Five years of implementation of guidelines in hematology and transfusion medicine in Brazil

In 2009, the Associação Brasileira de Hematologia e Hemoterapia (ABHH) started to participate in an important mission proposed by the Associação Médica Brasileira (AMB) and the Conselho Federal de Medicina named "Project Guidelines". This project had already been adopted by some other specialties. It aims to determine diagnostic, monitoring, prevention and therapeutic practices according to the best scientific evidence available in the international literature. Some attempts had already been made within hematology, but without systematization or continuity. Thus the ABHH brought together a group of experts representative of the most important teaching and research institutions of Brazil and from the most varied areas of knowledge in hematology to discuss diverse issues. After training, this group prepared several guidelines from the results of systematic investigations of the literature. Seventeen priority themes, working groups and their coordinators were defined as were the start and end dates for each issue. It was decided that all the reports would be published in Portuguese in the journal of the Associação Médica Brasileira (RAMB) and in English in the Revista Brasileira de Hematologia e Hemoterapia (RBHH). The working methodology included regular meetings between the group of researchers and those who were carrying out the systematic reviews of the literature. The most important questions were identified by experts of different fields within clinical hematology, pediatric hematology and transfusion medicine. The first set of guidelines, completed and published in 2012, was related to chronic myeloid leukemia,¹ an uncommon disease, but one with a modern research and therapeutic model in oncology and hematology that uses several generations of tyrosine kinase inhibitors. This set of guidelines was fundamental to revise national treatment protocols and allow access to these drugs through health insurers. Guidelines on other important diseases followed including those on multiple myeloma,² primary immune thrombocytopenia in children and adolescents^{3 , 4} and acute promyelocytic leukemia.⁵ Other guidelines are currently being completed and will be published in future issues of the RBHH. The dominion of the methodology to prepare these guidelines in Brazil has contributed significantly to all levels of education, to research and to the development of public policies of access to diagnoses and therapeutic advancements. This justifies the great effort made by the ABHH and members. We will continue to work to prepare other guidelines and update the existing ones. This commitment has the goal of offering the best and most relevant scientific data for the good of our patients and our society. In addition, it aims to allow that our actions, together with the regulatory agencies and the incorporation of new technologies, are always supported by the best scientific evidence available and, with this, reduce any kind of conflict of interest that may exist.

REFERENCES

• ¹
  Souza CA, Pagnano KB, Bendit I, Conchon M, Freitas CM, Coelho AM, et al. Chronic myeloid leukemia treatment guidelines: Brazilian Association of Hematology Hemotherapy and Cell Therapy. Brazilian Medical Association Guidelines Project - 2012. Rev Bras Hematol Hemoter. 2012;34:367-82.
• ²
  Hungria VT, Crusoe ET, Quero AA, Sampaio M, Maiolino A, Bernardo WM. Guidelines on the diagnosis and management of multiple myeloma treatment: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular Project guidelines: Associação Médica Brasileira - 2012. Rev Bras Hematol Hemoter. 2013;35:201-17.
• ³
  Loggetto SR, Braga JA, Veríssimo MP, Bernardo WM, Medeiros L, Hoepers AT. Guidelines on the treatment of primary immune thrombocytopenia in children and adolescents: Associação Brasileira de Hematologia Hemoterapia e Terapia Celular Guidelines Project: Associação Médica Brasileira - 2012. Rev Bras Hematol Hemoter. 2013;35:417-27.
• ⁴
  Braga JA, Loggetto SR, Hoepers AT, Bernardo WM, Medeiros L, Veríssimo MP. Guidelines on the diagnosis of primary immune thrombocytopenia in children and adolescents: Associação Brasileira de Hematologia Hemoterapia e Terapia CelularGuidelines Project: Associação Médica Brasileira - 2012. Rev Bras Hematol Hemoter. 2013;35:358-65.
• ⁵
  Pagnano KB, Rego EM, Rohr S, Chauffaille ML, Jacomo RH, Bittencourt R, et al. Guidelines on the diagnosis and treatment for acute promyelocytic leukemia: Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular Guidelines Project: Associação Médica Brasileira - 2013. Rev Bras Hematol Hemoter. 2014;36:71-92.

Publication Dates

• Publication in this collection
  May-Jun 2014