Ramos-Peñafiel CO, Castellanos-Sinco H, Adolfo Martínez-Tovar, Efreen Montaño-Figueroa, Carlos Martínez-Murillo, Irma Olarte-Carrillo, Juan Collazo-Jaloma, Etta Rozen-Fuller

Idioma: Español
Referencias bibliográficas: 35
Paginas: 57-61
Archivo PDF: 74.67 Kb.

RESUMEN

La leucemia linfoide aguda es una neoplasia maligna originada en las células linfoides inmaduras de estirpe B o T. Su expresión clínica es variable e involucra diversas alteraciones citogenéticas y moleculares. El tratamiento se divide en: inducción a la remisión, consolidación y mantenimiento, entre éstas está la profilaxis al sistema nervioso central. Sin ésta, la posibilidad de recaída es de alrededor de 50%. Como medida de profilaxis se han realizado diversas estrategias; las principales son la radioterapia y la quimioterapia con administración intratecal. Con estas estrategias, la tasa de infiltración se ha reducido a menos de 5%. Recientemente, los diversos regímenes de quimioterapia intratecal desplazaron a la radioterapia de cráneo debido a los efectos secundarios tardíos, como el déficit de aprendizaje y las neoplasias secundarias. En el Hospital General de México, desde el 2007, se sustituyó la radioterapia por la administración intensiva de quimioterapia intratecal. En este estudio se analizaron alrededor de 153 pacientes bajo el régimen institucional HGMLAL07/09. La infiltración al sistema nervioso central al diagnóstico se registro sólo en 2% de los casos. Durante la inducción se administró quimioterapia intratecal semanal con triple esquema (citarabina, hidrocortisona, metotrexato) y, posteriormente, cada mes hasta el término del tratamiento. La incidencia de recaída al SNC fue menor de 2% a 34 meses de seguimiento. En conclusión, la profilaxis con triple esquema es un tratamiento eficaz para prevenir las recaídas al SNC en pacientes adultos con leucemia linfoide aguda.

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