Acute Myeloid Leukemia: analysis of epidemiological profile and survival rate

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"apellidos" => "Freund" ] 3 => array:2 [ "nombre" => "Juliana Shmitz" "apellidos" => "Dacoregio" ] 4 => array:2 [ "nombre" => "Tatiana El Jaick Bonifácio" "apellidos" => "Costa" ] 5 => array:2 [ "nombre" => "Imaruí" "apellidos" => "Costa" ] 6 => array:2 [ "nombre" => "Daniel" "apellidos" => "Faraco" ] 7 => array:2 [ "nombre" => "Maurício Laerte" "apellidos" => "Silva" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Service of Pediatric Oncology, Hospital Infantil Joana de Gusmão, Florianópolis, SC, Brazil" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Leucemia Mielóide Aguda: análise do perfil epidemiológico e taxa de sobrevida" ] ] "textoCompleto" => "IntroductionAcute myeloid leukemia (AML) is a clonal disease of hematopoietic tissue characterized by abnormal proliferation of progenitor cells of myeloid lineage, resulting in the insufficient generation of normal mature blood cells.<a class="elsevierStyleCrossRef" href="#bib0150">1</a>It represents approximately 15–20% of acute leukemia cases in childhood,<a class="elsevierStyleCrossRef" href="#bib0150">1</a> and accounts for about 30% of deaths in this age range.<a class="elsevierStyleCrossRef" href="#bib0155">2</a> In Brazil, its estimated incidence is 400 cases per year.<a class="elsevierStyleCrossRef" href="#bib0160">3</a>Hemorrhagic manifestations, fever, and pallor are frequent symptoms of the disease at diagnosis. The main causes of death are infections, bleeding episodes, leukostasis, and tumor lysis syndrome.<a class="elsevierStyleCrossRef" href="#bib0165">4</a>The main factors affecting the mortality rate of these patients are those resulting from therapy intensification and disease relapse.<a class="elsevierStyleCrossRefs" href="#bib0170">5,6</a>AML prognosis improvement has been made possible by disease stratification into risk groups based on cytogenetics, the evaluation of early response to treatment, and the identification of chemotherapy-induction failure. Currently, the likelihood of AML cure in developed countries is around 60%.<a class="elsevierStyleCrossRefs" href="#bib0180">7,8</a>Considering that in recent decades there has been progress in the introduction of new chemotherapy treatment protocols for AML and that the information in the pediatric population and its clinical outcomes are still scarce, this study aimed to analyze the eight-year experience in a pediatric oncology service, in the South of Brazil.MethodsThis was a clinical–epidemiological, observational, retrospective, descriptive study approved by the Ethics Committee on Human Research of Hospital Infantil Joana de Gusmão (HIJG).The study included all new cases of AML patients younger than 15 years treated in HIJG between January 2004 and August 2012.Exclusion criteria were loss to follow-up; patient transfer to another service; insufficient data at the hospital cancer registry and medical records and statistics department of HIJG.The diagnosis of AML was based on morphology, cytochemistry, and immunophenotyping by flow cytometry of bone marrow aspirate and/or peripheral blood, performed with EuroFlow 8-color antibody panels (EuroFlow-ESLHO, Rotterdam, NL). The minimal residual disease (MRD) was analyzed by flow cytometry in the bone marrow after 15 days of induction treatment. The treatment protocols used were from the International Berlin-Frankfurt-Münster (BFM) Study Group AML-83 (n=6), AML-98 (n=22), and AML-2004 (n=23).The analyzed variables were age at diagnosis (age range stratified as <1 year, 1 year to 10 years, and >10 years); gender; ethnicity/skin color, as established by the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística – IBGE) as white, black, brown, yellow, and indigenous; origin, according to the mesoregions of the state of Santa Catarina established by IBGE (city of Florianópolis, Northern Santa Catarina, Western Santa Catarina, Mountain Region, Southern Santa Catarina, Valley of Itajaí) and others (from other states); predominant signs and symptoms at diagnosis (fever, bone pain, abdominal pain, enlarged lymph nodes, hemorrhagic manifestations, gingival hypertrophy, pallor, asthenia/lack of appetite, swelling of soft tissue, and respiratory symptoms); laboratory findings at diagnosis (white blood cell count, neutropenia, and platelet count); extramedullary involvement at diagnosis (CNS or other sites); AML classification according to the French–American–British group (FAB)<a class="elsevierStyleCrossRef" href="#bib0150">1</a>; presence and type of laboratory genetic alterations; presence or absence of clinical and laboratory remission after the first chemotherapy induction, according to the MRD value on the 15th day of induction, obtained by flow cytometry; vital status (alive or deceased); death (in remission or not from neoplastic disease), immediate cause of death; presence and location of disease recurrence (bone marrow, extramedullary, or combined); and bone marrow transplantation.The statistical procedures used in the study were descriptive measures, frequency tables, and Pearson's chi-squared test, with 95% of significance (p<0.05) to analyze, as an exploratory characteristic, the association between two variables. Associations were verified between the variables vital status and white blood cell count, vital status and type M3-AML MRD, and vital status and non-M-AML MRD.ResultsOf the 51 patients, 55% (n=28) were males and 45% (n=23) females, at a ratio of 1.2:1. Whites predominated, accounting for 84% of patients. Brown and black patients represented 16% of the sample.Mean age at diagnosis was 7.3 years (SD±4.8 years) with a median of 9 years. The youngest age at diagnosis was 19 days and the oldest, 14 years. Regarding the age range, 8% of the sample were aged <1 year, 47% were between 1 and 10 years, and 45% were >10 years.As for the origin, according to the mesoregions of Santa Catarina by IBGE, 29% were from the city of Florianópolis (n=15), 24% were from the Western Region (n=12), 20% from the Mountain Region (n=10), 10% from the Northern Region (n=5), 8% from the Southern Region (n=4), 8% from the Itajai Valley (n=4), and 2% (n=1) were from another state, Paraná.The main signs and symptoms at diagnosis are described in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>At diagnosis, 24% of patients had extramedullary disease (n=12), and the most often affected site was the central nervous system (CNS) in 14% (n=7). The other 10% had skin involvement (n=2), bone involvement, and soft tissue edema (n=3).Laboratory data at AML diagnosis (leukocytes, platelets, and neutropenia) and morphological FAB classification are described in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>When correlating WBC count at diagnosis with vital status (p=0.014), it was observed that 79.2% of patients with WBC count <10,000 lived, whereas 29.4% of those with WBC counts between 10,000 and 50,000 lived. The three patients (6%) that had WBC count >100,000 died.The study of genetic disorders was documented in 51% of patients (n=26), showing alterations in 46.15% of cases (n=12). The most frequent alteration was t(15;17), found in six patients (23%). One of these patients had an association of t(15;17) with FLT3-ITD mutation. The other genetic disorders found were polyploidy, t(8;21), presence of MLL rearrangement, t(3;5) deletion of chromosome 18, trisomy of chromosome 21, trisomy of chromosome 8, and tetrasomy of chromosome 8.MRD analysis in 45% of patients (n=23) was <0.1%; in 16% (n=8) it was between 0.1% and 1.0%; in 25% (n=13) it was >1.0%; 14% (n=7) of the cases lacked the test result in the medical record.The comparison between the bone marrow MRD, on the 15th day of treatment and the vital status of patients with acute promyelocytic leukemia (M3-AML) and acute non-promyelocytic leukemia (non-M-AML) is described in <a class="elsevierStyleCrossRefs" href="#tbl0015">Tables 3 and 4</a>.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia>Overall survival was 57% in this study. By correlating vital status with M3-AML and non-M-AML, it was observed that 71.42% and 54.05% of the patients were alive, respectively, at the end of the study.Of the patients who died (n−22), 64% (n=14) were not in complete clinical remission of leukemia at the end of chemotherapy induction. The main immediate cause of death was septic shock in 63.6% of patients (n=14). Of the deaths, three occurred within the first 15 days of treatment, one from intracranial hemorrhage (M3-AML) and the other two, in addition to sepsis, had pulmonary leukostasis and intracranial hemorrhage with spinal fluid infiltrate at diagnosis, respectively.Regarding the deaths that occurred after the 16th day of induction treatment (n=19), 12 occurred due to septic shock. Of these, six occurred after chemotherapy re-induction for recurrence.Of patients with WBC count >100,000, one patient had M3-AML, whose immediate cause of death was septic shock, another had M0-AML with pulmonary leukostasis associated with septic shock, and the other had M5-AML with acute renal failure.Regarding the patients (n=6) that had t(15;17) mutations, two died. The patient that had t(15;17) and FLT3-ITD mutations was alive and in remission until the date of completion of this study.Among the assessed patients, 39% (n=20) were submitted to radiotherapy and 16% (n=8) to bone marrow transplantation (BMT). Of the patients who underwent BMT, two died and the others are alive and in complete remission of leukemia.In 14% of cases (n=7) there was disease recurrence in the bone marrow and, of these, six patients died.DiscussionIn this study, most patients were male and older than 1 year. Most of those that had WBC count <10,000/mm3 at diagnosis are alive.Overall survival is higher in patients with MRD <0.1% and the prognosis is better in patients with M3-AML.In other studies,<a class="elsevierStyleCrossRefs" href="#bib0190">9,10</a> male gender also showed a slight predominance to females (1.2:1).As in the study by Kavcic,<a class="elsevierStyleCrossRef" href="#bib0195">10</a> it was observed that AML predominated in whites. In Santa Catarina, as a result of the white descent of the majority of the population, white ethnicity was predominant, making it impossible to establish comparisons between the ethnic groups.Corroborating other studies,<a class="elsevierStyleCrossRefs" href="#bib0195">10–12</a> this study showed a higher prevalence of AML in the age range >1 year old.This study, as in the literature, also demonstrated that the signs and symptoms of AML result from bone marrow infiltration, with hemorrhagic manifestations, fever, asthenia, pallor, and bone pain.<a class="elsevierStyleCrossRef" href="#bib0155">2</a>In previously published studies, the percentage of CNS involvement at diagnosis ranged from 5% to 15%.<a class="elsevierStyleCrossRefs" href="#bib0155">2,13</a> In this study, 14% of patients had CNS involvement at diagnosis, similarly to what was described by Rubnitz et al.<a class="elsevierStyleCrossRef" href="#bib0210">13</a>Studies have shown that the percentage of patients with WBC counts >100,000/mm3 is between 12% and 15%.<a class="elsevierStyleCrossRefs" href="#bib0175">6,9,14</a> In this series, only 6% of cases had this elevated WBC count at diagnosis. This difference can be explained by the lack of data available in the medical records of some patients, the size of this sample, or the earlier disease diagnosis.WBC count is the most important risk factor for treatment failure, due to the possibility of causing bleeding complications or respiratory failure due to leukostasis.<a class="elsevierStyleCrossRefs" href="#bib0190">9,15</a> The present study showed that 80% of patients had WBC count <50,000/mm3 at diagnosis, similar to the study by Imamura et al.<a class="elsevierStyleCrossRef" href="#bib0215">14</a>The probability of event-free survival (EFS) in five years was only 23% in patients with WBC count >100,000/mm3 according to the analysis of the BFM-83 and BFM-87 treatment protocols.