Anel (SMD-ARSA). Importante relatar que a grande maioria destes casos com aumento de sideroblastos em anel não foi encaminhada ao nosso serviço, com suspeita de SMD, e em somente um caso foi solicitada a realização da coloração de Perls.

Myelodisplastic syndromes are a heterogeneous group of malignant haematopoietic stem cells. They are classified by the World Health Organization as refractory anemia, refractory anemia with ringed sideroblasts, refractory cytopenia with multilineage displasia, refractory anemia with excess of blast cells, unclassified myelodisplastic syndrome and myelodisplastic syndrome associated with a 5q chromosomal delection. Refractory anemia with ringed sideroblasts is defined by red blood cell hyperplasia and dysplasia with 15% or more of ringed sideroblasts. We studied bone marrow aspirates using Perls' stain with blood smears from over 40-year-old patients that had one or more cytopenias in their peripheral blood associated with anemia. A total of 18.7% of patients had ringed sideroblasts leading to a possible diagnosis of refractory anemia with ringed sideroblasts, one of the myelodisplastic syndromes. Most of those cases were refered to our service without clinical suspicion of myelodisplastic syndrome and in only one case Perls' stain was requested. Perls' stain is easily performed and the results are fast and so we suggest that it should be routinely used in all cases of possible myelodisplastic syndrome.

A leucemia promielocítica aguda (LPA) corresponde a 10% -15% das leucemias mielóides agudas (LMA). Este tipo de leucemia (LMA-M3 de acordo com a classificação FAB) está associado, em cerca de 90% dos casos, à translocação t(15;17)(q22;q21), que resulta na fusão dos genes PML e RARalfa. A análise citogenética tradicional tem sido utilizada para confirmar o diagnóstico morfológico da LPA. Embora a t(15;17) não seja detectada em outros tipos de leucemia, podem ocorrer resultados "falso-negativos", decorrentes da análise de células que não pertencem ao clone neoplásico, da dificuldade de visualização da translocação ou, até mesmo, da existência de rearranjos crípticos que mascaram a translocação. Por outro lado, foram descritas alterações cromossômicas alternativas em pacientes com LPA e, nesses casos, o tratamento com ATRA não é eficaz. No período de julho de 1993 a dezembro de 2002 foram encaminhados para análise citogenética 47 casos com suspeita e/ou diagnóstico clínico-morfológico de LPA. Trinta e quatro pacientes (72,3%) apresentaram a t(15;17), detectada pela citogenética tradicional e/ou molecular. Em seis destes pacientes foram observadas alterações cromossômicas adicionais ou rearranjos envolvendo um terceiro cromossomo. Em cinco (10%) pacientes com características de LPA, a técnica de FISH não revelou a fusão PML/RARalfa, dado importante para a orientação do diagnóstico e da conduta terapêutica desses pacientes. O presente trabalho foi realizado com o objetivo de avaliar a importância da análise citogenética tradicional e molecular no diagnóstico de pacientes com LPA.

Acute promyelocytic leukemia (APL) accounts for 10 to 15% of acute myeloid leukemias (AML). This type of leukemia (AML-M3 according to the FAB classification) is associated, in about 90% of the cases, with a t(15;17)(q22;q21) translocation, resulting in the fusion of the PML and RARalpha genes. Traditional cytogenetic analysis has been used to confirm the morphological diagnosis of ALP. Although the t(15;17) translocation is characteristic for this kind of leukemia, "false-negative" results may occur as a result of the analysis of cells which do not belong to the neoplastic clone, of the difficulty to visualize the translocation and even of the existence of cryptic rearrangements masking the translocation. Moreover, alternative chromosome alterations were described in patients with APL and in these cases treatment with ATRA is not effective. From July 1993 to December 2002, 47 cases suspected of or being diagnosed with APL by clinical-laboratorial methods were referred for cytogenetic analysis. Thirty-four patients (72.3%) had the t(15;17) translocation, detected by traditional and/or molecular cytogenetics. In six of these patients, additional chromosome alterations or rearrangements involving a third chromosome were observed. In five patients (10%) with APL characteristics, the FISH technique did not reveal the PML/RARalpha fusion, an important finding in the process of reaching a diagnosis and of establishing a therapeutic conduct for these patients. This work was carried out with the purpose of evaluating the importance of traditional and molecular cytogenetic analysis in the diagnosis of APL.

