Consenso de la Sociedad Chilena de Infectología para el manejo de episodios de neutropenia febril en adultos y niños con cáncer

Álvarez, Ana María Arias; Morales, Ricardo; Raijmakers, Mariella; Contardo, Verónica; Barraza, Marlon; Lafourcade, Mónica; Durán, Luisa; Amador, Roberto; Bidart, Teresa; Flores, Ivonne; Gambra, Pilar; González, Claudio; López, Tania; Rabagliati, Ricardo; Santolaya, Marı́a Elena; Vizcaya, Cecilia; Zubieta, Marcela

doi:10.4067/s0716-10182023000200105

Rev. chil. infectol.

2023

DOI: 10.4067/s0716-10182023000200105

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Consenso de la Sociedad Chilena de Infectología para el manejo de episodios de neutropenia febril en adultos y niños con cáncer

Ana María Arias Álvarez

Ricardo Morales²,

Mariella Raijmakers

et al.

Abstract: presenta aquí una actualización en el Manejo de episodios de neutropenia febril en adultos y niños con cáncer, derivado de los grandes cambios ocurridos en los últimos años en el enfrentamiento de estos pacientes. Para estos efectos, un grupo multidisciplinario desarrolló recomendaciones en relación a: su enfrentamiento inicial, exámenes de laboratorio requeridos, el tratamiento antimicrobiano inicial empírico y frente a focos infecciosos conocidos, las infecciones fúngicas invasoras y profilaxis antimicrobian… Show more

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2024

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Clinical networking results in continuous improvement of the outcome of patients with acute promyelocytic leukemia

Koury,

Kim,

Undurraga

et al. 2024

Blood

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The introduction of all-trans retinoic acid (ATRA) combined with anthracyclines has significantly improved the outcomes for patients with acute promyelocytic leukemia (APL), and this strategy remains the standard of care in countries where arsenic trioxide is not affordable. However, data from national registries and real-world databases indicate that low- and middle-income countries (LMIC) still face disappointing results, mainly due to high induction mortality and suboptimal management of complications. The American Society of Hematology established the International Consortium on Acute Leukemias (ICAL) to address this challenge through international clinical networking. Here, we present the findings from the ICAPL study involving 806 patients with APL recruited in Brazil, Chile, Paraguay, Peru, and Uruguay. The induction mortality rate has decreased to 14.6% compared to the pre-ICAL rate of 32%. Multivariable logistic regression analysis revealed as factors associated with induction death: age ≥ 40 years, ECOG = 3, high-risk status based on the PETHEMA/GIMEMA classification, albumin level ≤ 3.5 g/dL, bcr3 PML/RARA isoform, the interval between presenting symptoms to diagnosis exceeding 48 hours, and the occurrence of central nervous system and pulmonary bleeding. With a median follow-up of 53 months, the estimated 4-year overall survival (OS) rate is 81%, the 4-year disease-free survival (DFS) rate is 80%, and the 4-year cumulative incidence of relapse (CIR) rate is 15%. These results parallel those observed in studies conducted in high-income countries, highlighting the long-term effectiveness of developing clinical networks to improve clinical care and infrastructure in LMIC.

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Clinical networking results in continuous improvement of the outcome of patients with acute promyelocytic leukemia

Koury,

Kim,

Undurraga

et al. 2024

Blood

View full text Add to dashboard Cite

show abstract

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Consenso de la Sociedad Chilena de Infectología para el manejo de episodios de neutropenia febril en adultos y niños con cáncer

Cited by 1 publication

References 221 publications

Clinical networking results in continuous improvement of the outcome of patients with acute promyelocytic leukemia

Clinical networking results in continuous improvement of the outcome of patients with acute promyelocytic leukemia

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