Supervivencia y factores asociados a infiltración del Sistema Nervioso Central por Leucemia Linfoblástica Aguda, en SOLCA-Cuenca, período 2012 - 2016 - Survival and factors associated with infiltration of the Central Nervous System by Acute Lymphoblastic Leukemia, in SOLCA-Cuenca, period 2012 - 2016

Autores/as

DOI:

https://doi.org/10.29166/rfcmq.v49i2.6646

Palabras clave:

Infiltración Leucémica, Leucemia-Linfoma Linfoblástico de Células Precursoras, Sistema Nervioso Central

Resumen

Introducción: La infiltración leucémica del sistema nervioso central es un factor negativo en la supervivencia de pacientes con leucemia linfoblástica aguda.

Objetivo: Identificar factores de riesgo asociados con infiltración por leucemia linfoblástica aguda al sistema nervioso central al diagnóstico y determinar la supervivencia libre de enfermedad y supervivencia global, en niños con y sin infiltración al sistema nervioso central. 

Material y métodos: Cohorte retrospectiva, pacientes entre 1 y 18 años, diagnosticados de LLA, mayo 2012 enero 2016, SOLCA-Cuenca, Ecuador. Variables dependientes: infiltración leucémica, supervivencia libre de enfermedad y supervivencia global. Variables independientes: edad, glóbulos blancos, plaquetas, deshidrogenasa láctica, día primera intratecal, inmunofenotipo, cromosoma Philadelphia, uso de anestesia general en el procedimiento y glóbulos rojos en líquido cefalorraquídeo

Resultados: 68 pacientes, 23 (33,8%) presentaron al diagnóstico infiltración leucémica al Sistema Nervioso Central. El análisis bivariado reveló que GB>10 000/μL, plaquetas <41 500/μL y DHL ≥610U/L tuvieron 3,05; 4,67 y 4,5 respectivamente mayor riesgo de infiltración (p<0,05). La supervivencia libre de enfermedad entre infiltrados y no infiltrados fue 52,6% (error típico (ET): 0,13) y 68,4% (ET: 0,08) respectivamente (p>0,05). La SG fue 60,9% (ET: 0,1) en los infiltrados y 72,5% (ET: 0,06) en los no infiltrados (p>0,05).

Conclusiones: Los factores de riesgo asociados a infiltración por Leucemia Linfoblástica Aguda al Sistema Nervioso Central fueron GB>10 000/μL, plaquetas <41 500/μL y deshidrogenasa láctica ≥610 U/L. La supervivencia libre de enfermedad y supervivencia global fue menor en los pacientes infiltrados que en no infiltrados.

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Publicado

2024-05-27

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1.
Guerrero Quiroz E, Bastidas Sánchez A, Mejía Buri J, Martínez Reyes F. Supervivencia y factores asociados a infiltración del Sistema Nervioso Central por Leucemia Linfoblástica Aguda, en SOLCA-Cuenca, período 2012 - 2016 - Survival and factors associated with infiltration of the Central Nervous System by Acute Lymphoblastic Leukemia, in SOLCA-Cuenca, period 2012 - 2016. Rev Fac Cien Med (Quito) [Internet]. 27 de mayo de 2024 [citado 23 de julio de 2024];49(2):9-18. Disponible en: https://revistadigital.uce.edu.ec/index.php/CIENCIAS_MEDICAS/article/view/6646