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ISSN 0016-3813 (Impreso)

2013, Número 3

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Gac Med Mex 2013; 149 (3)


Dosis baja de ácido transretinoico en adultos con leucemia promielocítica aguda

Ramos-Blas G, López-Karpovitch X, Crespo-Solís E, Aguayo Á

Idioma: Español
Referencias bibliográficas: 39
Paginas: 265-271
Archivo PDF: 94.80 Kb.


RESUMEN

Antecedentes: El tratamiento estándar de la leucemia promielocítica aguda (LPA) incluye ácido transretinoico (ATRA) (45 mg/m2) con quimioterapia (QT). Un estudio previo evaluó ATRA a dosis bajas (25 mg/m2) y mostró eficacia clínica parecida a la dosis estándar. Objetivo: Evaluar remisión completa (RC) y supervivencia (SV) en adultos con LPA de novo expuestos a dosis baja de ATRA y daunorubicina (DNR). Material y método: Se incluyeron pacientes con LPA diagnosticados entre 2000-2006. El tratamiento consistió en fase de inducción a la remisión (IR) con ATRA (25 mg/m2) + DNR (45 mg/m2) y posteriormente tres consolidaciones con ATRA (25 mg/m2) y DNR (25 mg/m2), seguido de mantenimiento por 2 años con 6-mercaptopurina, metotrexato y ATRA (25 mg/m2). Resultados: La mediana de edad de los 19 pacientes fue 31 años. El 78.9% alcanzó RC. La mortalidad durante la IR fue 15.8%. Cuarenta por ciento de los enfermos recayeron y todos alcanzaron segunda RC con ATRA (45 mg/m2) + QT. Con una mediana de seguimiento de 2.97 años la SV fue 57.9%. Conclusión: La dosis baja de ATRA logra una tasa de RC aceptable. No se recomienda el empleo de ATRA a dosis ‹ 45 mg/m2 durante la IR en adultos con LPA de novo por la alta tasa de recaída.


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