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2018, Número 3

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Acta Med 2018; 16 (3)


Mesilato de imatinib como tratamiento de primera línea en pacientes con leucemia mieloide crónica Filadelfia + (LMC-Ph+) en fase acelerada (FA), en comparación con fase crónica (FC)

Hurtado MR, Vicente HB, Sarre ÁD, Vargas VP, Candelaria HM, Rojas SM, Best ACR, Cruz VJ

Idioma: Español
Referencias bibliográficas: 32
Paginas: 204-208
Archivo PDF: 261.84 Kb.


RESUMEN

Introducción: La fase acelerada es un estado de progresión de la LMC Ph+. Nuestra primera línea de tratamiento es el mesilato de imatinib (MI); sin embargo, no se tiene información sobre resultados a largo plazo en FA. Material y métodos: Se realizó un estudio retrospectivo, comparativo de pacientes con LCM Ph+. Los casos de FC recibieron MI 400 mg/día y los de FA 600 mg/día y seguimiento con estudios citogenéticos con hibridización in situ por fluorescencia (FISH) (mínimo 200 núcleos analizados) cada tres meses. Resultados: La mediana de tiempo para la respuesta citogenética completa (RCgC) fue de ocho meses en FC y 12 meses en FA. La duración de esta respuesta en FC fue de 73 meses en el 100% de los pacientes y 30 meses en el 42.9% de la FA. La mediana de supervivencia (seguimiento de 120 meses) en FA fue 70 meses y en FC 150 meses (p ‹ 0.0001). La mediana libre de enfermedad y supervivencia libre de eventos fue de 73 meses en FC y 30 meses en FA. Conclusiones: En FA se obtiene menor RCgC y menor supervivencia, lo cual sugiere la necesidad de un cambio desde su manejo inicial.


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