Impacto da idade, leucometria e rearranjos genéticos na Doença Residual Mínima em leucemia linfoblástica aguda pediátrica: estudo de revisão integrativa

Detalhes bibliográficos
Autor(a) principal: Romagnoli, Louise Christine Sala
Data de Publicação: 2025
Outros Autores: Casteller, Elias Scheffer
Tipo de documento: Trabalho de conclusão de curso
Idioma: por
Título da fonte: Repositório Institucional da UFSC
Texto Completo: https://repositorio.ufsc.br/handle/123456789/271632
Resumo: TCC (graduação) - Universidade Federal de Santa Catarina, Campus Araranguá, Medicina.
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spelling Universidade Federal de Santa Catarina.Romagnoli, Louise Christine SalaCasteller, Elias SchefferRigon, PéttalaReis, Simone Farias Antunez2025-12-26T15:47:47Z2025-12-26T15:47:47Z2025-11-27https://repositorio.ufsc.br/handle/123456789/271632TCC (graduação) - Universidade Federal de Santa Catarina, Campus Araranguá, Medicina.Introdução: A Leucemia Linfoblástica Aguda (LLA) é a neoplasia maligna mais comum na infância e uma das maiores causas de mortalidade por neoplasias nessa faixa etária. Os avanços terapêuticos elevaram a sobrevida global, mas a integração de fatores clínicos, genéticos e Doença Residual Mínima (DRM) para uma estratificação de risco precisa ainda é um desafio. A análise de fatores prognósticos clássicos fundamenta-se em sua relevância na LLA pediátrica. Objetivo: Sintetizar as evidências sobre a influência de idade, contagem de leucócitos e alterações genéticas (ETV6-RUNX1 e hiperdiploidia) na DRM e no prognóstico da LLA pediátrica. Métodos: Esta revisão integrativa utilizou estudos da base de dados PubMed entre 2023 e 2025. A análise dos dados ocorreu de forma síntese narrativa, avaliando análises univariadas e multivariadas, sobrevida livre de eventos (SLE), sobrevida global (SG), HR (Hazard Ratio), RR (risco relativo), intervalos de confiança (IC) e valor de p. Resultados: A busca inicial resultou em 238 referências, com 13 estudos selecionados. Idade extrema (< 1 ano e ≥ 10 anos) e hiperleucocitose (WBC ≥ 50 x 10-3/µL) correlacionaram-se com desfechos desfavoráveis e maior DRM. Citogenética de baixo risco associou-se à rápida depuração da doença e melhor SLE. A análise multivariada demonstrou que a DRM é o fator preditivo mais robusto e independente. Conclusão: A superioridade da DRM exige a adoção de um modelo dinâmico de estratificação de risco, e identificar como ela se comporta nestas diferentes condições é fundamental para o desenvolvimento de estratégias futuras de tratamento, otimização de terapias e melhores taxas de cura.Introduction: Acute Lymphoblastic Leukemia (ALL) is the most common malignant neoplasm in childhood and one of the leading causes of mortality from neoplasms in this age group. Therapeutic advances have increased overall survival rates, but integrating clinical, genetic factors, and Minimal Residual Disease (MRD) for precise risk stratification remains a challenge. The analysis of classical prognostic factors is based on their relevance in