Tratamiento de la leucemia linfoide aguda del adulto: Experiencia de un hospital en la Ciudad de México

Ramos, Christian; Rozen, Etta; Léon, Maria Elena; T, Adolfo Martínez; Olarte, Irma; Catellanos, Humberto; Martínez, Carlos Gómez; Montaño, Efréen; Kassack, Juan; Zamora, Jorge; Miranda, Enrique; Ros, Andrés De la; Gutiérrez, Mario; Collazo, Juan

doi:10.4067/s0034-98872011000900004

Cited by 8 publications

(7 citation statements)

References 27 publications

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“…Another limitation of our study of a retrospective nature, is the scarce availability of certain immunophenotype markers such as aberrant myeloid markers; this precludes trustworthy correlation analyses between aberrant markers and the Philadelphia chromosome status, as well their inclusion in the survival analysis. ALL‐T cases were identified in 2.9%; which is less than previously reported by other authors in Mexico (5–10%) as well as in other countries (10–30%) . We do not have an explanation for this finding.…”

Section: Discussioncontrasting

confidence: 78%

“…Furthermore, data collection allowed us to determine the principal areas of opportunity in the participating centers. Such is the case of caryotype testing that historically has been described as deficient in the past few years in Mexico ; however, some investigators have recently reported an improvement in this caveat as a result of the routine implementation of FISH or molecular techniques to identify cases of Ph + ‐ALL . Another multicentric study was recently conducted in Mexico, including six referral hematological centers, of a large series of patients with acute myeloid leukemia and ALL; however, they did not conduct a survival analysis nor risk factor identification.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, there are no large ALL patient series in many Latin American countries.Reports in Mexico have referred CR rates between 60% and 80% with hyper-CVAD and other locally designed institutional regimens. Among the limitations of studies published in Mexico are the use of diverse treatment protocols that make interinstitutional comparisons difficult, the series are small, there are deficiencies in cytogenetic results (inaccessible or technique failures), all impinging on the reported incidence of Philadelphia-positive ALL (Ph + -ALL); also, most studies lack a survival analysis and risk factor identification [1,[21][22][23][24]. A recent series of 94 patients at the Hospital Universitario de Monterrey, Nuevo León [25] treated with the Berlin-Frankfurt-Münster (BFM) regimen, reported a CR of 71.3% and a 5-year OS of 31.1%.…”

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confidence: 99%

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Survival analysis of adult patients with ALL in Mexico City: first report from the Acute Leukemia Workgroup (ALWG) (GTLA)

et al. 2018

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Acute lymphoblastic leukemia (ALL) is a hematologic malignancy characterized by the clonal expansion of hematopoietic lymphoid progenitors. With new target therapies, the survival of adults with ALL has improved in the past few decades. Unfortunately, there are no large ALL patient series in many Latin American countries. Data from the Acute Leukemia Workgroup that includes five Mexico City referral centers were used. Survival was estimated for adult patients with ALL during 2009–2015. In total, 559 adults with ALL were included. The median age was 28 years; 67% were classified into the adolescent and young adult group. Cytogenetic information was available in 54.5% of cases. Of the 305 analyzed cases, most had a normal caryotype (70.5%) and Philadelphia‐positive was present in 16.7%. The most commonly used treatment regimen was hyper‐CVAD. In approximately 20% of cases, there was considerable delay in the administration of chemotherapy. Primarily refractory cases accounted for 13.1% of patients. At the time of analysis, 26.7% of cases had survived. The 3‐year overall survival was 22.1%. The main cause of death was disease progression in 228 (55.6%). Clinical and public health strategies are needed to improve diagnosis, treatment and survivorship care for adult with ALL. This multicentric report represents the largest series in Mexico of adult ALL patients in which a survival analysis and risk identification were obtained.

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Survival analysis of adult patients with ALL in Mexico City: first report from the Acute Leukemia Workgroup (ALWG) (GTLA)

et al. 2018

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“…En América Latina Combariza et al evaluaron 83 pacientes tratados con Hyper-CVAD como primera línea de tratamiento, su tasa de remisiones completas reportadas fueron del 61% con una supervivencia global de 11,3 meses (10) . El Hospital General de México cuenta con el régimen institucional HGMLAL07 desde el año 2007, fundamentado en el protocolo GIMEMA ALL0288 (12) , debido a que la experiencia de los autores con el esquema Hyper-CVAD se limita solo a leucemias en recaída, el objetivo del estudio fue evaluar este esquema como primera línea en pacientes jóvenes y con un buen estado funcional.…”

Section: Introductionunclassified

Comparación del hyper-CVAD con un régimen institucional en el tratamiento de la leucemia linfoblástica aguda del adulto en un hospital de México

