Resultados de Supervivencia en Leucemia Linfoblástica Aguda del Adulto en un Hospital de Tercer Nivel en Ecuador
DOI:
https://doi.org/10.29166/rfcmq.v51i1.8797Palabras clave:
Leucemia linfoblástica aguda, adulto, análisis de supervivencia, estudios retrospectivos, disparidades en salud, América Latina, EcuadorResumen
Introducción: La leucemia linfoblástica aguda del adulto en América Latina plantea desafíos clínicos y epidemiológicos, agravados por la disponibilidad de datos en la región.
Objetivo: Evaluar la supervivencia global a 5 años y la supervivencia libre de recaída en pacientes tratados con quimioterapia intensiva, caracterizar de manera sistemática las complicaciones relacionadas con el tratamiento, identificar factores pronósticos asociados con los desenlaces clínicos y describir los perfiles clínicos y demográficos de la población estudiada.
Métodos: Estudio observacional retrospectivo en 127 pacientes adultos diagnosticados con LLA, tratados con quimioterapia intensiva. Se analizaron sistemáticamente variables demográficas, clínicas, citogenéticas, entre otras, así como los desenlaces de supervivencia.
Resultados: 63,7% de los pacientes tenía menos de 40 años. La tasa de remisión completa tras la terapia de inducción fue del 58,5%. La mortalidad relacionada con la inducción alcanzó el 26,7%, atribuible a sepsis por Klebsiella pneumoniae productora de carbapenemasas, responsable del 67,4% de las muertes durante la inducción. La infección por K. pneumoniae productora de carbapenemasas , el aumento de la edad y el tratamiento con esquemas basados en L-asparaginasa emergieron como predictores independientes de mortalidad relacionada con la inducción. La supervivencia global estimada a cinco años fue del 17%, solo el 4% fue sometido a trasplante alogénico de células madre hematopoyéticas.
Discusión: La LLA del adulto se caracterizó por una elevada mortalidad relacionada con la inducción, impulsada principalmente por infecciones bacterianas multirresistentes, junto con un acceso severamente limitado al trasplante alogénico.
Conclusiones: hallazgos subrayan la necesidad urgente de implementar políticas de salud integrales orientadas a mejorar los resultados clínicos en esta población de pacientes.
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Derechos de autor 2026 Andres Orquera, Leonardo Mendieta-Carrión, Gabriela Muñoz-Velastegui , Melissa Arévalo-Anchundia , Andrea Cristina Aragón-Jácome , Giovanny Israel Silva-Patiño , Paola Velasco-Maldonado , Pamela Vanessa Carvajal-Aguirre , Néstor Roberto Yáñez-Coba
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