pediatric ALL. Objective: To synthesize evidence on the influence of age, white blood cell count, and genetic alterations (ETV6-RUNX1 and hyperdiploidy) on MRD and the prognosis of pediatric ALL. Methods: This integrative review utilized studies from the PubMed database between 2023 and 2025. Data analysis occurred through narrative synthesis, evaluating univariate and multivariate analyses, event-free survival (EFS), overall survival (OS), HR (Hazard Ratio), RR (relative risk), confidence intervals (CI), and p-values. Results: The initial search yielded 238 references, with 13 studies selected. Extreme age (< 1 year and ≥ 10 years) and hyperleukocytosis (WBC ≥ 50 x 10-3/µL) correlated with unfavorable outcomes and higher MRD. Low-risk cytogenetics were associated with rapid disease clearance and better EFS. Multivariate analysis demonstrated that MRD is the most robust and independent predictive factor. Conclusion: The superiority of MRD necessitates the adoption of a dynamic risk stratification model, and understanding how it behaves under different conditions is crucial for developing future treatment strategies, optimizing therapies, and improving cure rates.46porAraranguá, SC.Open Access.info:eu-repo/semantics/openAccessCriançaDoença residual mínimaLeucemia linfoblástica agudaPrognósticoChildMinimal residual diseaseAcute lymphoblastic leukemiaPrognosisImpacto da idade, leucometria e rearranjos genéticos na Doença Residual Mínima em leucemia linfoblástica aguda pediátrica: estudo de revisão integrativainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/bachelorThesisreponame:Repositório Institucional da UFSCinstname:Universidade Federal de Santa Catarina (UFSC)instacron:UFSCLICENSElicense.txtlicense.txttext/plain; charset=utf-817508https://repositorio.ufsc.br/bitstream/123456789/271632/2/license.txtc0bc68be64da770871e46b24415ba2e2MD52ORIGINALTCC - Louise Romagnoli e Elias Casteller.pdfTCC - Louise Romagnoli e Elias Casteller.pdfTCCapplication/pdf596946https://repositorio.ufsc.br/bitstream/123456789/271632/1/TCC%20-%20Louise%20Romagnoli%20e%20Elias%20Casteller.pdf2ce42c3f25408a767c1c64ef2ec98d4dMD51123456789/2716322025-12-26 12:47:47.473oai:repositorio.ufsc.br:123456789/271632T3MgdHJhYmFsaG9zIGRlcG9zaXRhZG9zIG5vIFJlcG9zaXTDs3JpbyBJbnN0aXR1Y2lvbmFsIGRhIFVGU0Mgc8OjbyBzdWJtZXRpZG9zIHNvYiBhIExpY2Vuw6dhIENyZWF0aXZlIENvbW1vbnMgQXRyaWJ1acOnw6NvIE7Do28tQ29tZXJjaWFsIENDIEJZLU5DLiBFc3RhIGxpY2Vuw6dhIHBlcm1pdGU6CgogICAgMS4gQ29tcGFydGlsaGFyIOKAlCBjb3BpYXIgZSByZWRpc3RyaWJ1aXIgbyBtYXRlcmlhbCBlbSBxdWFscXVlciBzdXBvcnRlIG91IGZvcm1hdG8KICAgIDIuIEFkYXB0YXIg4oCUIHJlbWl4YXIsIHRyYW5zZm9ybWFyLCBlIGNyaWFyIGEgcGFydGlyIGRvIG1hdGVyaWFsLgoKTyBsaWNlbmNpYW50ZSBuw6NvIHBvZGUgcmV2b2dhciBlc3RlcyBkaXJlaXRvcyBkZXNkZSBxdWUgc2VqYW0gcmVzcGVpdGFkb3Mgb3Mgc2VndWludGVzIHRlcm1vcyBkYSBsaWNlbsOnYToKCiAgICAxLiBBdHJpYnVpw6fDo28g4oCUIERldmUtc2UgZGFyIG8gY3LDqWRpdG8gYXByb3ByaWFkbywgcHJvdmVyIHVtIGxpbmsgcGFyYSBhIGxpY2Vuw6dhIGUgaW5kaWNhciBzZSBtdWRhbsOnYXMgZm9yYW0gZmVpdGFzLiBEZXZlLXNlIGZhesOqLWxvIGVtIHF1YWxxdWVyIGNpcmN1bnN0w6JuY2lhIHJhem/DoXZlbCwgbWFzIGRlIG