<a class="elsevierStyleCrossRef" href="#bib0190">9</a> This study showed that 79.2% of the patients (p=0.014) with WBC count <10,000/mm3 at diagnosis lived, whereas among those with WBC counts between 10,000 and 50,000/mm3, only 29.4% lived. Only three patients in this study had a WBC count >100,000/mm3 at diagnosis, thus making the statistical analysis impossible.The FAB morphological classification for AML can define treatment and risk group stratification.<a class="elsevierStyleCrossRef" href="#bib0160">3</a> In previously published studies<a class="elsevierStyleCrossRefs" href="#bib0190">9,14,16</a> the most frequently identified subtype was M2, ranging from 33.6% to 37%. In the present study, the most prevalent morphological types were M2 (27%) and M3 (27%), similar to the findings of Xiao-Jun Xu et al.<a class="elsevierStyleCrossRef" href="#bib0175">6</a>After the advent of all-trans-retinoic acid (TRA), M3-AML became the FAB subtype with the best prognosis, by inducing the differentiation of leukemic precursors into mature cells, controlled by this drug.<a class="elsevierStyleCrossRefs" href="#bib0150">1,17</a> The present study also found good therapeutic response to this medication, considering that 71.42% of patients with M3-AML and 54.05% of those with non-M3-AML were alive at the end of this study.AML is a heterogeneous disease from the molecular point of view, including somatic and epigenetic alterations that contribute to myeloid leukemogenesis. These cytogenetic abnormalities, somatic mutations, and the induction therapy response are important information for risk stratification and adequate therapy allocation.<a class="elsevierStyleCrossRef" href="#bib0235">18</a>Chromosomal abnormalities in AML include aberrations described as gain or loss of whole chromosomes structural abnormalities or balanced translocations.<a class="elsevierStyleCrossRef" href="#bib0240">19</a> The literature reports that the translocation t(8;21) is the most prevalent, varying between 12% and 23%,<a class="elsevierStyleCrossRefs" href="#bib0205">12–14</a> whereas t(15;17) is observed in 3.4–10% of cases.<a class="elsevierStyleCrossRefs" href="#bib0205">12,13</a>According to the present results, 46% of the assessed patients have some cytogenetic alteration, and translocation t(15;17) was most prevalent (23%), which is justified by the number of cases of M3-AML in this study. As this alteration has a favorable prognosis, it confirms the findings of increased survival in patients with M3-AML. It is noteworthy that the cytogenetic analysis of patients in this study was documented in only 51% of cases, which might have underestimated the results.A recent study<a class="elsevierStyleCrossRef" href="#bib0220">15</a> stated that survival is poor in patients with translocation t(15;17) and FLT3-ITD mutation association, thus representing an independent prognostic predictor, with a progression-free survival rate of 16%. In the present series, only one patient with M3-AML had the translocation t(15;17) and FLT3-ITD association, and was alive and without signs of relapse at the end of the study.In the BFM study, bone marrow MRD measured after the first treatment course was the best event-free survival predictor when compared to the risk classification scheme by FAB subtype, cytogenetics, and the presence of blasts in peripheral blood morphology on the 15th day of anti-neoplastic treatment.<a class="elsevierStyleCrossRef" href="#bib0220">15</a> The presence of high MRD after the first course of induction was significantly associated with an adverse outcome. The recurrence rate was particularly high (49%) in patients with MRD >1%, while in patients with lower MRD (0.1–1%), the rate was only 17%.<a class="elsevierStyleCrossRef" href="#bib0220">15</a>The study by Al-Mawali et al.<a class="elsevierStyleCrossRef" href="#bib0245">20</a> also demonstrated that MRD >0.15% was an independent predictor of poor prognosis after chemotherapy induction. Other studies have also demonstrated a correlation between MRD <0.1% and improved event-free survival, such as the study by Rubnitz et al.<a class="elsevierStyleCrossRef" href="#bib0250">21</a> and Inaba et al.<a class="elsevierStyleCrossRefs" href="#bib0255">22,23</a>Although MRD is a strong prognostic factor, approximately 25% of patients with low MRD will have disease recurrence. The study by Karol et al.<a class="elsevierStyleCrossRef" href="#bib0265">24</a> identified, among the risk factors for recurrence, certain 11q23 abnormalities such as t(6;11) and t(10;11), megakaryocytic leukemia without t(1:22), and age ≥10 years.<a class="elsevierStyleCrossRef" href="#bib0265">24</a>In this study, when comparing the MRD <0.1% on the 15th day of treatment with vital status, it was observed that 100% of patients with M3-AML and 76.5% of patients with non-M3-AML were alive, respectively. When MRD was >1.0%, it was observed that 75% of M3-AML patients and 25% of non-M3-AML patients were alive. There was a statistical significance between bone marrow MRD and vital status (p=0.022), as well as between M3-AML and vital status (p=0.025) and non-M3-AML and vital status (p=0.019). These data corroborate the prognostic importance of MRD quantification.Regarding recurrence, the bone marrow is the most frequent site of AML relapse.<a class="elsevierStyleCrossRef" href="#bib0220">15</a> In this series, all recurrences occurred at this site.Recent antineoplastic therapies, such as new chemotherapeutic agents, monoclonal antibodies, and immunomodulators, are challenges in the assessment of the impact on the child's immune function and of infectious complications.<a class="elsevierStyleCrossRef" href="#bib0240">19</a>The literature reports that the leading cause of death in these patients is infection, and that it is mainly related to chemotherapy intensification.<a class="elsevierStyleCrossRefs" href="#bib0170">5,6,9</a>A study by Silva et al.,<a class="elsevierStyleCrossRef" href="#bib0270">25</a> analyzing mortality trends in Brazil in children with leukemia in the 1980–2010 period, reports that the deaths associated to the treatment of acute myeloid leukemia in less developed countries can reach up to 33%, as the intensive chemotherapy regimen predisposes to severe neutropenia and exposes patients to infections.Pediatric patients treated for AML are at high risk for infectious complications, predominantly bacterial and fungal. Some institutions have implemented prophylaxis with antibiotic and anti-fungal agents, aimed at reducing these infections. However, the systematic evaluation of antibiotic prophylaxis studies indicates that there is insufficient data to define guidelines for their use. Therefore, additional studies are needed to accurately identify the best antibiotic regimen, as well as for which population of children they would be indicated.<a class="elsevierStyleCrossRefs" href="#bib0275">26,27</a>The present study also showed that septic shock (63.6%) was the most prevalent cause of death. Of the 19 patients that died after the 15th day of the induction therapy, six had relapsed. The deaths that occurred in this period were probably due to infections after aplasia induction.In recent decades, in spite of the improved AML prognosis, approximately one-third of patients had recurrence. This population has a poor prognosis, with long-term survival probability of approximately 35%, despite the use of intensive chemotherapy and allogeneic bone marrow transplantation. The toxicity and mortality resulting from this treatment are also significant.<a class="elsevierStyleCrossRef" href="#bib0285">28</a>Currently, studies with targeted therapies are being developed, focusing primarily on the functional pathways of leukemic cells, such as cell surface receptors, specific intracellular kinases, proteins that regulate cell death and gene expression modulators, aiming to improve AML patient survival.<a class="elsevierStyleCrossRef" href="#bib0290">29</a>AML treatment should be based on a clinical structure capable of supporting the therapeutic aggressiveness, in addition to a laboratory structure capable of discriminating the risk groups and contributing to the identification of relevant prognostic factors, as well as providing supportive measures for the care of these patients.In this series, selection bias was considered due to the inclusion of all cases diagnosed at the service. These results may have been influenced by characteristics of the assessed population; the different treatment protocols used (BFM); the available medical and hospital resources in this service; and the sample size. However, the results observed in this study show the need to perform national, multicenter, analytical studies, aiming at confirmation of the observed associations and thus, establishing prognostic factors for AML.In this study, the comparison of bone marrow MRD on the 15th day of induction treatment with vital status showed that 71.42% of patients with type M3 AML and 54.05% of those with non-M3-AML were alive. The death rate was 43% and the main immediate cause was septic shock (63.6%).Conflicts of interestThe authors declare no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres655691" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec665310" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres655690" "titulo" => "Resumo" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusões" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec665309" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-04-22" "fechaAceptado" => "2015-08-05" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec665310" "palabras" => array:3 [ 0 => "Acute myeloid leukemia" 1 => "Leukemia" 2 => "Children" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec665309" "palabras" => array:3 [ 0 => "Leucemia mielóide aguda" 1 => "Leucemia" 2 => "Criança" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveTo describe the epidemiological profile and the survival rate of patients with acute myeloid leukemia (AML) in a state reference pediatric hospital. MethodClinical–epidemiological, observational, retrospective, descriptive study. The study included new cases of patients with AML, diagnosed between 2004 and 2012, younger than 15 years. ResultsOf the 51 patients studied, 84% were white; 45% were females and 55%, males. Regarding age, 8% were younger than 1 year, 47% were aged between 1 and 10 years, and 45% were older than 10 years. The main signs/symptoms were fever (41.1%), asthenia/lack of appetite (35.2%), and hemorrhagic manifestations (27.4%). The most affected extra-medullary site was the central nervous system (14%). In 47% of patients, the white blood cell (WBC) count was below 10,000/mm3 at diagnosis. The minimal residual disease (MRD) was less than 0.1%, on the 15th day of treatment in 16% of the sample. Medullary relapse occurred in 14% of cases. When comparing the bone marrow MRD with the vital status, it was observed that 71.42% of the patients with type M3 AML were alive, as were 54.05% of those with non-M3 AML. The death rate was 43% and the main proximate cause was septic shock (63.6%). ConclusionsIn this study, the majority of patients were male, white, and older than 1 year. Most patients with WBC count <10,000/mm3 at diagnosis lived. Overall survival was higher in patients with MRD <0.1%. The prognosis was better in patients with AML-M3." