Larios-Farak TC, Rendón-García H, Ornelas-Ceballos JR, Covarrubias-Espinoza G, Ríos-García CG, Morales-Peralta A

Language: Spanish
References: 13
Page: 19-25
PDF size: 500.87 Kb.

ABSTRACT

Introduction: Acute lymphoblastic leukemia is the most common pediatric cancer. (40%) of all cancer pathology. Survival has increased is estimated that about 80-85% achieve a cure. Prognostic factors orient the treatment protocol adapted to the risk of each individual. The intermediate risk, it is often difficult to classify .It aims to increase survival intensifying treatment and reducing toxic effects. The objective is to evaluate the survival of patients with acute lymphoblastic leukemia who were treated with intermediate-risk protocol, survival around 70% is estimated..
Material and Methods: a cross-sectional study with data obtained from clinical records of oncology at Children’s Hospital of the State of Sonora, clinical records 4 years of follow up with a diagnosis of acute lymphoblastic leukemia intermediate risk with treatment of 30 months of continuous complete remission. Statistical analysis was performed with descriptive measurements, chi2 and survival curves Kapplan Meier.
Results: Free survival by Kaplan Meier mediated disease 3.5 years is 50%. 10 relapsed (50%) of these 35% were early and 15% late. Patients without relapse 70% currently has more than 24 months in surveillance. The most common site of relapse is bone marrow 30%
Discussion: Survival is below that reported in the international literature. One factor is the difficulty in classifying the intermediate risk according to not well standardized clinical criteria. The percentage of relapse to bone marrow failure alert to systemic disease control. It is well established that the levels of minimal residual disease during induction is an important pronostic factors.
Conclusion: It is necessary to expand the cabinet studies with which we in our hospital to define intermediate risk criteria and thus have an impact on survival. It requires definitely intensify the treatment of this patient group.

REFERENCES

1. 1.- Pizzo AP, Poplack DG, Principles and practice of Pediatric Oncology, Leuekemia Lymphoblastic Acute 7th.Ed.Lippincott- Raven. USA. 2015. p. 463-93.

2. 2.- Locatelli F, et al, How I treat relapse childhood acute lymphoblastic leukemia. Blood Oct 2012 120: 2807-16.

3. 3.- Mejía AJ, et al, epidemiología de las leucemias agudas en niños parte 1. Revista Médica del IMSS 2005; 43 (4) 323- 33.

4. 4.- Sociedad argentina de hematología .Guias de diagnóstico y tratamiento 2012. Leucemia Linfoblástica aguda. 83-115.

5. 5.- Arico M , Long-Term Results of the AIEOP-ALL-95 Trial for Childhood Acute Lymphoblastic Leukemia: Insight on the Prognostic Value of DNA Index in the Framework of Berlin- Frankfurt-Muenster–Based Chemotherapy. Journal Of Clinical Oncology. January 10. 2008; 26(2): 283-9.

6. 6.- Protocolo para Leucemia Aguda Linfoblástica de la Sociedad Española de Hematología y Oncología Pediátricas (SEHOP) en colaboración con el grupo PETHEMA. Versión LAL/SEHOP-PETHEMA 2013 Versión 1.0 (1.04.13).

7. 7.- Möricke A, et al, Risk-adjusted therapy of acute lymphoblastic leukemia can decrease treatment burden and improve survival: treatment results of 2169 unselected pediatric and adolescent patients enrolled in the trial ALL-BFM 95.Blood, 2008. 111 (9): 4477-89.

8. 8.- Larios FT, Rendón GH. Evaluacion de los factores de riesgo intermedio en niños con leucemia linfoblastica aguda del hospital infantil del estado de sonora.2010.

9. 9.- Tsuchida M, Ohara A, Manabe A, et al., “Long-term results of Tokyo children’s cancer study group trials for childhood acute lymphoblastic leukemia, 1984–1999”, Leukemia, vol. 24, no. 2: 383–96, 2010.

10. 10.- Koka A, et al, A 17-year experience with ALL-BFM protocol in acute lymphoblastic leukemia: Prognostic predictors and interruptions during protocol. Leukemia Research, 2014. 38: 699–705.

11. 11.- López FE, Larios FT, Rendón GH, Validez de la enfermedad mínima residual por citometría de flujo en la predicción de recaída en pacientes con leucemia linfoblástica aguda en el HIES. [Tesis]. 2014.

12. 12.- Ching-Hon P, et al, Clinical utility of sequential minimal residual disease measurements in the context of risk-based therapy in childhood acute lymphoblastic leukaemia: a prospective study. Lancet Oncology,2015. 16: 465-74.

13. 13.- Basso G, et al, Risk of Relapse of Childhood Acute Lymphoblastic Leukemia Is Predicted By Flow Cytometric Measurement of Residual Disease on Day 15 Bone Marrow. Journal of Clinical Oncology, 2009. 27 (31): 5168-74.