5lbmh1bWEgbWFuZWlyYSBxdWUgc3VnaXJhIHF1ZSBvIGxpY2VuY2lhbnRlIGFwb2lhIHZvY8OqIG91IG8gc2V1IHVzby4KICAgIDIuIE7Do28tQ29tZXJjaWFsIOKAlCDDiSBwcm9pYmlkbyBvIHVzbyBkbyBtYXRlcmlhbCBwYXJhIGZpbnMgY29tZXJjaWFpcy4KICAgIDMuIFNlbSByZXN0cmnDp8O1ZXMgYWRpY2lvbmFpcyDigJQgTsOjbyBhcGxpY2FyIHRlcm1vcyBqdXLDrWRpY29zIG91IG1lZGlkYXMgZGUgY2Fyw6F0ZXIgdGVjbm9sw7NnaWNvIHF1ZSByZXN0cmluamFtIGxlZ2FsbWVudGUgb3V0cm9zIGRlIGZhemVyZW0gYWxnbyBxdWUgYSBsaWNlbsOnYSBwZXJtaXRhLgoKTsOjbyBzZSBhcGxpY2FtIG9zIHRlcm1vcyBkYSBsaWNlbsOnYSByZWxhdGl2YW1lbnRlIGEgZWxlbWVudG9zIGRvIG1hdGVyaWFsIHF1ZSBlc3RlamFtIG5vIGRvbcOtbmlvIHDDumJsaWNvIG91IGN1amEgdXRpbGl6YcOnw6NvIHNlamEgcGVybWl0aWRhIHBvciB1bWEgZXhjZcOnw6NvIG91IGxpbWl0YcOnw6NvIHF1ZSBzZWphIGFwbGljw6F2ZWwuIE7Do28gc8OjbyBkYWRhcyBxdWFpc3F1ZXIgZ2FyYW50aWFzLiBBIGxpY2Vuw6dhIHBvZGUgbsOjbyBkYXIgdG9kYXMgYXMgYXV0b3JpemHDp8O1ZXMgbmVjZXNzw6FyaWFzIHBhcmEgbyB1c28gcHJldGVuZGlkby4gUG9yIGV4ZW1wbG8sIG91dHJvcyBkaXJlaXRvcywgdGFpcyBjb21vIGRpcmVpdG9zIGRlIGltYWdlbSwgZGUgcHJpdmFjaWRhZGUgb3UgZGlyZWl0b3MgbW9yYWlzLCBwb2RlbSBsaW1pdGFyIG8gdXNvIGRvIG1hdGVyaWFsLgoKTGljZW7Dp2EgQ3JlYXRpdmUgQ29tbW9ucyBBdHJpYnVpw6fDo28gTsOjby1Db21lcmNpYWwgQ0MgQlktTkMgNC4wIChodHRwczovL2NyZWF0aXZlY29tbW9ucy5vcmcvbGljZW5zZXMvYnktbmMvNC4wL2xlZ2FsY29kZS5wdCkKCkxFSUEgQSBMSUNFTsOHQSBBQkFJWE8gRSBDT05DT1JERSBDT00gT1MgVEVSTU9TIFBBUkEgUFJPU1NFR1VJUjoKCkF0cmlidWnDp8OjbyBOw6NvLUNvbWVyY2lhbCA0LjAgSW50ZXJuYWNpb25hbAoKQW8gZXhlcmNlciBvcyBEaXJlaXRvcyBMaWNlbmNpYWRvcyAoZGVmaW5pZG9zIGFiYWl4byksIFZvY8OqIGFjZWl0YSBlIGNvbmNvcmRhIGVzdGFyIHN1amVpdG8gYW9zIHRlcm1vcyBlIGNvbmRpw6fDtWVzIGRlc3RhIExpY2Vuw6dhIFDDumJsaWNhIENyZWF0aXZlIENvbW1vbnMgQXRyaWJ1acOnw6NvIE7Do28tQ29tZXJjaWFsIDQuMCBJbnRlcm5hY2lvbmFsICgiTGljZW7Dp2EgUMO6YmxpY2EiKS4gTmEgbWVkaWRhIGVtIHF1ZSBlc3RhIExpY2Vuw6dhIFDDumJsaWNhIHBvc3NhIHNlciBpbnRlcnByZXRhZGEgY29tbyB1bSBjb250cmF0bywgVm9jw6ogcmVjZWJlIG9zIERpcmVpdG9zIExpY2VuY2lhZG9zIGVtIGNvbnRyYXBhcnRpZGEgcGVsYSBTdWEgYWNlaXRhw6fDo28gZGVzdGVzIHRlcm1vcyBlIGNvbmRpw6fDtWVzLCBlIG8gTGljZW5jaWFudGUgY29uY2VkZS1MaGUgdGFpcyBkaXJlaXRvcyBlbSBjb250cmFwYXJ0aWRhIHBlbG9zIGJlbmVmw61jaW9zIHF1ZSBvIExpY2VuY2lhbnRlIHJlY2ViZSBwb3IgZGlzcG9uaWJpbGl6YXIgbyBNYXRlcmlhbCBMaWNlbmNpYWRvIHNvYiBlc3RlcyB0ZXJtb3MgZSBjb25kacOnw7Vlcy4KCkNsw6F1c3VsYSAxIOKAkyBEZWZpbmnDp8O1ZXMuCgogICAgYS4gTWF0ZXJpYWwgQWRhcHRhZG8gc2lnbmlmaWNhIG1hdGVyaWFsIHN1amVpdG8gYSBEaXJlaXRvIGRlIEF1dG9yIGUgRGlyZWl0b3MgU2ltaWxhcmVzIHF1ZSDDqSBkZXJpdmFkbyBkZSBvdSBiYXNlYWRvIG5vIE1hdGVyaWFsIExpY2VuY2lhZG8gZSBubyBxdWFsIG8gTWF0ZXJpYWwgTGljZW5jaWFkbyDDqSB0cmFkdXppZG8sIGFsdGVyYWRvLCBhcnJhbmphZG8sIHRyYW5zZm9ybWFkbywgb3UgZGUgb3V0cmEgZm9ybWEgbW9kaWZpY2FkbyBkZSB1bWEgbWFuZWlyYSBxdWUgcmVxdWVpcmEgcGVybWlzc8OjbyBjb20gYmFzZSBubyBEaXJlaXRvIGRlIEF1dG9yIGUgRGlyZWl0b3MgU2ltaWxhcmVzIGRldGlkb3MgcGVsbyBMaWNlbmNpYW50ZS4gUGFyYSBvcyBmaW5zIGRlc3RhIExpY2Vuw6dhIFDDumJsaWNhLCBxdWFuZG8gbyBNYXRlcmlhbCBMaWNlbmNpYWRvIHNlamEgdW1hIG9icmEgbXVzaWNhbCwgcGVyZm9ybWFuY2UsIG91IGZvbm9ncmFtYSwgw6kgc2VtcHJlIHByb2R1emlkbyBNYXRlcmlhbCBBZGFwdGFkbyBxdWFuZG8gbyBNYXRlcmlhbCBMaWNlbmNpYWRvIMOpIHNpbmNyb25pemFkbyBlbSByZWxhw6fDo28gdGVtcG9yYWwgY29tIHVtYSBpbWFnZW0gZW0gbW92aW1lbnRvLgogICAgYi4gTGljZW7Dp2EgZG8gQWRhcHRhZG9yIHNpZ25pZmljYSBhIGxpY2Vuw6dhIHF1ZSBWb2PDqiBhcGxpY2EgYW8gU2V1IERpcmVpdG8gZGUgQXV0b3IgZSBEaXJlaXRvcyBTaW1pbGFyZXMgbmFzIFN1YXMgY29udHJpYnVpw6fDtWVzIGFvIE1hdGVyaWFsIEFkYXB0YWRvIGRlIGFjb3JkbyBjb20gb3MgdGVybW9zIGUgY29uZGnDp8O1ZXMgZGVzdGEgTGljZW7Dp2EgUMO6YmxpY2EuCiAgICBjLiBEaXJlaXRvIGRlIEF1dG9yIGUgRGlyZWl0b3MgU2ltaWxhcmVzIHNpZ25pZmljYSBkaXJlaXRvIGRlIGF1dG9yIGUvb3UgZGlyZWl0b3Mgc2ltaWxhcmVzIGVzdHJlaXRhbWVudGUgcmVsYWNpb25hZG9zIGNvbSBvIGRpcmVpdG8gZGUgYXV0b3IsIGluY2x1aW5kbywgbWFzIG7Do28gc2UgbGltaXRhbmRvIGEsIGRpcmVpdG9zIGRlIGV4ZWN1w6fDo28sIHJhZGlvZGlmdXPDo28sIGZpeGHDp8OjbyBkZSBzb25zLCBlIERpcmVpdG9zIFN1aSBHZW5lcmlzIHNvYnJlIEJhc2VzIGRlIERhZG9zLCBpbmRlcGVuZGVudGVtZW50ZSBkZSBjb21vIHNlamFtIGNsYXNzaWZpY2Fkb3Mgb3UgY2F0ZWdvcml6YWRvcy4gUGFyYSBvcyBmaW5zIGRlc3RhIExpY2Vuw6dhIFDDumJsaWNhLCBvcyBkaXJlaXRvcyBlc3BlY2lmaWNhZG9zIG5hIENsw6F1c3VsYSAyKGIpKDEpLSgyKSBuw6NvIHPDo28gRGlyZWl0byBkZSBBdXRvciBlIERpcmVpdG9zIFNpbWlsYXJlcy4KICAgIGQuIE1lZGlkYXMgRWZpY2F6ZXMgZGUgQ2Fyw6F0ZXIgVGVjbm9sw7NnaWNvIHNpZ25pZmljYW0gYXF1ZWxhcyBtZWRpZGFzIHF1ZSwgbmEgYXVzw6puY2lhIGRlIGRpcmVpdG8gcGFyYSB0YW50bywgbsOjbyBwb2RlbSBzZXIgY29udG9ybmFkYXMgZW0ganVyaXNkacOnw7VlcyBjdW1wcmluZG8gb2JyaWdhw6fDtWVzIHNvYiBvIEFydGlnbyAxMSBkbyBUcmF0YWRvIGRhIE9NUEkgZGUgRGlyZWl0byBkZSBBdXRvciBhZG90YWRvIGVtIDIwIGRlIGRlemVtYnJvIGRlIDE5OTYsIGUvb3UgYWNvcmRvcyBpbnRlcm5hY2lvbmFpcyBzaW1pbGFyZXMuCiAgICBlLiBFeGNlw6fDtWVzIGUgTGltaXRhw6fDtWVzIHNpZ25pZmljYW0gdXRpbGl6YcOnw6NvIGp1c3RhICjigJxmYWlyIHVzZeKAnSksIHRyYXRhbWVudG8ganVzdG8gKOKAnGZhaXIgZGVhbGluZ+KAnSksIGUvb3UgcXVhbHF1ZXIgb3V0cmEgZXhjZcOnw6NvIG91IGxpbWl0YcOnw6NvIGFvIERpcmVpdG8gZGUgQXV0b3IgZSBEaXJlaXRvcyBTaW1pbGFyZXMgcXVlIHNlIGFwbGlxdWUgw6AgU3VhIHV0aWxpemHDp8OjbyBkbyBNYXRlcmlhbCBMaWNlbmNpYWRvLgogICAgZi4gTWF0ZXJpYWwgTGljZW5jaWFkbyBzaWduaWZpY2EgbyB0cmFiYWxobyBhcnTDrXN0aWNvIG91IGxpdGVyw6FyaW8sIGJhc2UgZGUgZGFkb3MsIG91IG91dHJvIG1hdGVyaWFsIGFvIHF1YWwgbyBMaWNlbmNpYW50ZSBhcGxpY291IGVzdGEgTGljZW7Dp2EgUMO6YmxpY2EuCiAgICBnLiBEaXJlaXRvcyBMaWNlbmNpYWRvcyBzaWduaWZpY2FtIG9zIGRpcmVpdG9zIGNvbmNlZGlkb3MgYSBWb2PDqiBzdWplaXRvcyBhb3MgdGVybW9zIGUgY29uZGnDp8O1ZXMgZGVzdGEgTGljZW7Dp2EgUMO6YmxpY2EsIHF1ZSBzw6NvIGxpbWl0YWRvcyBhIHRvZG9zIG9zIERpcmVpdG9zIGRlIEF1dG9yIGUgRGlyZWl0b3MgU2ltaWxhcmVzIHF1ZSBzZSBhcGxpcXVlbSDDoCBTdWEgdXRpbGl6YcOnw6NvIGRvIE1hdGVyaWFsIExpY2VuY2lhZG8gZSBxdWUgbyBMaWNlbmNpYW50ZSB0ZW0gbyBkaXJlaXRvIGRlIGxpY2VuY2lhci4KICAgIGguIExpY2VuY2lhbnRlIHNpZ25pZmljYSBvKHMpIGluZGl2w61kdW8ocykgb3UgZW50aWRhZGUocykgY29uY2VkZW5kbyBkaXJlaXRvcyBzb2IgZXN0YSBMaWNlbsOnYSBQw7pibGljYS4KICAgIGkuIE7Do28tQ29tZXJjaWFsIHNpZ25pZmljYSBuw6NvIHByaW1hcmlhbWVudGUgaW50ZW5jaW9uYWRvIG91IGRpcmVjaW9uYWRvIGEgdW1hIHZhbnRhZ2VtIGNvbWVyY2lhbCBvdSBjb21wZW5zYcOnw6NvIG1vbmV0w6FyaWEuIFBhcmEgb3MgZmlucyBkZXN0YSBMaWNlbsOnYSBQw7pibGljYSwgYSB0cm9jYSBkZSBNYXRlcmlhbCBMaWNlbmNpYWRvIHBvciBvdXRybyBtYXRlcmlhbCBzdWplaXRvIGEgRGlyZWl0byBkZSBBdXRvciBlIERpcmVpdG9zIFNpbWlsYXJlcyB2aWEgY29tcGFydGlsaGFtZW50byBkaWdpdGFsIGRlIGFycXVpdm9zICgicGFydGlsaGEgZGUgZmljaGVpcm9zIikgb3UgbWVpb3Mgc2ltaWxhcmVzIMOpIE7Do28tQ29tZXJjaWFsLCBkZXNkZSBxdWUgbsOjbyBoYWphIHBhZ2FtZW50byBvdSBjb21wZW5zYcOnw6NvIG1vbmV0w6FyaWEgcmVsYWNpb25hZG9zIGNvbSBhIHRyb2NhLgogICAgai4gQ29tcGFydGlsaGFyIHNpZ25pZmljYSBmb3JuZWNlciBtYXRlcmlhbCBhbyBww7pibGljbyBwb3IgcXVhbHF1ZXIgbWVpbyBvdSBwcm9jZXNzbyBxdWUgcmVxdWVpcmEgcGVybWlzc8OjbyBzb2Igb3MgRGlyZWl0b3MgTGljZW5jaWFkb3MsIGNvbW8gcmVwcm9kdcOnw6NvLCBleGliacOnw6NvIHDDumJsaWNhLCBleGVjdcOnw6NvIHDDumJsaWNhLCBkaXN0cmlidWnDp8OjbywgZGlzc2VtaW5hw6fDo28sIGNvbXVuaWNhw6fDo28gb3UgaW1wb3J0YcOnw6NvLCBlIGRpc3BvbmliaWxpemFyIG1hdGVyaWFsIGFvIHDDumJsaWNvLCBpbmNsdWluZG8gcG9yIHZpYXMgcGVsYXMgcXVhaXMgb3MgbWVtYnJvcyBkbyBww7pibGljbyBwb3NzYW0gdGVyIGFjZXNzbyBhbyBtYXRlcmlhbCBhIHBhcnRpciBkZSB1bSBsb2NhbCBlIG5vIG1vbWVudG8gaW5kaXZpZHVhbG1lbnRlIGVzY29saGlkb3MgcG9yIGVsZXMuCiAgICBrLiBEaXJlaXRvcyBTdWkgR2VuZXJpcyBzb2JyZSBCYXNlcyBkZSBEYWRvcyBzaWduaWZpY2FtIG91dHJvcyBkaXJlaXRvcywgcXVlIG7Do28gbyBkaXJlaXRvIGRlIGF1dG9yIGUgZGlyZWl0b3MgY29uZXhvcywgcmVzdWx0YW50ZXMgZGEgRGlyZXRpdmEgOTYvOS9FQyBkbyBQYXJsYW1lbnRvIEV1cm9wZXUgZSBkbyBDb25zZWxobyBkZSAxMSBkZSBNYXLDp28gZGUgMTk5NiBzb2JyZSBhIHByb3Rlw6fDo28gbGVnYWwgZGUgYmFzZXMgZGUgZGFkb3MsIGNvbmZvcm1lIGVtZW5kYWRhIGUvb3Ugc3VjZWRpZGEsIGJlbSBjb21vIG91dHJvcyBkaXJlaXRvcyBlc3NlbmNpYWxtZW50ZSBlcXVpdmFsZW50ZXMgZW0gcXVhbHF1ZXIgbHVnYXIgZG8gbXVuZG8uCiAgICBsLiBWb2PDqiBzaWduaWZpY2EgbyBpbmRpdsOtZHVvIG91IGVudGlkYWRlIHF1ZSBleGVyY2Ugb3MgRGlyZWl0b3MgTGljZW5jaWFkb3Mgc29iIGVzdGEgTGljZW7Dp2EgUMO6YmxpY2EuIExoZSwgU2V1LCBTdWEgZSBTdWFzIHTDqm0gdW0gc2lnbmlmaWNhZG8gY29ycmVzcG9uZGVudGUuCgpDbMOhdXN1bGEgMiDigJMgw4JtYml0by4KCiAgICBhLiBDb25jZXNzw6NvIGRhIGxpY2Vuw6dhLgogICAgICAgIGEuIERlIGFjb3JkbyBjb20gb3MgdGVybW9zIGUgY29uZGnDp8O1ZXMgZGVzdGEgTGljZW7Dp2EgUMO6YmxpY2EsIG8gTGljZW5jaWFudGUgY29uY2VkZS1MaGUsIHBlbG8gcHJlc2VudGUsIHVtYSBsaWNlbsOnYSBtdW5kaWFsLCBpc2VudGEgZGUgcm95YWx0aWVzLCBuw6NvIHN1YmxpY2VuY2nDoXZlbCwgbsOjbyBleGNsdXNpdmEsIGUgaXJyZXZvZ8OhdmVsIHBhcmEgZXhlcmNlciBvcyBEaXJlaXRvcyBMaWNlbmNpYWRvcyBzb2JyZSBvIE1hdGVyaWFsIExpY2VuY2lhZG8gcGFyYToKICAgICAgICAgICAgQS4gcmVwcm9kdXppciBlIENvbXBhcnRpbGhhciBvIE1hdGVyaWFsIExpY2VuY2lhZG8sIG5vIHRvZG8gb3UgZW0gcGFydGUsIHNvbWVudGUgcGFyYSB1bSBmaW0gTsOjby1Db21lcmNpYWw7IGUKICAgICAgICAgICAgQi4gcHJvZHV6aXIsIHJlcHJvZHV6aXIsIGUgQ29tcGFydGlsaGFyIE1hdGVyaWFsIEFkYXB0YWRvIHNvbWVudGUgcGFyYSB1bSBmaW0gTsOjby1Db21lcmNpYWwuCiAgICAgICAgYi4gRXhjZcOnw7VlcyBlIExpbWl0YcOnw7Vlcy4gUGFyYSBldml0YXIgZMO6dmlkYXMsIHF1YW5kbyBFeGNlw6fDtWVzIGUgTGltaXRhw6fDtWVzIHNlamFtIGFwbGljw6F2ZWlzIMOgIFN1YSB1dGlsaXphw6fDo28sIGVzdGEgTGljZW7Dp2EgUMO6YmxpY2EgbsOjbyBzZSBhcGxpY2EsIGUgVm9jw6ogbsOjbyBwcmVjaXNhIGRlIGN1bXByaXIgY29tIG9zIHNldXMgdGVybW9zIGUgY29uZGnDp8O1ZXMuCiAgICAgICAgYy4gVGVybW8uIE8gdGVybW8gZGVzdGEgTGljZW7Dp2EgUMO6YmxpY2EgZXN0w6EgZXNwZWNpZmljYWRvIG5hIENsw6F1c3VsYSA2KGEpLgogICAgICAgIGQuIE1laW9zL3N1cG9ydGVzIGUgZm9ybWF0b3M7IG1vZGlmaWNhw6fDtWVzIHTDqWNuaWNhcyBwZXJtaXRpZGFzLiBPIExpY2VuY2lhbnRlIGF1dG9yaXphIFZvY8OqIGEgZXhlcmNlciBvcyBEaXJlaXRvcyBMaWNlbmNpYWRvcyBlbSB0b2RvcyBvcyBtZWlvcy9zdXBvcnRlcyBlIGZvcm1hdG9zIGNvbmhlY2lkb3MgYWdvcmEgb3UgY3JpYWRvcyBwb3N0ZXJpb3JtZW50ZSwgZSBhIGZhemVyIGFzIG1vZGlmaWNhw6fDtWVzIHTDqWNuaWNhcyBuZWNlc3PDoXJpYXMgcGFyYSB0YW50by4gTyBMaWNlbmNpYW50ZSBjZWRlIGUvb3UgY29uY29yZGEgZW0gbsOjbyByZWl2aW5kaWNhciBuZW5odW0gZGlyZWl0byBxdWUgcHJvw61iYSBWb2PDqiBkZSBmYXplciBtb2RpZmljYcOnw7VlcyB0w6ljbmljYXMgbmVjZXNzw