RESUMO
Background: GIMEMA ALL 0288 trial was designed to evaluate the impact of a 7-day prednisone (PDN) pretreatment on complete remission of acute lymphoblastic leukemia. We adopted this trial in 2007. Aim: To evaluate the results of treatment in two cohorts of patients with acute lymphoblastic leukemia, treated from 2007 to January 2009 and from February to December 2009. Material and Methods: We studied 99 patients treated in the first period (58 males) and 54 patients treated in the second period (33 males) The age of patients ranged from 16 to 60 years and 70 percent of patients were of high risk. BCR/ABL fusion transcript was present in 12 percent of patients. Results: Remission rates were 61 and 51 percent for patients of the first and second group of treatment, respectively. The main cause of death were infections during the induction period. There were 49 relapses, mainly detected in the blood marrow. Global and event free 34 months survival were 32 and 30 percent respectively. Multivariate analysis disclosed risk stratification and central nervous system infiltration as risk factors for mortality. Conclusions: The main obstacles for the treatment of acute lymphoblastic leukemia in these cohorts of patients were the high incidence of infections and the lack of use of growth stimulating factors.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Neoplasias Encefálicas/prevenção & controle , Métodos Epidemiológicos , Quimioterapia de Indução/métodos , México/epidemiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade , Leucemia-Linfoma Linfoblástico de Células Precursoras/prevenção & controle , Recidiva , Indução de Remissão/métodos , Resultado do TratamentoRESUMO
Se presentan los resultados del estudio citogenético realizado en sangre periférica y/o médula ósea de 25 pacientes (22 adultos y 3 niños) con LLA estudiados entre 1987 a 1990. Todos los casos presentaron alteraciones cromosómicas (25/25), aunque en 23 pacientes (23/25) estaba presente una línea celular normal. Entre las aberriguaciones estructurales encontradas están t(17;19) (q11;p13), t(2;9;22)(q34;q34;q11), t(1;7)(p13;q33), t(6;11)(q26;p16), t(3;4)(q24-25;q26), t(1;12)(q23;q34), t(2;18)(q15;p12), t(2;4;)(q23;35) y t(4;11)(q21ñq23). Estos rearreglos fueron indicadores de riesgo y se correlacionaron con la respuesta al tratamiento y la supervivencia de los pacientes. Algunas de estas anomalías no habían sido previamente descritas en LLA; sin embargo, los puntos de ruptura coinciden con los observados en otras neoplasias hematológicas, lo cual suguiere que esas regiones son críticas en la patogénesis de estos desórdenes.