O Mieloma Mútiplo é uma doença de evolução heterogênea, na qual a maioria dos pacientes recai muito precocemente após o tratamento. Nesse contexto, o objetivo principal deste trabalho é relatar diferentes estratégias de análise do mieloma por citometria de fluxo e sua importância na associação com citogenética no diagnóstico de doença residual. Entre 2.450 casos de doenças onco-hematológicas estudados, de setembro de 1993 a agosto de 2004, foram diagnosticados 50 (2,0%) Mieloma Múltiplo. Foram feitas análises morfológicas e, até o ano de 2000, as imunofenotipagens foram realizadas no citômetro de fluxo XL-MCL (Coulter) pela estratégia tamanho/complexidade, utilizando os anticorpos monoclonais CD19, CD20, CD38, CD45, CD56, HLA-DR, kappa e lambda de superfície e intracitoplasmáticas. A partir de 2001 passaram-se a utilizar painéis seqüenciais através do histograma CD138/Complexidade e anticorpos monoclonais CD19, CD38, CD56, CD117, kappa e lambda intracitoplasmáticas. Mais recentemente foram incluídos no painel os anticorpos CD45, HLA-DR e CD33. A análise do DNA foi realizada por citometria com auxílio do programa Multicycle em nove amostras, sendo que sete apresentaram população aneuplóide. O cariótipo com banda G foi realizado em 25 casos, e a pesquisa de deleção do 13q por FISH em 15. Alterações cromossômicas foram encontradas em 4 casos, sendo duas deleções de 13q confirmadas por FISH. A mudança na estratégia de gates associada à citogenética e ao estudo da cinética do ciclo do DNA permitem melhor identificação de células plasmáticas anômalas, avaliação do prognóstico e detecção de doença residual.

Multiple myeloma is a disease with variable natural history, but a clinical fact is that most of the transplanted patients relapse early after transplantation. Minimal residual disease should be one prognostic factor of transplanted patients that could judge if such patients are at risk for early relapse. We diagnosed 50 multiple myeloma cases from 2450 oncohematologic cancer diseases studied between September 1993 and August 2004 (2% of all cases). Until 2000 these cases were studied using a Coulter Flow Cytometer XL-MCL with monoclonal antibodies against CD19, CD38, CD45, CD56, intra-cytoplasmatic and surface kappa and lambda in a Forward Scatter x Side Scatter gate strategy. After 2001 we performed sequential studies using CD138 histogram complexity and monoclonal antibodies anti CD19, CD38, CD56, CD117, intra-cytoplasmatic kappa and lambda. More recently we included in the antibody pool anti-CD45, anti-HLA-DR and anti-CD33. DNA cytometric studies were performed with the Multicycle software in 9 cases, 7 of those with aneuploidy. G band karyotyping was made in 25 cases and the 13 q deletion was checked in 15 cases. Chromosomal alterations were found in 4 cases including two 13 q deletions, confirmed by FISH. Gate choice, cytogenetic studies and cycle kinetics of DNA are all data that permit better identification of anomalous plasma cells and therefore detection of minimal residual disease, that probably correlates with relapse prognosis.

A quantificação das células CD34+ em sangue periférico é utilizada para determinar o melhor momento de iniciar a aférese, enquanto que na leucoaférese e no sangue de cordão umbilical determinam a quantidade de células CD34+ para o transplante de células progenitoras. O objetivo deste trabalho foi comparar três diferentes metodologias de quantificação de células CD34+. Foram utilizados três diferentes tipos de amostras: a) 32 amostras de sangue periférico, coletadas de pacientes estimulados com G-CSF 50 µg/Kg/dose total, sem quimioterapia na mobilização. b) 31 amostras de produto de aférese de pacientes estimulados com o mesmo protocolo de G-CSF. c) 20 amostras de sangue de cordão coletadas em CPDA-1, por punção de veia umbilical. As amostras permaneceram à temperatura ambiente no máximo até 24h da análise. O citômetro de fluxo utilizado foi o Epics XL-MCL (Coulter) com os protocolos de dupla plataforma: ISHAGE e Mulhouse modificado para análise de maior numero de eventos, e o citômetro Imagn 2000 (Biometric Imaging) de plataforma única, conforme técnicas recomendadas. Os anticorpos monoclonais utilizados foram: CD45-FITC, CD34-PE, e isotipo IgG1-PE da Immunotech. As análises estatísticas foram: ANOVA e correlação de teste t de Student. Os resultados não apresentaram diferenças estatisticamente significativas nos três métodos.

CD34+ cell quantification in peripheral blood is useful to determinate the best moment to begin apheresis while, when applied in leukapheresis products and umbilical cord blood it is important to establish the total number of CD34+ in stem cell transplantation. We aimed at comparing three different methodologies of CD34+ cell quantification. Three different blood products were analyzed: a) peripheral blood samples from 32 patients collected using EDTA, mobilized without previous chemotherapy and with G-CSF 50 mcg/Kg/total. b) 31 leukapheresis samples obtained using a CS 3000 (Baxter) cell separator. c) 20 cord blood samples collected using umbilical venipuncture. All samples were maintained at room temperature and analyzed until 24h after collection by three different methods: double platform protocols ISHAGE, a Mulhouse modified (for analysis of a higher number of events) applied in a Epics XL flow cytometer (Coulter) and a single platform for a fixed volume cytometer IMAGN 2000 (Biometric Imaging) according to manufacturer instructions. Monoclonal antibodies used were: CD 45-FITC, CD 34-PE and IgG1-PE isotype control (Immunotech, Marseille, FR). Statistical analysis was made using ANOVA and T Student test. Results showed no statistical differences (p< 0.05) among the three methods used to quantify CD34+ cells from any sample source.