6FyaWFzIGFvIGV4ZXJjw61jaW8gZG9zIERpcmVpdG9zIExpY2VuY2lhZG9zLCBpbmNsdWluZG8gbW9kaWZpY2HDp8O1ZXMgdMOpY25pY2FzIG5lY2Vzc8OhcmlhcyBwYXJhIGNvbnRvcm5hciBNZWRpZGFzIEVmaWNhemVzIGRlIENhcsOhdGVyIFRlY25vbMOzZ2ljby4gUGFyYSBvcyBmaW5zIGRlc3RhIExpY2Vuw6dhIFDDumJsaWNhLCBmYXplciBzaW1wbGVzbWVudGUgbW9kaWZpY2HDp8O1ZXMgYXV0b3JpemFkYXMgcG9yIGVzdGEgQ2zDoXVzdWxhIDIoYSkoNCkgbnVuY2EgcHJvZHV6IE1hdGVyaWFsIEFkYXB0YWRvLgogICAgICAgIGUuIFJlY2VwdG9yZXMgc3Vic2VxdWVudGVzLgogICAgICAgICAgICBBLiBPZmVydGEgcGVsbyBMaWNlbmNpYW50ZSDigJMgTWF0ZXJpYWwgTGljZW5jaWFkby4gQ2FkYSByZWNlcHRvciBkbyBNYXRlcmlhbCBMaWNlbmNpYWRvIHJlY2ViZSBhdXRvbWF0aWNhbWVudGUgdW1hIG9mZXJ0YSBkbyBMaWNlbmNpYW50ZSBwYXJhIGV4ZXJjZXIgb3MgRGlyZWl0b3MgTGljZW5jaWFkb3Mgc29iIG9zIHRlcm1vcyBlIGNvbmRpw6fDtWVzIGRlc3RhIExpY2Vuw6dhIFDDumJsaWNhLgogICAgICAgICAgICBCLiBTZW0gcmVzdHJpw6fDtWVzIHN1YnNlcXVlbnRlcy4gVm9jw6ogbsOjbyBwb2RlIHByb3BvciBvdSBpbXBvciBxdWFpc3F1ZXIgdGVybW9zIG91IGNvbmRpw6fDtWVzLCBhZGljaW9uYWlzIG91IGRpZmVyZW50ZXMsIG91IGFwbGljYXIgcXVhaXNxdWVyIE1lZGlkYXMgRWZpY2F6ZXMgZGUgQ2Fyw6F0ZXIgVGVjbm9sw7NnaWNvLCBzb2JyZSBvIE1hdGVyaWFsIExpY2VuY2lhZG8sIHNlIHRhbCByZXN0cmluZ2lyIG8gZXhlcmPDrWNpbyBkb3MgRGlyZWl0b3MgTGljZW5jaWFkb3MgcG9yIHF1YWxxdWVyIHJlY2VwdG9yIGRvIE1hdGVyaWFsIExpY2VuY2lhZG8uCiAgICAgICAgZi4gU2VtIGVuZG9zc28uIE5hZGEgbmVzdGEgTGljZW7Dp2EgUMO6YmxpY2EgY29uc3RpdHVpIG91IHBvZGUgc2VyIGVudGVuZGlkbyBjb21vIHVtYSBwZXJtaXNzw6NvIHBhcmEgYWZpcm1hciBvdSBzdWdlcmlyIHF1ZSBWb2PDqiwgb3UgcXVlIGEgU3VhIHV0aWxpemHDp8OjbyBkbyBNYXRlcmlhbCBMaWNlbmNpYWRvLCDDqSBjb25lY3RhZG8gYW8sIHBhdHJvY2luYWRvIG91IGVuZG9zc2FkbyBwZWxvLCBvdSB0ZW0gc3RhdHVzIG9maWNpYWwgY29uY2VkaWRvIHBlbG8sIExpY2VuY2lhbnRlIG91IHRlcmNlaXJvcyBkZXNpZ25hZG9zIHBhcmEgcmVjZWJlciBhdHJpYnVpw6fDo28gY29tbyBwcmV2aXN0byBuYSBDbMOhdXN1bGEgMyhhKSgxKShBKShpKS4KICAgIGIuIE91dHJvcyBkaXJlaXRvcy4KICAgICAgICBhLiBEaXJlaXRvcyBtb3JhaXMsIGNvbW8gbyBkaXJlaXRvIMOgIGludGVncmlkYWRlLCBuw6NvIHPDo28gbGljZW5jaWFkb3MgcG9yIGVzdGEgTGljZW7Dp2EgUMO6YmxpY2EsIG5lbSBvIHPDo28gb3MgZGlyZWl0b3MgZGUgaW1hZ2VtLCBwcml2YWNpZGFkZSwgZS9vdSBvdXRyb3MgZGlyZWl0b3MgZGUgcGVyc29uYWxpZGFkZSBzaW1pbGFyZXM7IGNvbnR1ZG8sIG5hIG1lZGlkYSBkbyBwb3Nzw612ZWwsIG8gTGljZW5jaWFudGUgcmVudW5jaWEgZS9vdSBjb25jb3JkYSBuw6NvIGV4ZXJjZXIgcXVhaXNxdWVyIGRlc3NlcyBkaXJlaXRvcyBkZXRpZG9zIHBlbG8gTGljZW5jaWFudGUsIG5hIG1lZGlkYSBuZWNlc3PDoXJpYSBwYXJhIHBlcm1pdGlyIHF1ZSBWb2PDqiBleGVyw6dhIG9zIERpcmVpdG9zIExpY2VuY2lhZG9zLCBtYXMgbsOjbyBkZSBvdXRyYSBmb3JtYS4KICAgICAgICBiLiBEaXJlaXRvcyBkZSBwYXRlbnRlIGUgbWFyY2FzIG7Do28gc2UgZW5jb250cmFtIGxpY2VuY2lhZG9zIHNvYiBlc3RhIExpY2Vuw6dhIFDDumJsaWNhLgogICAgICAgIGMuIE5hIG1lZGlkYSBkbyBwb3Nzw612ZWwsIG8gTGljZW5jaWFudGUgcmVudW5jaWEgYSBxdWFscXVlciBkaXJlaXRvIGRlIGNvYnJhci1MaGUgcm95YWx0aWVzIHBlbG8gZXhlcmPDrWNpbyBkb3MgRGlyZWl0b3MgTGljZW5jaWFkb3MsIHF1ZXIgZGlyZXRhbWVudGUgcXVlciBwb3IgbWVpbyBkZSB1bWEgZW50aWRhZGUgZGUgZ2VzdMOjbyBjb2xldGl2YSwgc29iIHF1YWxxdWVyIHJlZ2ltZSBkZSBsaWNlbmNpYW1lbnRvIHZvbHVudMOhcmlvIG91IGxlZ2FsLCBkaXNwb27DrXZlbCBvdSBjb21wdWxzw7NyaW8uIEVtIHRvZG9zIG9zIG91dHJvcyBjYXNvcywgbyBMaWNlbmNpYW50ZSByZXNlcnZhIGV4cHJlc3NhbWVudGUgbyBkaXJlaXRvIGRlIGFycmVjYWRhciB0YWlzIHJveWFsdGllcywgaW5jbHVzaXZlIHF1YW5kbyBvIE1hdGVyaWFsIExpY2VuY2lhZG8gw6kgdXRpbGl6