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2003, Número 6

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Gac Med Mex 2003; 139 (6)


Análisis del tipo de transcrito bcr-abl y su relación con la cuenta plaquetaria en pacientes mexicanos con leucemia mieloide crónica

Rosas-Cabral A, Martínez-Mancilla M, Ayala-Sánchez M, Vela-Ojeda J, Bahena-Reséndiz P, Vadillo-Buenfil M, Aviña-Zubieta JA, Salazar-Exaire D, Miranda-Peralta E, Marroquín A, Longoria-Revilla E

Idioma: Español
Referencias bibliográficas: 54
Paginas: 553-559
Archivo PDF: 240.23 Kb.


RESUMEN

Problema: Se ha sugerido que el tipo de transcrito quimérico bcr-abl (b3a2 o b2a2) está asociado con diferencias en las características clínicas y hematológicas de los pacientes con Leucemia Mieloide Crónica (LMC); sin embargo su valor pronóstico aún es controvertible. Métodos: Se analizaron 97 casos de LMC Filadelfia-positiva, para determinar el tipo de transcrito bcr-abl y su relación con los parámetros clínicos al diagnóstico, mediante la Reacción Inversa en Cadena de la Polimerasa (RT-PCR). Resultados: Nosotros detectamos 27 (28%) pacientes con un transcrito b3a2 y 57 (59%) con un transcrito b2a2, en 13 casos (13%) se detectaron ambos transcritos b3a2/b2a2, estas frecuencias son inversas a las reportadas por otros grupos. No se encontraron diferencias estadísticamente significativas entre los pacientes que presentaron el transcrito b3a2 o el b2a2 con respecto a edad, sexo, concentración de hemoglobina o cuenta leucocitaria. Sin embargo, la cuenta plaquetaria de los pacientes que expresaron un transcrito b3a2 fue significativamente más elevada que la de los pacientes con transcrito b2a2 (743.3 vs 477.3 x 109/L; p=0.01). Además, en el subgrupo de pacientes cuya cuenta leucocitaria al diagnóstico fue >100 x 109/L y que presentaban un transcrito b3a2, la cuenta plaquetaria fue significativamente mayor que la de los pacientes que expresaron un transcrito b2a2 (679.1 vs 352.2 x 109/L; p=0.001) Conclusiones. Se observó una frecuencia de transcritos de bcr-abl inversa a la reportada en la mayor parte de los estudios realizados en esta dirección, pero acorde con otros estudios realizados en Latinoamérica. Además, se observó que, al menos en nuestra población existe un subgrupo de pacientes en los cuales el transcrito b3a2 de bcr-abl esta asociado a una mayor actividad trombopoyética, lo cual sugiere en nuestra población una conducta biológica diferente de la LMC.


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