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "pt" => array:3 [ "titulo" => "Resumo" "resumen" => "ObjetivoDescrever o perfil epidemiológico e a taxa de sobrevida dos pacientes com Leucemia Mielóide Aguda (LMA), em um hospital pediátrico de referência estadual. MétodoEstudo clínico-epidemiológico, observacional, retrospectivo e descritivo. Foram incluídos casos novos de pacientes com LMA, diagnosticados entre os anos de 2004 e 2012, com idade <15 anos. ResultadosEntre os 51 pacientes estudados, 84% eram da raça branca, 45% do sexo feminino e 55% do masculino. Quanto a faixa etária, 8% tinham idade <1 ano, 47% entre 1 e 10 anos e, 45% >10 anos. Os principais sinais/sintomas ao diagnóstico foram febre (41,1%), astenia/inapetência (35,2%) e manifestações hemorrágicas (27,4%). O Sistema Nervoso Central foi o local extra-medular mais acometido (14%). Em 47% dos pacientes a leucometria ao diagnóstico foi <10.000/mm3. A doença residual mínima (DRM) no 15° dia de tratamento foi <0,1% em 16% da casuística. Recidiva medular ocorreu em 14% dos casos. Ao se comparar a DRM da medula óssea com o status vital, observou-se que estavam vivos 71,42% dos pacientes com LMA tipo M3 e 54,05% daqueles com LMA não-M3. A taxa de óbito foi de 43% e a principal causa imediata foi o choque séptico (63,6%). ConclusõesNeste estudo, a maioria dos pacientes é do sexo masculino, raça branca, maiores que 1 ano de idade. A maioria dos pacientes com leucometria <10.000/mm3 ao diagnóstico está viva. A sobrevida global é maior nos pacientes com DRM <0,1%. O prognóstico é melhor nos pacientes com LMA-M3." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusões" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: de Lima MC, da Silva DB, Freund AP, Dacoregio JS, Costa TE, Costa I, et al. Acute Myeloid Leukemia: analysis of epidemiological profile and survival rate. J Pediatr (Rio J). 2016;92:283–9." ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Signs/symptoms \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pallor \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25.40% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemorrhagic manifestations \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.40% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fever \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41.10% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Asthenia/lack of appetite \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.20% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Increase in soft tissue volume \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.80% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bone pain \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.50% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Abdominal pain \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.90% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Adenomegaly \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.90% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gingival hypertrophy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.80% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Respiratory symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.80% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1077184.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Signs and symptoms at diagnosis in number (n) and percentage (%) of patients with acute myeloid leukemia treated in Hospital Infantil Joana de Gusmão (HIJG), from 2004 to 2012." ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:2 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hematological alterations \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">White blood cell count</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><10,000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">10,000–50,000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">>50,000–100,000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">>100,000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Not mentioned \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">No. of platelets</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><20,000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">20,000–100,000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">>100,000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Not mentioned \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">Neutropenia</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Not mentioned \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1077183.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FAB \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1077185.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Hematological alterations and French–American–British (FAB) classification at diagnosis of patients with acute myeloid leukemia treated at Hospital Infantil Joana de Gusmão (HIJG), from 2004 to 2012." ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">MRD \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Vital status</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Alive</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Dead</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Total</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><0.1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42.85% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42.85% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">0.1–1.0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.14% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.14% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">>1.0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.44% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.14% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.58% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Not mentioned \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.44% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.44% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">71.42% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.58% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1077186.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Minimal residual disease (MRD) in bone marrow on the 15th day of treatment of acute promyelocytic leukemia (M3-AML) and vital status of patients treated at Hospital Infantil Joana de Gusmão (HIJG), from 2004 to 2012 (p=0.025)." ] ] 3 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">MRD \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Vital status</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Alive</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Dead</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Total</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><0.1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.14% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.81% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45.95% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">0.1–1.0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.51% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.11% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.62% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">>1.0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.40% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16.22% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.62% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Not mentioned \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.81% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.81% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54.05% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45.95% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1077187.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Minimal residual disease (MRD) in bone marrow on the 15th day of treatment of non-acute promyelocytic leukemia (non-M3-AML) and vital status of patients treated at Hospital Infantil Joana de Gusmão (HIJG), from 2004 to 2012 (p=0.019)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib0150" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A importância da imunofenotipagem na leucemia mielóide aguda" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.L. Martins" 1 => "R.P. Falcão" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Assoc Med Bras" "fecha" => "2000" "volumen" => "46" "paginaInicial" => "57" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10770904" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0155" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute myeloid leukemia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.E. Rubnitz" 1 => "B. Gibson" 2 => "F.O. Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.pcl.2007.11.003" "Revista" => array:6 [ "tituloSerie" => "Pediatr Clin North Am" "fecha" => "2008" "volumen" => "55" "paginaInicial" => "21" "paginaFinal" => "51" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18242314" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0160" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Leucemia mielocítica aguda da infância e adolescência – fracassos e vitórias" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W.V. Pereira" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Bras Hematol Hemoter" "fecha" => "2006" "volumen" => "28" "paginaInicial" => "239" "paginaFinal" => "241" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0165" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Leucemia mielóide aguda" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L.M. Cristofani" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Doenças neoplásicas da criança e do adolescente (Pediatria Instituto da Criança do Hospital das Clínicas-FMUSP)" "paginaInicial" => "81" "paginaFinal" => "87" "edicion" => "1st ed." "serieFecha" => "2012" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0170" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Perspectivas para a leucemia mieloide aguda na infância após observação de um grupo de pacientes tratados convencionalmente" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.A. Zanichelli" 1 => "L.M. Cistófani" 2 => "M.T. Almeida" 3 => "P.T. Maluf Júnior" 4 => "V.O. Filho" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Bras Hematol Hemoter" "fecha" => "2006" "volumen" => "28" "paginaInicial" => "246" "paginaFinal" => "252" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0175" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term outcome of childhood acute myeloid leukemia in a developing country: experience from a children's hospital in China" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "X.J. Xu" 1 => "Y.M. Tang" 2 => "H. Song" 3 => "S.L. Yang" 4 => "S.W. Shi" 5 => "J. Wei" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/10428194.2010.518653" "Revista" => array:6 [ "tituloSerie" => "Leuk Lymphoma" "fecha" => "2010" "volumen" => "51" "paginaInicial" => "2262" "paginaFinal" => "2269" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20929322" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0180" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pediatric acute myeloid leukemia: towards high-quality cure of all patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G.J. Kaspers" 1 => "C.M. Zwaan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3324/haematol.11203" "Revista" => array:6 [ "tituloSerie" => "Haematologica" "fecha" => "2007" "volumen" => "92" "paginaInicial" => "1519" "paginaFinal" => "1532" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18024401" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0185" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Children's Oncology Group's 2013 Blueprint for Research: acute myeloid leukemia" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "On behalf of the COG Acute Myeloid Leukemia Committee" "etal" => false "autores" => array:4 [ 0 => "A.S. Gamis" 1 => "T.A. Alonzo" 2 => "J.P. Perentesis" 3 => "S Meshinchi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/pbc.24432" "Revista" => array:6 [ "tituloSerie" => "Pediatr Blood Cancer" "fecha" => "2013" "volumen" => "60" "paginaInicial" => "964" "paginaFinal" => "971" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23255301" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0190" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Leucemia mieloide aguda na criança: experiência de 15 anos em uma única instituição" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.B. Viana" 