YWRvIHBhcmEgZmlucyBkaWZlcmVudGVzIGRvIGZpbSBOw6NvLUNvbWVyY2lhbC4KCkNsw6F1c3VsYSAzIOKAkyBDb25kacOnw7VlcyBkYSBMaWNlbsOnYS4KCk8gU2V1IGV4ZXJjw61jaW8gZG9zIERpcmVpdG9zIExpY2VuY2lhZG9zIGZpY2EgZXhwcmVzc2FtZW50ZSBzdWplaXRvIMOgcyBjb25kacOnw7VlcyBzZWd1aW50ZXMuCiAgICBhLiBBdHJpYnVpw6fDo28uCiAgICAgICAgYS4gU2UgVm9jw6ogQ29tcGFydGlsaGFyIG8gTWF0ZXJpYWwgTGljZW5jaWFkbyAoaW5jbHVpbmRvIHNvYiB1bWEgZm9ybWEgbW9kaWZpY2FkYSksIFZvY8OqIGRldmU6CiAgICAgICAgICAgIEEuIG1hbnRlciBvIHNlZ3VpbnRlLCBzZSBmb3IgZm9ybmVjaWRvIHBlbG8gTGljZW5jaWFudGUgY29tIG8gTWF0ZXJpYWwgTGljZW5jaWFkbzoKICAgICAgICAgICAgICAgIGkuIGlkZW50aWZpY2HDp8OjbyBkbyhzKSBjcmlhZG9yKGVzKSBkbyBNYXRlcmlhbCBMaWNlbmNpYWRvIGUgcXVhaXNxdWVyIG91dHJvcyBkZXNpZ25hZG9zIHBhcmEgcmVjZWJlciBhdHJpYnVpw6fDo28sIGRlIHF1YWxxdWVyIGZvcm1hIHJhem/DoXZlbCBzb2xpY2l0YWRhIHBlbG8gTGljZW5jaWFudGUgKGluY2x1aW5kbyBwb3IgcHNldWTDs25pbW8sIHNlIGRlc2lnbmFkbyk7CiAgICAgICAgICAgICAgICBpaS4gdW0gYXZpc28gZGUgZGlyZWl0byBkZSBhdXRvciBlIGRpcmVpdG9zIGNvbmV4b3M7CiAgICAgICAgICAgICAgICBpaWkuIHVtIGF2aXNvIHF1ZSBzZSByZWZlcmUgYSBlc3RhIExpY2Vuw6dhIFDDumJsaWNhOwogICAgICAgICAgICAgICAgaXYuIHVtIGF2aXNvIHF1ZSBzZSByZWZlcmUgw6AgZXhjbHVzw6NvIGRlIGdhcmFudGlhczsKICAgICAgICAgICAgICAgIHYuIHVtIFVSSSBvdSB1bSBoeXBlcmxpbmsgcGFyYSBvIE1hdGVyaWFsIExpY2VuY2lhZG8gbmEgbWVkaWRhIHJhem9hdmVsbWVudGUgZXhlcXXDrXZlbDsKICAgICAgICAgICAgQi4gaW5kaWNhciBzZSBWb2PDqiBtb2RpZmljb3UgbyBNYXRlcmlhbCBMaWNlbmNpYWRvIGUgbWFudGVyIHVtYSBpbmRpY2HDp8OjbyBkZSBxdWFpc3F1ZXIgbW9kaWZpY2HDp8O1ZXMgcHLDqXZpYXM7IGUKICAgICAgICAgICAgQy4gaW5kaWNhciBxdWUgbyBNYXRlcmlhbCBMaWNlbmNpYWRvIMOpIGxpY2VuY2lhZG8gY29tIGVzdGEgTGljZW7Dp2EgUMO6YmxpY2EsIGUgaW5jbHVpciBvIHRleHRvIGRlLCBvdSBvIFVSSSBvdSBvIGh5cGVybGluayBwYXJhLCBlc3RhIExpY2Vuw6dhIFDDumJsaWNhLgogICAgICAgIGIuIFZvY8OqIHBvZGUgc2F0aXNmYXplciBhcyBjb25kacOnw7VlcyBkYSBDbMOhdXN1bGEgMyhhKSgxKSBkZSBxdWFscXVlciBmb3JtYSByYXpvw6F2ZWwsIHRlbmRvIGVtIGNvbnRhIG8gc3Vwb3J0ZSwgb3MgbWVpb3MgZSBvIGNv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InstitucionalPUBhttp://150.162.242.35/oai/requestsandra.sobrera@ufsc.bropendoar:23732025-12-26T15:47:47Repositório Institucional da UFSC - Universidade Federal de Santa Catarina (UFSC)false
dc.title.pt_BR.fl_str_mv Impacto da idade, leucometria e rearranjos genéticos na Doença Residual Mínima em leucemia linfoblástica aguda pediátrica: estudo de revisão integrativa
title Impacto da idade, leucometria e rearranjos genéticos na Doença Residual Mínima em leucemia linfoblástica aguda pediátrica: estudo de revisão integrativa
spellingShingle Impacto da idade, leucometria e rearranjos genéticos na Doença Residual Mínima em leucemia linfoblástica aguda pediátrica: estudo de revisão integrativa
Romagnoli, Louise Christine Sala
Criança
Doença residual mínima
Leucemia linfoblástica aguda
Prognóstico
Child
Minimal residual disease
Acute lymphoblastic leukemia
Prognosis
title_short Impacto da idade, leucometria e rearranjos genéticos na Doença Residual Mínima em leucemia linfoblástica aguda pediátrica: estudo de revisão integrativa
title_full Impacto da idade, leucometria e rearranjos genéticos na Doença Residual Mínima em leucemia linfoblástica aguda pediátrica: estudo de revisão integrativa
