2015, Número 3
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Gac Med Mex 2015; 151 (3)
Factores predictivos de respuesta hematológica en adultos con síndrome mielodisplásico (SMD) tratados con ciclosporina A (CSA)
Zamora-Pérez E, López-Karpovitch X
Idioma: Español
Referencias bibliográficas: 42
Paginas: 345--353
Archivo PDF: 255.63 Kb.
RESUMEN
Antecedentes: Los SMD son enfermedades clonales de las células hematopoyéticas. La escala de riesgo más utilizada es
el
International Prognostic Scoring System (IPSS). La CSA se ha empleado para tratar las citopenias en los SMD.
Objetivo:
Evaluar la respuesta hematológica e identificar factores predictivos de respuesta en adultos con SMD tratados con CSA.
Material y métodos: Se incluyeron pacientes con SMD diagnosticados de acuerdo con los criterios de la Organización
Mundial de la Salud (OMS). Se usaron las escalas de riesgo IPSS, IPSS revisado (IPSS-R), WHO Prognostic Scoring System
(WPSS) y WPSS revisado (WPSS-R). La dosis inicial de CSA fue de 5 mg/kg/día.
Resultados: Cumplieron con los criterios
de inclusión 32 pacientes. La mediana de edad fue de 56.5 años y la de seguimiento, de 3.1 años. Se obtuvo una tasa de
respuesta hematológica del 56.2% y una independencia de trasfusión de concentrados eritrocitarios (CE) del 42.9%. La
edad, la cifra de hemoglobina (Hb) y la escala WPSS en el momento del diagnóstico fueron factores independientes
predictivos de respuesta para CSA. La supervivencia entre los pacientes con respuesta a CSA fue mayor que la de aquellos
sin respuesta (p = 0.06).
Conclusiones: La CSA indujo respuesta hematológica › 50% de pacientes con SMD, ‹ 57 años
de edad, Hb ‹ 8 g/dl y WPSS bajo en el momento del diagnóstico.
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