1 => "K.C. Cunha" 2 => "G. Ramos" 3 => "M. Murao" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Pediatr (Rio J)" "fecha" => "2003" "volumen" => "79" "paginaInicial" => "489" "paginaFinal" => "496" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0195" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assembly of a cohort of children treated for acute myeloid leukemia at free-standing children's hospitals in the United States using an administrative database" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Kavcic" 1 => "B.T. Fisher" 2 => "K. Torp" 3 => "L. Yimei" 4 => "Y.S. Huang" 5 => "A.E. Seif" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/pbc.24402" "Revista" => array:6 [ "tituloSerie" => "Pediatr Blood Cancer" "fecha" => "2013" "volumen" => "60" "paginaInicial" => "508" "paginaFinal" => "511" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23192853" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0200" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors and short-term outcomes of hyperleukocytosis in children with acute myeloid leukemia: a report from the Children's Oncology Group" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "AML0531/PHIS Group" "etal" => false "autores" => array:5 [ 0 => "L. Sung" 1 => "R. Aplenc" 2 => "T.A. Alonzo" 3 => "R.B. Gerbing" 4 => "A.S. Gamis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3324/haematol.2012.065490" "Revista" => array:6 [ "tituloSerie" => "Haematologica" "fecha" => "2012" "volumen" => "97" "paginaInicial" => "1770" "paginaFinal" => "1773" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22801969" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0205" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment strategies and long-term results in paediatric treated in four consecutive AML-BFM trials" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "U. Creutzig" 1 => "M. Zimmermann" 2 => "J. Ritter" 3 => "D. Reinhardt" 4 => "J. Hermann" 5 => "G. Henze" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sj.leu.2403920" "Revista" => array:6 [ "tituloSerie" => "Leukemia" "fecha" => "2005" "volumen" => "19" "paginaInicial" => "2030" "paginaFinal" => "2042" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16304570" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0210" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis and management of acute myeloid leukemia in children and adolescents: recommendations from an international expert panel" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "on behalf of the AML Committee of the International BFM Study Group" "etal" => true "autores" => array:6 [ 0 => "U. Creutzig" 1 => "M.M. Heuvel-Eibrink" 2 => "B. Gibson" 3 => "M.N. Dworzak" 4 => "S. Adachi" 5 => "E. Bont" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2012-03-362608" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2012" "volumen" => "120" "paginaInicial" => "3187" "paginaFinal" => "3205" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22879540" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0215" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcome in 146 patients with paediatric acute myeloid leukaemia treated according to the AML99 protocol in the period 2003–06 from the Japan Association of Childhood Leukaemia Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Imamura" 1 => "S. Iwamoto" 2 => "R. Kanai" 3 => "A. Shimada" 4 => "K. Terui" 5 => "Y. Osugi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bjh.12030" "Revista" => array:7 [ "tituloSerie" => "Br J Haematol" "fecha" => "2012" "volumen" => "159" "paginaInicial" => "204" "paginaFinal" => "210" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22924344" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1053077008002267" "estado" => "S300" "issn" => "10530770" ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0220" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Childhood acute myeloid leukaemia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.E. Rubnitz" 1 => "H. Inaba" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bjh.12040" "Revista" => array:6 [ "tituloSerie" => "Br J Haematol" "fecha" => "2012" "volumen" => "159" "paginaInicial" => "259" "paginaFinal" => "287" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22966788" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0225" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early blast clearance by remission induction therapy is a major independent prognostic factor for both achievement of complete remission and long-term outcome in acute myeloid leukemia: data from the Germa AML Cooperative Group (AMLCG) 1992 Trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W. Kern" 1 => "T. Haferlach" 2 => "C. Schoch" 3 => "H. Loffler" 4 => "W. Gassmann" 5 => "A. Heinecke" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2002-02-0532" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2003" "volumen" => "101" "paginaInicial" => "64" "paginaFinal" => "70" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12393605" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0230" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Síndrome atra: experiência de 2 anos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.F. Pinheiro" 1 => "L.A. Pelloso" 2 => "M. Yamamoto" 3 => "M.L. Chauffaille" 4 => "J.A. Bordim" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Bras Cancerol" "fecha" => "2003" "volumen" => "49" "paginaInicial" => "27" "paginaFinal" => "31" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0235" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pediatric acute myeloid leucemia: biology and therapeutic implications of genomic variants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K. Tarlock" 1 => "S. Meshinchi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.pcl.2014.09.007" "Revista" => array:6 [ "tituloSerie" => "Pediatr Clin North Am" "fecha" => "2015" "volumen" => "62" "paginaInicial" => "75" "paginaFinal" => "93" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25435113" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0240" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute myeloid leukemia, myeloproliferative and myelodysplastic disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T.M. Cooper" 1 => "H. Hasle" 2 => "F.O. Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Principles and practice of pediatric oncology" "paginaInicial" => "566" "paginaFinal" => "610" "edicion" => "6th ed." 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Leucemia Mielóide Aguda: análise do perfil epidemiológico e taxa de sobrevida

Mariana Cardoso de Lima

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marianac_lima@yahoo.com.br

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, Denise Bousfield da Silva, Ana Paula Ferreira Freund, Juliana Shmitz Dacoregio, Tatiana El Jaick Bonifácio Costa, Imaruí Costa, Daniel Faraco, Maurício Laerte Silva

Service of Pediatric Oncology, Hospital Infantil Joana de Gusmão, Florianópolis, SC, Brazil

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Acute myeloid leukemia &#40;AML&#41; is a clonal disease of hematopoietic tissue characterized by abnormal proliferation of progenitor cells of myeloid lineage&#44; resulting in the insufficient generation of normal mature blood cells&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">It represents approximately 15&#8211;20&#37; of acute leukemia cases in childhood&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a> and accounts for about 30&#37; of deaths in this age range&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">2</span></a> In Brazil&#44; its estimated incidence is 400 cases per year&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Hemorrhagic manifestations&#44; fever&#44; and pallor are frequent symptoms of the disease at diagnosis&#46; The main causes of death are infections&#44; bleeding episodes&#44; leukostasis&#44; and tumor lysis syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The main factors affecting the mortality rate of these patients are those resulting from therapy intensification and disease relapse&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">AML prognosis improvement has been made possible by disease stratification into risk groups based on cytogenetics&#44; the evaluation of early response to treatment&#44; and the identification of chemotherapy-induction failure&#46; Currently&#44; the likelihood of AML cure in developed countries is around 60&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7&#44;8</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Considering that in recent decades there has been progress in the introduction of new chemotherapy treatment protocols for AML and that the information in the pediatric population and its clinical outcomes are still scarce&#44; this study aimed to analyze the eight-year experience in a pediatric oncology service&#44; in the South of Brazil&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">This was a clinical&#8211;epidemiological&#44; observational&#44; retrospective&#44; descriptive study approved by the Ethics Committee on Human Research of Hospital Infantil Joana de Gusm&#227;o &#40;HIJG&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The study included all new cases of AML patients younger than 15 years treated in HIJG between January 2004 and August 2012&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Exclusion criteria were loss to follow-up&#59; patient transfer to another service&#59; insufficient data at the hospital cancer registry and medical records and statistics department of HIJG&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The diagnosis of AML was based on morphology&#44; cytochemistry&#44; and immunophenotyping by flow cytometry of bone marrow aspirate and&#47;or peripheral blood&#44; performed with EuroFlow 8-color antibody panels &#40;EuroFlow-ESLHO&#44; Rotterdam&#44; NL&#41;&#46; The minimal residual disease &#40;MRD&#41; was analyzed by flow cytometry in the bone marrow after 15 days of induction treatment&#46; The treatment protocols used were from the International Berlin-Frankfurt-M&#252;nster &#40;BFM&#41; Study Group AML-83 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#41;&#44; AML-98 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>22&#41;&#44; and AML-2004 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>23&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The analyzed variables were age at diagnosis &#40;age range stratified as &#60;1 year&#44; 1 year to 10 years&#44; and <span class="elsevierStyleMonospace">&#62;</span>10 years&#41;&#59; gender&#59; ethnicity&#47;skin color&#44; as established by the Brazilian Institute of Geography and Statistics &#40;Instituto Brasileiro de Geografia e Estat&#237;stica &#8211; IBGE&#41; as white&#44; black&#44; brown&#44; yellow&#44; and indigenous&#59; origin&#44; according to the mesoregions of the state of Santa Catarina established by IBGE &#40;city of Florian&#243;polis&#44; Northern Santa Catarina&#44; Western Santa Catarina&#44; Mountain Region&#44; Southern Santa Catarina&#44; Valley of Itaja&#237;&#41; and others &#40;from other states&#41;&#59; predominant signs and symptoms at diagnosis &#40;fever&#44; bone pain&#44; abdominal pain&#44; enlarged lymph nodes&#44; hemorrhagic manifestations&#44; gingival hypertrophy&#44; pallor&#44; asthenia&#47;lack of appetite&#44; swelling of soft tissue&#44; and respiratory symptoms&#41;&#59; laboratory findings at diagnosis &#40;white blood cell count&#44; neutropenia&#44; and platelet count&#41;&#59; extramedullary involvement at diagnosis &#40;CNS or other sites&#41;&#59; AML classification according to the French&#8211;American&#8211;British group &#40;FAB&#41;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a>&#59; presence and type of laboratory genetic alterations&#59; presence or absence of clinical and laboratory remission after the first chemotherapy induction&#44; according