title_fullStr Impacto da idade, leucometria e rearranjos genéticos na Doença Residual Mínima em leucemia linfoblástica aguda pediátrica: estudo de revisão integrativa
title_full_unstemmed Impacto da idade, leucometria e rearranjos genéticos na Doença Residual Mínima em leucemia linfoblástica aguda pediátrica: estudo de revisão integrativa
title_sort Impacto da idade, leucometria e rearranjos genéticos na Doença Residual Mínima em leucemia linfoblástica aguda pediátrica: estudo de revisão integrativa
author Romagnoli, Louise Christine Sala
author_facet Romagnoli, Louise Christine Sala
Casteller, Elias Scheffer
author_role author
author2 Casteller, Elias Scheffer
author2_role author
dc.contributor.pt_BR.fl_str_mv Universidade Federal de Santa Catarina.
dc.contributor.author.fl_str_mv Romagnoli, Louise Christine Sala
Casteller, Elias Scheffer
dc.contributor.advisor1.fl_str_mv Rigon, Péttala
dc.contributor.advisor-co1.fl_str_mv Reis, Simone Farias Antunez
contributor_str_mv Rigon, Péttala
Reis, Simone Farias Antunez
dc.subject.por.fl_str_mv Criança
Doença residual mínima
Leucemia linfoblástica aguda
Prognóstico
Child
Minimal residual disease
Acute lymphoblastic leukemia
Prognosis
topic Criança
Doença residual mínima
Leucemia linfoblástica aguda
Prognóstico
Child
Minimal residual disease
Acute lymphoblastic leukemia
Prognosis
description TCC (graduação) - Universidade Federal de Santa Catarina, Campus Araranguá, Medicina.
publishDate 2025
dc.date.accessioned.fl_str_mv 2025-12-26T15:47:47Z
dc.date.available.fl_str_mv 2025-12-26T15:47:47Z
dc.date.issued.fl_str_mv 2025-11-27
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/bachelorThesis
format bachelorThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://repositorio.ufsc.br/handle/123456789/271632
url https://repositorio.ufsc.br/handle/123456789/271632
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv Open Access.
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Open Access.
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 46
dc.publisher.none.fl_str_mv Araranguá, SC.
publisher.none.fl_str_mv Araranguá, SC.
dc.source.none.fl_str_mv reponame:Repositório Institucional da UFSC
instname:Universidade Federal de Santa Catarina (UFSC)
instacron:UFSC
instname_str Universidade Federal de Santa Catarina (UFSC)
instacron_str UFSC
institution UFSC
reponame_str Repositório Institucional da UFSC
collection Repositório Institucional da UFSC
bitstream.url.fl_str_mv https://repositorio.ufsc.br/bitstream/123456789/271632/2/license.txt
https://repositorio.ufsc.br/bitstream/123456789/271632/1/TCC%20-%20Louise%20Romagnoli%20e%20Elias%20Casteller.pdf
bitstream.checksum.fl_str_mv c0bc68be64da770871e46b24415ba2e2
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bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
repository.name.fl_str_mv Repositório Institucional da UFSC - Universidade Federal de Santa Catarina (UFSC)
repository.mail.fl_str_mv sandra.sobrera@ufsc.br
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