Ramos-Peñafiel

Cabrera-García

Rozen-Fuller

et al. 2014

Rev Peru Med Exp Salud Publica

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RESUMENCon el objetivo de evaluar la mortalidad y toxicidad del protocolo Hyper-CVAD utilizado como primera línea de tratamiento de la leucemia linfoblástica aguda se realizó un estudio de cohorte retrospectiva en pacientes de 40 años a menos durante marzo a septiembre de 2011 atendidos con el régimen Hyper-CVAD. La mortalidad y toxicidad se comparó con los resultados de los pacientes atendidos con el régimen institucional HGMLAL07 entre 2009 a 2012. Se incluyeron 18 pacientes, la mediana de edad fue de 26 años. Tanto las remisiones completas (67,7% frente a 81,9%) como la supervivencia a un año (40% frente a 62%) y 2 años (18% frente a 34%) fueron menores con el régimen Hyper-CVAD. Al seleccionar exclusivamente pacientes menores de 35 años, la eficacia de Hyper-CVAD también fue menor. Según esta experiencia y debido a su alto costo y toxicidad, el régimen Hyper-CVAD debe de limitarse a aquellos pacientes con leucemias refractarias o en recaída. Palabras clave: Leucemia linfoblástica; Protocolos de quimioterapia combinada antineoplásica; Adulto (fuente DeCS BIREME). COMPARISON OF THE HYPER-CVAD WITH AN INSTITUTIONAL REGIMEN FOR THE TREATMENT OF ACUTE LYMPHOBLASTIC LEUKEMIA IN ADULTS IN A HOSPITAL OF MEXICO ABSTRACTIn order to assess the mortality and toxicity of the Hyper-CVAD protocol used as first-line treatment of acute lymphoblastic leukemia, a retrospective cohort study was performed in patients less than 40 years of age from March to September 2011 treated with Hyper-CVAD regimen. Mortality and toxicity was compared with the results of patients treated with the institutional HGMLAL07 regimen between 2009-2012. 18 patients were included; the median age was 26 years old. Complete remissions (67.7% versus 81.9%) as well as one-year (40% versus 62%) and 2 year survival rates (18% versus 34%) were lower with the Hyper-CVAD regimen. By selecting only patients younger than 35 years, the effectiveness of Hyper-CVAD was also lower. In our experience and because of its high cost and toxicity, the Hyper-CVAD regimen should be limited to patients with relapsed or refractory leukemia.

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“…La edad, continua siendo uno de los principales factores EDAD Y RECUENTO LEUCOCITARIO COMO FACTORES PRONÓSTICOS EN LEUCEMIA LINFOBLÁSTICA AGUDA: COHORTE HGMLA07 pronósticos ya que diversos grupos como el GIMEMA ALL 0288 consideran la edad de corte entre los 30 a 40 años como factor pronóstico 14 . En un primer análisis del protocolo institucional HGMLAL07, la cifra de leucocitos de 30 x 10 9 /L no tuvo un impacto determinante sobre la supervivencia, aunque esta si se vio reducida de forma significativa por otros factores como el tipo de riesgo y la expresión del oncogén BCR-ABL1 15 .…”

Section: Introductionunclassified

Edad y recuento leucocitario como factores pronósticos en leucemia linfoblástica aguda: cohorte hgmla07

Ladines-Castro

Santoyo-Sánchez

Rozen-Fuller

et al. 2016

Duazary

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Con el objetivo de establecer la cifra de corte de leucocitos y edad con implicación pronostica en adultos con leucemia linfoblástica aguda (LLA), se efectuó un estudio observacional, descriptivo y analítico anidado en la cohorte retrospectiva de pacientes con LLA tratados mediante el protocolo institucional HGMLAL07 durante 2007-2014. Se estudiaron 255 pacientes, el 52.9% (n=135) correspondieron al género femenino y 47.1% (n=120) al género masculino. La media de edad fue de 31 (16-80) años. La supervivencia libre de la enfermedad (SLE) disminuyó en ambos géneros a partir de los 20 años (p=0.001). La media de leucocitos fue 56.1 x 109/L (0.1-850 x 109/L). La SLE disminuyó significativamente a partir de una cifra igual o mayor de 20 x 109/L (p<0.05). Con esto se puede concluir que emplear puntos de corte para leucocitos y edad obtenidos en poblaciones distintas pudiera condicionar una mala clasificación pronostica y un consiguiente tratamiento subóptimo.

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Tratamiento de la leucemia linfoide aguda del adulto: Experiencia de un hospital en la Ciudad de México

Abstract: Results of treatment of acute lymphoblastic leukemia in two cohorts of Mexican patients (Rev Med Chile 2011; 139: 1135-1142.

Cited by 8 publications

References 27 publications

Survival analysis of adult patients with ALL in Mexico City: first report from the Acute Leukemia Workgroup (ALWG) (GTLA)

Survival analysis of adult patients with ALL in Mexico City: first report from the Acute Leukemia Workgroup (ALWG) (GTLA)

Comparación del hyper-CVAD con un régimen institucional en el tratamiento de la leucemia linfoblástica aguda del adulto en un hospital de México

Edad y recuento leucocitario como factores pronósticos en leucemia linfoblástica aguda: cohorte hgmla07

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