Contributions of a regional approach to document hematologic disease in Mexico: a 10-year experience in an open population

Jaime‐Pérez, José Carlos; Treviño-Reyna, Goel; Aguilar-Calderón, Patrizia; Cantú-Rodrı́guez, Olga Graciela; Marfil-Rivera, Luis Javier; Gómez‐Almaguer, David

doi:10.1080/10245332.2018.1498166

Cited by 8 publications

(5 citation statements)

References 37 publications

(45 reference statements)

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“…2,30,33 Perez-Saldivar reported a major peak at age of 2 for lymphoid leukemias, while for myeloid leukemias at 10. 30 Interestingly, we recorded a major peak at age of 6 to 7 for B-cell leukemias, similar to what was observed in Nuevo León, 33 and a slight peak for myeloid entities around ages 4 to 5. Adolescents were analyzed separately as unfavorable features worse outcomes have been associated with such age group.…”

Section: Discussionmentioning

confidence: 99%

“…Remarkably, a substantially higher frequency of myeloid leukemias (22.48%) compared with previous studies conducted in Mexico City and Nuevo León (10%-13%). 2,30,33 Perez-Saldivar reported a major peak at age of 2 for lymphoid leukemias, while for myeloid leukemias at 10. 30 Interestingly, we recorded a major peak at age of 6 to 7 for B-cell leukemias, similar to what was observed in Nuevo León, 33 and a slight peak for myeloid entities around ages 4 to 5.…”

Section: Discussionmentioning

confidence: 99%

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Poor Prognosis Biomolecular Factors Are Highly Frequent in Childhood Acute Leukemias From Oaxaca, Mexico

Juárez-Avendaño

Luna-Silva²,

Chargoy-Vivaldo

et al. 2020

Technol Cancer Res Treat

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Objective: To investigate the cellular and molecular epidemiology of acute leukemias in vulnerable populations of children and adolescents in Oaxaca de Juarez, Mexico. Material and Methods: Descriptive, cross-sectional and retrospective study, conducted from 2014 to 2018 in which profiles of molecular and immunophenotypic aberrations were investigated in children and adolescents diagnosed with acute leukemia, by evaluating 28 molecular abnormalities by HemaVision-Q28 multiplex RT-PCR kit and standardized EuroFlow Immunophenotyping of bone marrow cells. Results: We included 218 patients, with 82.5% younger than 14 years and 17.5% adolescents. The median age was 9 years and a main peak of incidence was recorded at age of 4 to 5 years. B-cell acute lymphoblastic leukemia was diagnosed in 70.64% of all cases, acute myeloid leukemia was in 22.48%, T-cell acute lymphoblastic leukemia in 6.42%, and mixed lineage acute leukemia in 0.46% of cases. Overall, chromosomal translocations were positive in 29.82% of cases. While 65.31% of patients with acute myeloid leukemia reported aberrancies, only in 18.83% of B-cell acute lymphoblastic leukemia cases genetic abnormalities were obvious. Surprisingly, most prevalent translocations in B-cell acute lymphoblastic leukemia were t(9;22) in 20.7%, followed by t(4;11) in 17.2% and t(6;11) in 13.8%, whereas patients with acute myeloid leukemia showed t(15;17) in 40.6% and t(8;21) in 21.9%. In contrast, an homogeneous expression of t(3;21) and t(6;11) was recorded for T-cell acute lymphoblastic leukemia and mixed lineage acute leukemia cases, respectively. Except for t(1;19), expressed only by pre-B cells, there was no association of any of the studied translocations with differentiation stages of the B-leukemic developmental pathway. Conclusion: Our findings identify near 50% of patients with acute lymphoblastic leukemia at debut with high-risk translocations and poor prognosis in B-cell acute lymphoblastic leukemia as well as an unexpected increase of acute myeloid leukemia cases in young children, suggesting a molecular shift that support a higher incidence of poor prognosis cases in Oaxaca.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Poor Prognosis Biomolecular Factors Are Highly Frequent in Childhood Acute Leukemias From Oaxaca, Mexico

Juárez-Avendaño

Luna-Silva²,

Chargoy-Vivaldo

et al. 2020

Technol Cancer Res Treat

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“…The high prevalence of overweight/obesity in our population adding up to 70% was the main factor contributing to the elevated TLP rate observed; the fact that ours is a reference centre caring for an elevated proportion of adults with high-risk ALL requiring performing more LPs also appears to have influenced our results. Interestingly, we have recently documented a higher incidence of ALL than acute myeloid leukemia in adults in Mexico 30 , 31 , which leads to the need for performing a higher number of LP procedures.…”

Section: Discussionmentioning

confidence: 99%

Impact of Obesity on Lumbar Puncture Outcomes in Adults with Acute Lymphoblastic Leukemia and Lymphoma: Experience at an Academic Reference Center

