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
DOI:
https://doi.org/10.29166/rfcmq.v49i2.6646Keywords:
Leukemic Infiltration, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Central Nervous SystemAbstract
Leukemic infiltration of the Central Nervous System (CNS) is a negative factor in the survival of patients with Acute Lymphoblastic Leukemia (ALL).
Objectives: Identify risk factors associated with leukemic CNS infiltration at the time of diagnosis and determine disease-free survival (DFS) and overall survival (OS) in children with and without CNS infiltration.
Methods: Retrospective cohort of patients between 1 and 18 years of age, diagnosed with ALL, between May 2012 and January 2016, at the Institute of the Society to Fight Cancer (SOLCA) in Cuenca, Ecuador. The dependent variables were: leukemic infiltration, DFS and OS. The independent ones included: age, white blood cells (WBC), platelets, lactic dehydrogenase (DHL), day of the first intrathecal (IT), immunophenotype, Philadelphia chromosome, use of general anesthesia in the procedure and red blood cells in cerebrospinal fluid.
Results: 68 patients were analyzed, 23 (33.8%) presented leukemic infiltration to the CNS at the time of diagnosis. The bivariate analysis revealed that WBC>10 000/μL, platelets <41 500/μL and DHL ≥610U/L had 3.05; 4.67 and 4.5 respectively higher risk of infiltration (p<0.05). The DFS between infiltrates and non-infiltrates was 52.6% (standard error (SE): 0.13) and 68.4% (SE: 0.08) respectively (p>0.05). OS was 60.9% (ET: 0.1) in infiltrates and 72.5% (ET: 0.06) in non-infiltrates (p>0.05).
Conclusions: The risk factors associated with leukemic infiltration to the CNS were WBC>10 000/μL, platelets <41 500/μL and DHL ≥610 U/L. DFS and OS were lower in infiltrated patients than in non-infiltrated patients.
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