to the MRD value on the 15th day of induction&#44; obtained by flow cytometry&#59; vital status &#40;alive or deceased&#41;&#59; death &#40;in remission or not from neoplastic disease&#41;&#44; immediate cause of death&#59; presence and location of disease recurrence &#40;bone marrow&#44; extramedullary&#44; or combined&#41;&#59; and bone marrow transplantation&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The statistical procedures used in the study were descriptive measures&#44; frequency tables&#44; and Pearson&#39;s chi-squared test&#44; with 95&#37; of significance &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; to analyze&#44; as an exploratory characteristic&#44; the association between two variables&#46; Associations were verified between the variables vital status and white blood cell count&#44; vital status and type M3-AML MRD&#44; and vital status and non-M-AML MRD&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">Of the 51 patients&#44; 55&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>28&#41; were males and 45&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>23&#41; females&#44; at a ratio of 1&#46;2&#58;1&#46; Whites predominated&#44; accounting for 84&#37; of patients&#46; Brown and black patients represented 16&#37; of the sample&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Mean age at diagnosis was 7&#46;3 years &#40;SD<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;8 years&#41; with a median of 9 years&#46; The youngest age at diagnosis was 19 days and the oldest&#44; 14 years&#46; Regarding the age range&#44; 8&#37; of the sample were aged &#60;1 year&#44; 47&#37; were between 1 and 10 years&#44; and 45&#37; were &#62;10 years&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">As for the origin&#44; according to the mesoregions of Santa Catarina by IBGE&#44; 29&#37; were from the city of Florian&#243;polis &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#41;&#44; 24&#37; were from the Western Region &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#41;&#44; 20&#37; from the Mountain Region &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41;&#44; 10&#37; from the Northern Region &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41;&#44; 8&#37; from the Southern Region &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#41;&#44; 8&#37; from the Itajai Valley &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#41;&#44; and 2&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41; were from another state&#44; Paran&#225;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The main signs and symptoms at diagnosis are described in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">At diagnosis&#44; 24&#37; of patients had extramedullary disease &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#41;&#44; and the most often affected site was the central nervous system &#40;CNS&#41; in 14&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41;&#46; The other 10&#37; had skin involvement &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#44; bone involvement&#44; and soft tissue edema &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Laboratory data at AML diagnosis &#40;leukocytes&#44; platelets&#44; and neutropenia&#41; and morphological FAB classification are described in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">When correlating WBC count at diagnosis with vital status &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;014&#41;&#44; it was observed that 79&#46;2&#37; of patients with WBC count &#60;10&#44;000 lived&#44; whereas 29&#46;4&#37; of those with WBC counts between 10&#44;000 and 50&#44;000 lived&#46; The three patients &#40;6&#37;&#41; that had WBC count &#62;100&#44;000 died&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The study of genetic disorders was documented in 51&#37; of patients &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26&#41;&#44; showing alterations in 46&#46;15&#37; of cases &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#41;&#46; The most frequent alteration was t&#40;15&#59;17&#41;&#44; found in six patients &#40;23&#37;&#41;&#46; One of these patients had an association of t&#40;15&#59;17&#41; with FLT3-ITD mutation&#46; The other genetic disorders found were polyploidy&#44; t&#40;8&#59;21&#41;&#44; presence of MLL rearrangement&#44; t&#40;3&#59;5&#41; deletion of chromosome 18&#44; trisomy of chromosome 21&#44; trisomy of chromosome 8&#44; and tetrasomy of chromosome 8&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">MRD analysis in 45&#37; of patients &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>23&#41; was &#60;0&#46;1&#37;&#59; in 16&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41; it was between 0&#46;1&#37; and 1&#46;0&#37;&#59; in 25&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41; it was &#62;1&#46;0&#37;&#59; 14&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41; of the cases lacked the test result in the medical record&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The comparison between the bone marrow MRD&#44; on the 15th day of treatment and the vital status of patients with acute promyelocytic leukemia &#40;M3-AML&#41; and acute non-promyelocytic leukemia &#40;non-M-AML&#41; is described in <a class="elsevierStyleCrossRefs" href="#tbl0015">Tables 3 and 4</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Overall survival was 57&#37; in this study&#46; By correlating vital status with M3-AML and non-M-AML&#44; it was observed that 71&#46;42&#37; and 54&#46;05&#37; of the patients were alive&#44; respectively&#44; at the end of the study&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Of the patients who died &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>22&#41;&#44; 64&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41; were not in complete clinical remission of leukemia at the end of chemotherapy induction&#46; The main immediate cause of death was septic shock in 63&#46;6&#37; of patients &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41;&#46; Of the deaths&#44; three occurred within the first 15 days of treatment&#44; one from intracranial hemorrhage &#40;M3-AML&#41; and the other two&#44; in addition to sepsis&#44; had pulmonary leukostasis and intracranial hemorrhage with spinal fluid infiltrate at diagnosis&#44; respectively&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Regarding the deaths that occurred after the 16th day of induction treatment &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41;&#44; 12 occurred due to septic shock&#46; Of these&#44; six occurred after chemotherapy re-induction for recurrence&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Of patients with WBC count &#62;100&#44;000&#44; one patient had M3-AML&#44; whose immediate cause of death was septic shock&#44; another had M0-AML with pulmonary leukostasis associated with septic shock&#44; and the other had M5-AML with acute renal failure&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Regarding the patients &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#41; that had t&#40;15&#59;17&#41; mutations&#44; two died&#46; The patient that had t&#40;15&#59;17&#41; and FLT3-ITD mutations was alive and in remission until the date of completion of this study&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Among the assessed patients&#44; 39&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41; were submitted to radiotherapy and 16&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41; to bone marrow transplantation &#40;BMT&#41;&#46; Of the patients who underwent BMT&#44; two died and the others are alive and in complete remission of leukemia&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">In 14&#37; of cases &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41; there was disease recurrence in the bone marrow and&#44; of these&#44; six patients died&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0150" class="elsevierStylePara elsevierViewall">In this study&#44; most patients were male and older than 1 year&#46; Most of those that had WBC count &#60;10&#44;000&#47;mm<span class="elsevierStyleSup">3</span> at diagnosis are alive&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Overall survival is higher in patients with MRD &#60;0&#46;1&#37; and the prognosis is better in patients with M3-AML&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">In other studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">9&#44;10</span></a> male gender also showed a slight predominance to females &#40;1&#46;2&#58;1&#41;&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">As in the study by Kavcic&#44;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">10</span></a> it was observed that AML predominated in whites&#46; In Santa Catarina&#44; as a result of the white descent of the majority of the population&#44; white ethnicity was predominant&#44; making it impossible to establish comparisons between the ethnic groups&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Corroborating other studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">10&#8211;12</span></a> this study showed a higher prevalence of AML in the age range &#62;1 year old&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">This study&#44; as in the literature&#44; also demonstrated that the signs and symptoms of AML result from bone marrow infiltration&#44; with hemorrhagic manifestations&#44; fever&#44; asthenia&#44; pallor&#44; and bone pain&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">2</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">In previously published studies&#44; the percentage of CNS involvement at diagnosis ranged from 5&#37; to 15&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">2&#44;13</span></a> In this study&#44; 14&#37; of patients had CNS involvement at diagnosis&#44; similarly to what was described by Rubnitz et al&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">13</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">Studies have shown that the percentage of patients with WBC counts &#62;100&#44;000&#47;mm<span class="elsevierStyleSup">3</span> is between 12&#37; and 15&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">6&#44;9&#44;14</span></a> In this series&#44; only 6&#37; of cases had this elevated WBC count at diagnosis&#46; This difference can be explained by the lack of data available in the medical records of some patients&#44; the size of this sample&#44; or the earlier disease diagnosis&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">WBC count is the most important risk factor for treatment failure&#44; due to the possibility of causing bleeding complications or respiratory failure due to leukostasis&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">9&#44;15</span></a> The present study showed that 80&#37; of patients had WBC count &#60;50&#44;000&#47;mm<span class="elsevierStyleSup">3</span> at diagnosis&#44; similar to the study by Imamura et al&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">14</span></a></p><p id="par0195" class="elsevierStylePara elsevierViewall">The probability of event-free survival &#40;EFS&#41; in five years was only 23&#37; in patients with WBC count &#62;100&#44;000&#47;mm<span class="elsevierStyleSup">3</span> according to the analysis of the BFM-83 and BFM-87 treatment protocols&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">9</span></a> This study showed that 79&#46;2&#37; of the patients &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;014&#41; with WBC count &#60;10&#44;000&#47;mm<span class="elsevierStyleSup">3</span> at diagnosis lived&#44; whereas among those with WBC counts between 10&#44;000 and 50&#44;000&#47;mm<span class="elsevierStyleSup">3</span>&#44; only 29&#46;4&#37; lived&#46; Only three patients in this study had a WBC count &#62;100&#44;000&#47;mm<span class="elsevierStyleSup">3</span> at diagnosis&#44; thus making the statistical analysis