Jaime‐Pérez

Sotomayor-Duque

Aguilar-Calderón

et al. 2019

IJHOSCR

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Background: Lumbar puncture (LP) is a hematology procedure that can require repeated attempts leading to traumatic LP (TLP), which has been related to the central nervous system (CNS) relapse. LP success can depend on the size and anatomy of the patient and the skill of the hematologist. The main objective was to determine the influence of body mass index (BMI) on LP outcomes. Materials and Methods: Adults with lymphoid malignancies requiring LP were included prospectively over one year; hematology residents performed most procedures. A 22-gauge Quincke needle was employed. Comparison between non-traumatic vs. traumatic LPs according to BMI, CNS relapse, and residents’ year was performed. Results: Fifty-four patients with a mean age of 31.5±15.57 years were included. Diagnosis was Acute Lymphoblastic Leukemia-B (74%), Acute Lymphoblastic Leukemia-T (13%) and Non-Hodgkin Lymphoma (13%). 227 LPs were performed, 121 (53.3%) successful, 98 (43.2%) traumatic, 11 (11.2%) TLPs were macroscopically detectable and 87 (88%) microscopic; 8 (3.5%) were dry-taps. Median time between punctures was 11 days (1-202). Median BMI was 25 (22.8-39.6). Main indication for LP was prophylactic (74.5%); 39.2% were performed by first-year, 35.2% by second-year, 19.6% by third-year hematology residents. No difference (p = 0.145) for a TLP was found among residents. A BMI ≥30 (p = 0.040), non-palpable intervertebral space (p = 0.001) and more than one attempt (p = 0.001) were significant for TLP. TLP was not associated with CNS relapse (p = 0.962). Conclusion: Obesity predicted a TLP. A traumatic puncture did not increase the risk of CNS relapse at one-year follow-up.

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“…ITP is a relatively common disease in the geographic region of the study, being the second and third most frequent hematological diagnosis in children and adults, respectively 11 . Secondary ITP prevalence varies greatly worldwide, with an estimated 20% of all ITP cases in the United States compared to 32% in the present report 10 .…”

Section: Discussionmentioning

confidence: 99%

Diagnoses, Outcomes, and Chronicity Predictors of Patients with Secondary Immune Thrombocytopenia: Ten-Year Data from a Hematology Referral Center

Jaime‐Pérez¹,

Aguilar-Calderón²,

Jiménez-Castillo³

et al. 2021

RIC

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Background: Secondary immune thrombocytopenia (ITP) is a heterogeneous and unpredictable disease associated with various underlying conditions. Objective: The objective of the study was to investigate clinical evolution and chronicity predictors in secondary ITP. Methods: Patients treated at an academic medical center during 2008-2019 were stratified by age as children <16 years and adults >16 years. Responses to steroids, intravenous immunoglobulin G (IVIG), rituximab, and eltrombopag were classified as response (R) and complete response (CR). Risk factors for chronic ITP were determined by multiple regression with uni-and multi-variate analysis. Results: Eighty-three patients were included, 37 children and 46 adults. The most frequent associated conditions were infections 53%, systemic lupus erythematosus (SLE) 24%, thyroid disease 9.6%, and Evans syndrome 3.6%. Response to first-line treatment in the whole cohort was 94%; CR 45.7%; and R 50.6%. Initial response to steroids alone was 91.3% (n = 21/23), rituximab plus high-dose dexamethasone (HDD) 93.3% (n = 14/15); children receiving IVIG alone 100% (n=12/12); and eltrombopag in adults 100% (n = 3/3). Relapse was documented in 19.4% of children and 34% of adults, at a median time of 15 and 2 months, respectively; 30.4% of adults (15.2% from the miscellaneous group, 10.9% SLE-associated, and 4.3% infection-associated) and 18.9% of children followed a chronic course; age ≥10 years and platelets ≥20 × 10 9 /L were risk factors for chronic ITP in children. Conclusion: Evolution was heterogeneous: a better and more sustained response was documented in the infections group compared to SLE or the miscellaneous group.

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Contributions of a regional approach to document hematologic disease in Mexico: a 10-year experience in an open population

Abstract: Information on hematology diseases derived of regional registries in low-middle income countries is a reasonable alternative to complement and update national registries.

Cited by 8 publications

References 37 publications

Poor Prognosis Biomolecular Factors Are Highly Frequent in Childhood Acute Leukemias From Oaxaca, Mexico

Poor Prognosis Biomolecular Factors Are Highly Frequent in Childhood Acute Leukemias From Oaxaca, Mexico

Impact of Obesity on Lumbar Puncture Outcomes in Adults with Acute Lymphoblastic Leukemia and Lymphoma: Experience at an Academic Reference Center

Diagnoses, Outcomes, and Chronicity Predictors of Patients with Secondary Immune Thrombocytopenia: Ten-Year Data from a Hematology Referral Center

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