Nacho-Vargas KA, Sánchez-Valle E

Idioma: Español
Referencias bibliográficas: 42
Paginas: 106-112
Archivo PDF: 65.22 Kb.

FRAGMENTO

La Leucemia Linfoblástica Aguda (LLA) es la neoplasia más frecuente de la edad pediátrica, tiene un segundo pico de incidencia alrededor de los 50 años de edad y parece incrementarse con la edad. Los avances en la terapéutica han sido impresionantes en la LLA en niños, ya que hoy se puede alcanzar hasta un 90% de remisión completa y un 70 a 80% de estos niños tendrá una supervivencia libre de enfermedad (SLE) prolongada. Por el contrario, en la LLA del adulto se espera sólo un 30 a 40% de SLE prolongada. La mejor comprensión de la citogenética y biología molecular de la LLA, pueden explicar en parte las diferencias que existen entre la LLA del adulto y la LLA del niño tanto en la respuesta al tratamiento como en la supervivencia,. Es así que el cromosoma Filadelfia (Ph) que se asocia con el peor pronóstico, se encuentra en un 25 a 30% de los enfermos adultos con LLA, en contraste a un 5% en la edad pediátrica. Por el contrario, la anormalidad molecular TEL-AML1, que se expresa a nivel citogenético con la t(12;21), se asocia con una tasa de curación de hasta el 90%. Esta t(12;21), se encuentra hasta en un 30% de niños con LLA, y solo en 2% de adultos con LLA. Los niños, además presentan hasta en un 25% de los casos hiperdiploidía, que se asocia a buen pronóstico.

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