impossible&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">The FAB morphological classification for AML can define treatment and risk group stratification&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a> In previously published studies<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">9&#44;14&#44;16</span></a> the most frequently identified subtype was M2&#44; ranging from 33&#46;6&#37; to 37&#37;&#46; In the present study&#44; the most prevalent morphological types were M2 &#40;27&#37;&#41; and M3 &#40;27&#37;&#41;&#44; similar to the findings of Xiao-Jun Xu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">After the advent of all-trans-retinoic acid &#40;TRA&#41;&#44; M3-AML became the FAB subtype with the best prognosis&#44; by inducing the differentiation of leukemic precursors into mature cells&#44; controlled by this drug&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">1&#44;17</span></a> The present study also found good therapeutic response to this medication&#44; considering that 71&#46;42&#37; of patients with M3-AML and 54&#46;05&#37; of those with non-M3-AML were alive at the end of this study&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">AML is a heterogeneous disease from the molecular point of view&#44; including somatic and epigenetic alterations that contribute to myeloid leukemogenesis&#46; These cytogenetic abnormalities&#44; somatic mutations&#44; and the induction therapy response are important information for risk stratification and adequate therapy allocation&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">18</span></a></p><p id="par0215" class="elsevierStylePara elsevierViewall">Chromosomal abnormalities in AML include aberrations described as gain or loss of whole chromosomes structural abnormalities or balanced translocations&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">19</span></a> The literature reports that the translocation t&#40;8&#59;21&#41; is the most prevalent&#44; varying between 12&#37; and 23&#37;&#44;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">12&#8211;14</span></a> whereas t&#40;15&#59;17&#41; is observed in 3&#46;4&#8211;10&#37; of cases&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">12&#44;13</span></a></p><p id="par0220" class="elsevierStylePara elsevierViewall">According to the present results&#44; 46&#37; of the assessed patients have some cytogenetic alteration&#44; and translocation t&#40;15&#59;17&#41; was most prevalent &#40;23&#37;&#41;&#44; which is justified by the number of cases of M3-AML in this study&#46; As this alteration has a favorable prognosis&#44; it confirms the findings of increased survival in patients with M3-AML&#46; It is noteworthy that the cytogenetic analysis of patients in this study was documented in only 51&#37; of cases&#44; which might have underestimated the results&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">A recent study<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a> stated that survival is poor in patients with translocation t&#40;15&#59;17&#41; and FLT3-ITD mutation association&#44; thus representing an independent prognostic predictor&#44; with a progression-free survival rate of 16&#37;&#46; In the present series&#44; only one patient with M3-AML had the translocation t&#40;15&#59;17&#41; and FLT3-ITD association&#44; and was alive and without signs of relapse at the end of the study&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">In the BFM study&#44; bone marrow MRD measured after the first treatment course was the best event-free survival predictor when compared to the risk classification scheme by FAB subtype&#44; cytogenetics&#44; and the presence of blasts in peripheral blood morphology on the 15th day of anti-neoplastic treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a> The presence of high MRD after the first course of induction was significantly associated with an adverse outcome&#46; The recurrence rate was particularly high &#40;49&#37;&#41; in patients with MRD &#62;1&#37;&#44; while in patients with lower MRD &#40;0&#46;1&#8211;1&#37;&#41;&#44; the rate was only 17&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a></p><p id="par0235" class="elsevierStylePara elsevierViewall">The study by Al-Mawali et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">20</span></a> also demonstrated that MRD &#62;0&#46;15&#37; was an independent predictor of poor prognosis after chemotherapy induction&#46; Other studies have also demonstrated a correlation between MRD &#60;0&#46;1&#37; and improved event-free survival&#44; such as the study by Rubnitz et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">21</span></a> and Inaba et al&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">22&#44;23</span></a></p><p id="par0240" class="elsevierStylePara elsevierViewall">Although MRD is a strong prognostic factor&#44; approximately 25&#37; of patients with low MRD will have disease recurrence&#46; The study by Karol et al&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a> identified&#44; among the risk factors for recurrence&#44; certain 11q23 abnormalities such as t&#40;6&#59;11&#41; and t&#40;10&#59;11&#41;&#44; megakaryocytic leukemia without t&#40;1&#58;22&#41;&#44; and age &#8805;10 years&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a></p><p id="par0245" class="elsevierStylePara elsevierViewall">In this study&#44; when comparing the MRD &#60;0&#46;1&#37; on the 15th day of treatment with vital status&#44; it was observed that 100&#37; of patients with M3-AML and 76&#46;5&#37; of patients with non-M3-AML were alive&#44; respectively&#46; When MRD was &#62;1&#46;0&#37;&#44; it was observed that 75&#37; of M3-AML patients and 25&#37; of non-M3-AML patients were alive&#46; There was a statistical significance between bone marrow MRD and vital status &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;022&#41;&#44; as well as between M3-AML and vital status &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;025&#41; and non-M3-AML and vital status &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;019&#41;&#46; These data corroborate the prognostic importance of MRD quantification&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">Regarding recurrence&#44; the bone marrow is the most frequent site of AML relapse&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a> In this series&#44; all recurrences occurred at this site&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">Recent antineoplastic therapies&#44; such as new chemotherapeutic agents&#44; monoclonal antibodies&#44; and immunomodulators&#44; are challenges in the assessment of the impact on the child&#39;s immune function and of infectious complications&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">19</span></a></p><p id="par0260" class="elsevierStylePara elsevierViewall">The literature reports that the leading cause of death in these patients is infection&#44; and that it is mainly related to chemotherapy intensification&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">5&#44;6&#44;9</span></a></p><p id="par0265" class="elsevierStylePara elsevierViewall">A study by Silva et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">25</span></a> analyzing mortality trends in Brazil in children with leukemia in the 1980&#8211;2010 period&#44; reports that the deaths associated to the treatment of acute myeloid leukemia in less developed countries can reach up to 33&#37;&#44; as the intensive chemotherapy regimen predisposes to severe neutropenia and exposes patients to infections&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">Pediatric patients treated for AML are at high risk for infectious complications&#44; predominantly bacterial and fungal&#46; Some institutions have implemented prophylaxis with antibiotic and anti-fungal agents&#44; aimed at reducing these infections&#46; However&#44; the systematic evaluation of antibiotic prophylaxis studies indicates that there is insufficient data to define guidelines for their use&#46; Therefore&#44; additional studies are needed to accurately identify the best antibiotic regimen&#44; as well as for which population of children they would be indicated&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">26&#44;27</span></a></p><p id="par0275" class="elsevierStylePara elsevierViewall">The present study also showed that septic shock &#40;63&#46;6&#37;&#41; was the most prevalent cause of death&#46; Of the 19 patients that died after the 15th day of the induction therapy&#44; six had relapsed&#46; The deaths that occurred in this period were probably due to infections after aplasia induction&#46;</p><p id="par0280" class="elsevierStylePara elsevierViewall">In recent decades&#44; in spite of the improved AML prognosis&#44; approximately one-third of patients had recurrence&#46; This population has a poor prognosis&#44; with long-term survival probability of approximately 35&#37;&#44; despite the use of intensive chemotherapy and allogeneic bone marrow transplantation&#46; The toxicity and mortality resulting from this treatment are also significant&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">28</span></a></p><p id="par0285" class="elsevierStylePara elsevierViewall">Currently&#44; studies with targeted therapies are being developed&#44; focusing primarily on the functional pathways of leukemic cells&#44; such as cell surface receptors&#44; specific intracellular kinases&#44; proteins that regulate cell death and gene expression modulators&#44; aiming to improve AML patient survival&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">29</span></a></p><p id="par0290" class="elsevierStylePara elsevierViewall">AML treatment should be based on a clinical structure capable of supporting the therapeutic aggressiveness&#44; in addition to a laboratory structure capable of discriminating the risk groups and contributing to the identification of relevant prognostic factors&#44; as well as providing supportive measures for the care of these patients&#46;</p><p id="par0295" class="elsevierStylePara elsevierViewall">In this series&#44; selection bias was considered due to the inclusion of all cases diagnosed at the service&#46; These results may have been influenced by characteristics of the assessed population&#59; the different treatment protocols used &#40;BFM&#41;&#59; the available medical and hospital resources in this service&#59; and the sample size&#46; However&#44; the results observed in this study show the need to perform national&#44; multicenter&#44; analytical studies&#44; aiming at confirmation of the observed associations and thus&#44; establishing prognostic factors for AML&#46;</p><p id="par0300" class="elsevierStylePara elsevierViewall">In this study&#44; the comparison of bone marrow MRD on the 15th day of induction treatment with vital status showed that 71&#46;42&#37; of patients with type M3 AML and 54&#46;05&#37; of those with non-M3-AML were alive&#46; The death rate was 43&#37; and the main immediate cause was septic shock &#40;63&#46;6&#37;&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflicts of interest</span><p id="par0305" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest&#46;</p></span></span>"
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    "fechaRecibido" => "2015-04-22"
    "fechaAceptado" => "2015-08-05"
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          "clase" => "keyword"
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          "palabras" => array:3 [
            0 => "Acute myeloid leukemia"
            1 => "Leukemia"
            2 => "Children"
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          "clase" => "keyword"
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          "palabras" => array:3 [
            0 => "Leucemia miel&#243;ide aguda"
            1 => "Leucemia"
