Survival Outcomes in Adult Acute Lymphoblastic Leukemia at a Third-Level Hospital in Ecuador
DOI:
https://doi.org/10.29166/rfcmq.v51i1.8797Keywords:
Acute lymphoblastic leukemia, adult, Ecuador, survival analysis, retrospective studies, healthcare disparities, Latin AmericaAbstract
Background: Adult acute lymphoblastic leukemia in Latin America poses distinct clinical and epidemiological challenges, compounded by the limited availability of region-specific data. This study aimed to assess five-year overall survival and relapse-free survival in patients treated with intensive chemotherapy, to systematically characterize treatment-related complications, to identify prognostic factors associated with clinical outcomes, and to delineate the clinical and demographic profiles of the study population.
Methods: A retrospective observational study was conducted in 127 adult patients diagnosed with acute lymphoblastic leukemia who were treated with intensive chemotherapy. Demographic, clinical, cytogenetic, and treatment-related variables, as well as survival outcomes, were systematically analyzed.
Results: The median age at diagnosis was 33 years, with 63.7% of patients younger than 40 years. The complete remission rate following induction therapy was 58.5%. Induction-related mortality reached 26.7%, predominantly attributable to sepsis caused by carbapenemase-producing Klebsiella pneumoniae, which accounted for 67.4% of induction deaths. In multivariate analysis, infection with carbapenemase-producing K. pneumoniae, increasing age, and treatment with L-asparaginase–based regimens emerged as independent predictors of induction-related mortality. The estimated five-year overall survival was 17%, and only 4% of patients underwent allogeneic hematopoietic stem cell transplantation.
Discussion: Adult acute lymphoblastic leukemia in this cohort was marked by substantial induction-related mortality, largely driven by multidrug-resistant bacterial infections, in conjunction with severely limited access to allogeneic transplantation.
Conclusions: These findings underscore the urgent need for the implementation of comprehensive health policies aimed at improving clinical outcomes in this patient population.
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Copyright (c) 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
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