            2 => "Crian&#231;a"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To describe the epidemiological profile and the survival rate of patients with acute myeloid leukemia &#40;AML&#41; in a state reference pediatric hospital&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Clinical&#8211;epidemiological&#44; observational&#44; retrospective&#44; descriptive study&#46; The study included new cases of patients with AML&#44; diagnosed between 2004 and 2012&#44; younger than 15 years&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Of the 51 patients studied&#44; 84&#37; were white&#59; 45&#37; were females and 55&#37;&#44; males&#46; Regarding age&#44; 8&#37; were younger than 1 year&#44; 47&#37; were aged between 1 and 10 years&#44; and 45&#37; were older than 10 years&#46; The main signs&#47;symptoms were fever &#40;41&#46;1&#37;&#41;&#44; asthenia&#47;lack of appetite &#40;35&#46;2&#37;&#41;&#44; and hemorrhagic manifestations &#40;27&#46;4&#37;&#41;&#46; The most affected extra-medullary site was the central nervous system &#40;14&#37;&#41;&#46; In 47&#37; of patients&#44; the white blood cell &#40;WBC&#41; count was below 10&#44;000&#47;mm<span class="elsevierStyleSup">3</span> at diagnosis&#46; The minimal residual disease &#40;MRD&#41; was less than 0&#46;1&#37;&#44; on the 15th day of treatment in 16&#37; of the sample&#46; Medullary relapse occurred in 14&#37; of cases&#46; When comparing the bone marrow MRD with the vital status&#44; it was observed that 71&#46;42&#37; of the patients with type M3 AML were alive&#44; as were 54&#46;05&#37; of those with non-M3 AML&#46; The death rate was 43&#37; and the main proximate cause was septic shock &#40;63&#46;6&#37;&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In this study&#44; the majority of patients were male&#44; white&#44; and older than 1 year&#46; Most patients with WBC count &#60;10&#44;000&#47;mm<span class="elsevierStyleSup">3</span> at diagnosis lived&#46; Overall survival was higher in patients with MRD &#60;0&#46;1&#37;&#46; The prognosis was better in patients with AML-M3&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Descrever o perfil epidemiol&#243;gico e a taxa de sobrevida dos pacientes com Leucemia Miel&#243;ide Aguda &#40;LMA&#41;&#44; em um hospital pedi&#225;trico de refer&#234;ncia estadual&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudo cl&#237;nico-epidemiol&#243;gico&#44; observacional&#44; retrospectivo e descritivo&#46; Foram inclu&#237;dos casos novos de pacientes com LMA&#44; diagnosticados entre os anos de 2004 e 2012&#44; com idade <span class="elsevierStyleMonospace">&#60;</span>15 anos&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Entre os 51 pacientes estudados&#44; 84&#37; eram da ra&#231;a branca&#44; 45&#37; do sexo feminino e 55&#37; do masculino&#46; Quanto a faixa et&#225;ria&#44; 8&#37; tinham idade <span class="elsevierStyleMonospace">&#60;</span>1 ano&#44; 47&#37; entre 1 e 10 anos e&#44; 45&#37; &#62;10 anos&#46; Os principais sinais&#47;sintomas ao diagn&#243;stico foram febre &#40;41&#44;1&#37;&#41;&#44; astenia&#47;inapet&#234;ncia &#40;35&#44;2&#37;&#41; e manifesta&#231;&#245;es hemorr&#225;gicas &#40;27&#44;4&#37;&#41;&#46; O Sistema Nervoso Central foi o local extra-medular mais acometido &#40;14&#37;&#41;&#46; Em 47&#37; dos pacientes a leucometria ao diagn&#243;stico foi &#60;10&#46;000&#47;mm<span class="elsevierStyleSup">3</span>&#46; A doen&#231;a residual m&#237;nima &#40;DRM&#41; no 15&#176; dia de tratamento foi &#60;0&#44;1&#37; em 16&#37; da casu&#237;stica&#46; Recidiva medular ocorreu em 14&#37; dos casos&#46; Ao se comparar a DRM da medula &#243;ssea com o status vital&#44; observou-se que estavam vivos 71&#44;42&#37; dos pacientes com LMA tipo M3 e 54&#44;05&#37; daqueles com LMA n&#227;o-M3&#46; A taxa de &#243;bito foi de 43&#37; e a principal causa imediata foi o choque s&#233;ptico &#40;63&#44;6&#37;&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Neste estudo&#44; a maioria dos pacientes &#233; do sexo masculino&#44; ra&#231;a branca&#44; maiores que 1 ano de idade&#46; A maioria dos pacientes com leucometria &#60;10&#46;000&#47;mm<span class="elsevierStyleSup">3</span> ao diagn&#243;stico est&#225; viva&#46; A sobrevida global &#233; maior nos pacientes com DRM &#60;0&#44;1&#37;&#46; O progn&#243;stico &#233; melhor nos pacientes com LMA-M3&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; de Lima MC&#44; da Silva DB&#44; Freund AP&#44; Dacoregio JS&#44; Costa TE&#44; Costa I&#44; et al&#46; Acute Myeloid Leukemia&#58; analysis of epidemiological profile and survival rate&#46; J Pediatr &#40;Rio J&#41;&#46; 2016&#59;92&#58;283&#8211;9&#46;</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Signs&#47;symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pallor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#46;40&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemorrhagic manifestations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;40&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fever&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Asthenia&#47;lack of appetite&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#46;20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Increase in soft tissue volume&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;80&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bone pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;50&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Abdominal pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;90&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Adenomegaly&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;90&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gingival hypertrophy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;80&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Respiratory symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;80&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1077184.png"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Signs and symptoms at diagnosis in number &#40;<span class="elsevierStyleItalic">n</span>&#41; and percentage &#40;&#37;&#41; of patients with acute myeloid leukemia treated in Hospital Infantil Joana de Gusm&#227;o &#40;HIJG&#41;&#44; from 2004 to 2012&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hematological alterations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">White blood cell count</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;10&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>10&#44;000&#8211;50&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;50&#44;000&#8211;100&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;100&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Not mentioned&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">No&#46; of platelets</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;20&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>20&#44;000&#8211;100&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;100&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Not mentioned&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Neutropenia</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Not mentioned&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1077183.png"
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            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FAB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">M7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Hematological alterations and French&#8211;American&#8211;British &#40;FAB&#41; classification at diagnosis of patients with acute myeloid leukemia treated at Hospital Infantil Joana de Gusm&#227;o &#40;HIJG&#41;&#44; from 2004 to 2012&#46;</p>"
        ]
      ]
      2 => array:7 [
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        "etiqueta" => "Table 3"
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          "tablatextoimagen" => array:1 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">MRD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Vital status</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Alive</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Dead</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Total</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#60;0&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&#46;85&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&#46;85&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">0&#46;1&#8211;1&#46;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;14&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;14&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#62;1&#46;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;44&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;14&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;58&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Not mentioned&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;44&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;44&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71&#46;42&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;58&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;40&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;22&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;62&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;81&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;81&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&#46;05&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#46;95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&#37;&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Minimal residual disease &#40;MRD&#41; in bone marrow on the 15th day of treatment of non-acute promyelocytic leukemia &#40;non-M3-AML&#41; and vital status of patients treated at Hospital Infantil Joana de Gusm&#227;o &#40;HIJG&#41;&#44; from 2004 to 2012 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;019&#41;&#46;</p>"
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      "titulo" => "References"
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        0 => array:2 [
          "identificador" => "bibs0005"
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            0 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A import&#226;ncia da imunofenotipagem na leucemia miel&#243;ide aguda"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;L&#46; Martins"
                            1 => "R&#46;P&#46; Falc&#227;o"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Assoc Med Bras"
                        "fecha" => "2000"
                        "volumen" => "46"
                        "paginaInicial" => "57"
                        "paginaFinal" => "62"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10770904"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
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              "identificador" => "bib0155"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute myeloid leukemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;E&#46; Rubnitz"
                            1 => "B&#46; Gibson"
                            2 => "F&#46;O&#46; Smith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.pcl.2007.11.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Clin North Am"
                        "fecha" => "2008"
                        "volumen" => "55"
                        "paginaInicial" => "21"
                        "paginaFinal" => "51"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18242314"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Leucemia mieloc&#237;tica aguda da inf&#226;ncia e adolesc&#234;ncia &#8211; fracassos e vit&#243;rias"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "W&#46;V&#46; Pereira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Bras Hematol Hemoter"
                        "fecha" => "2006"
                        "volumen" => "28"
                        "paginaInicial" => "239"
                        "paginaFinal" => "241"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Leucemia miel&#243;ide aguda"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46;M&#46; Cristofani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Doen&#231;as neopl&#225;sicas da crian&#231;a e do adolescente &#40;Pediatria Instituto da Crian&#231;a do Hospital das Cl&#237;nicas-FMUSP&#41;"
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                        "serieFecha" => "2012"
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            ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Perspectivas para a leucemia mieloide aguda na inf&#226;ncia ap&#243;s observa&#231;&#227;o de um grupo de pacientes tratados convencionalmente"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;A&#46; Zanichelli"
                            1 => "L&#46;M&#46; Cist&#243;fani"
                            2 => "M&#46;T&#46; Almeida"
                            3 => "P&#46;T&#46; Maluf J&#250;nior"
                            4 => "V&#46;O&#46; Filho"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Bras Hematol Hemoter"
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                        "volumen" => "28"
                        "paginaInicial" => "246"
                        "paginaFinal" => "252"
                      ]
                    ]
                  ]
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term outcome of childhood acute myeloid leukemia in a developing country&#58; experience from a children&#39;s hospital in China"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "X&#46;J&#46; Xu"
                            1 => "Y&#46;M&#46; Tang"
                            2 => "H&#46; Song"
                            3 => "S&#46;L&#46; Yang"
                            4 => "S&#46;W&#46; Shi"
                            5 => "J&#46; Wei"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3109/10428194.2010.518653"
                      "Revista" => array:6 [
                        "tituloSerie" => "Leuk Lymphoma"
                        "fecha" => "2010"
                        "volumen" => "51"
                        "paginaInicial" => "2262"
                        "paginaFinal" => "2269"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20929322"
                            "web" => "Medline"
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                      "titulo" => "Pediatric acute myeloid leukemia&#58; towards high-quality cure of all patients"
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                        "paginaFinal" => "1532"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18024401"
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                    0 => array:2 [
                      "titulo" => "Children&#39;s Oncology Group&#39;s 2013 Blueprint for Research&#58; acute myeloid leukemia"
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                          "colaboracion" => "On behalf of the COG Acute Myeloid Leukemia Committee"
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                            0 => "A&#46;S&#46; Gamis"
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                            3 => "S Meshinchi"
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                    0 => array:2 [
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                        "paginaFinal" => "971"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23255301"
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                    0 => array:2 [
                      "titulo" => "Leucemia mieloide aguda na crian&#231;a&#58; experi&#234;ncia de 15 anos em uma &#250;nica institui&#231;&#227;o"
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                            3 => "M&#46; Murao"
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Pediatr &#40;Rio J&#41;"
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                0 => array:2 [
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                            4 => "Y&#46;S&#46; Huang"
                            5 => "A&#46;E&#46; Seif"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23192853"
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                          "colaboracion" => "AML0531&#47;PHIS Group"
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                            2 => "T&#46;A&#46; Alonzo"
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                            4 => "A&#46;S&#46; Gamis"
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                    ]
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                    0 => array:2 [
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                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22801969"
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                    0 => array:2 [
                      "titulo" => "Treatment strategies and long-term results in paediatric treated in four consecutive AML-BFM trials"
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                          "etal" => true
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                            4 => "J&#46; Hermann"
                            5 => "G&#46; Henze"
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                        "tituloSerie" => "Leukemia"
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                        "volumen" => "19"
                        "paginaInicial" => "2030"
                        "paginaFinal" => "2042"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16304570"
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                      "titulo" => "Diagnosis and management of acute myeloid leukemia in children and adolescents&#58; recommendations from an international expert panel"
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                0 => array:2 [
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22924344"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Childhood acute myeloid leukaemia"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22966788"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Early blast clearance by remission induction therapy is a major independent prognostic factor for both achievement of complete remission and long-term outcome in acute myeloid leukemia&#58; data from the Germa AML Cooperative Group &#40;AMLCG&#41; 1992 Trial"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12393605"
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Bras Cancerol"
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                        "paginaFinal" => "31"
                      ]
                    ]
                  ]
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                      "titulo" => "Pediatric acute myeloid leucemia&#58; biology and therapeutic implications of genomic variants"
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                    0 => array:2 [
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                        "tituloSerie" => "Pediatr Clin North Am"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25435113"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Acute myeloid leukemia&#44; myeloproliferative and myelodysplastic disorders"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "The role of multiparameter flow cytometry for detection of minimal residual disease in acute myelois leukemia"
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                        "tituloSerie" => "Am J Clin Pathol"
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                        "paginaFinal" => "26"
                        "link" => array:1 [
                          0 => array:2 [
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                        "paginaFinal" => "552"
                        "link" => array:1 [
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                    0 => array:2 [
                      "titulo" => "Comparative analysis of different approaches to measure treatment response in acute myeloid leukemia"
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                        "paginaInicial" => "3625"
                        "paginaFinal" => "3632"
                        "link" => array:1 [
                          0 => array:2 [
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                ]
              ]
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              "identificador" => "bib0260"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Infants with acute myeloid leucemia treated according to the associazione Italiana di Ematologia e Oncologia Pediatrica 2002&#47;01 protocol have an outcome comparable to that of older children"
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                        0 => array:2 [
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Prognostic factors in children with acute myeloid leukaemia and excellent response to remission induction therapy"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/bjh.13107"
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                        "paginaFinal" => "101"
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                        "link" => array:1 [
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                        "tituloSerie" => "Br J Haematol"
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                        "paginaInicial" => "636"
                        "paginaFinal" => "645"
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Article information

ISSN: 00217557
Original language: English

DOI:10.1016/j.jped.2015.08.008

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Year/Month	Html	Pdf	Total

2024 November	15	4	19
2024 October	64	22	86
2024 September	62	35	97
2024 August	70	44	114
2024 July	86	52	138
2024 June	74	17	91
2024 May	62	19	81
2024 April	41	27	68
2024 March	27	15	42
2024 February	44	30	74
2024 January	58	20	78
2023 December	35	22	57
2023 November	36	31	67
2023 October	32	35	67
2023 September	49	41	90
2023 August	18	12	30
2023 July	20	10	30
2023 June	46	23	69
2023 May	56	15	71
2023 April	63	5	68
2023 March	65	21	86
2023 February	32	15	47
2023 January	22	18	40
2022 December	75	17	92
2022 November	76	22	98
2022 October	52	27	79
2022 September	47	42	89
2022 August	68	33	101
2022 July	61	31	92
2022 June	46	32	78
2022 May	59	32	91
2022 April	75	29	104
2022 March	76	31	107
2022 February	66	25	91
2022 January	24	15	39
2021 December	22	29	51
2021 November	16	19	35
2021 October	28	14	42
2021 September	16	7	23
2021 August	29	11	40
2021 July	20	8	28
2021 June	18	13	31
2021 May	29	14	43
2021 April	142	45	187
2021 March	70	19	89
2021 February	37	7	44
2021 January	45	10	55
2020 December	36	15	51
2020 November	30	15	45
2020 October	22	12	34
2020 September	27	17	44
2020 August	28	14	42
2020 July	30	7	37
2020 June	55	4	59
2020 May	40	4	44
2020 April	26	16	42
2020 March	14	5	19
2020 February	27	13	40
2020 January	28	18	46
2019 December	15	8	23
2019 November	29	6	35
2019 October	22	12	34
2019 September	24	6	30
2019 August	30	12	42
2019 July	31	9	40
2019 June	34	21	55
2019 May	25	8	33
2019 April	23	17	40
2019 March	14	7	21
2019 February	11	9	20
2019 January	11	5	16
2018 December	16	8	24
2018 November	16	3	19
2018 October	30	16	46
2018 September	11	3	14
2018 August	8	9	17
2018 July	12	3	15
2018 June	7	6	13
2018 May	17	16	33
2018 April	3	0	3
2018 March	7	3	10
2018 February	6	3	9
2018 January	9	2	11
2017 December	2	1	3
2017 November	8	1	9
2017 October	10	0	10
2017 September	3	2	5
2017 August	7	7	14
2017 July	4	2	6
2017 June	11	3	14
2017 May	11	3	14
2017 April	6	3	9
2017 March	4	3	7
2017 February	5	2	7
2017 January	9	2	11
2016 December	10	6	16
2016 November	11	7	18
2016 October	11	10	21
2016 September	15	5	20
2016 August	17	7	24
2016 July	39	19	58
2016 June	36	16	52
2016 May	13	10	23
2016 April	8	11	19
2016 March	10	8	18
2016 February	7	5	12

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