ABSTRACT
Acute adult nonlymphoblastic leukemia (ANLL) involves a large group of diseases which originate in an abnormal process of differentiation of the hematopoietic stem cell. This paper analyses the historical background of such a group of malignant hemopathies, current criteria to perform the diagnosis and also the most important therapies used in both the stage of remission induction and the period following this stage (post-remission status). In this context, the therapeutic achievements that have had place during the last two decades at the Hospital de Especialidades del Centro Medico Nacional Siglo XXI are analyzed.
Subject(s)
Hematology , Hospitals, Special , Leukemia, Myeloid, Acute/drug therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Marrow Transplantation , Combined Modality Therapy , Humans , Leukemia, Myeloid, Acute/classification , Leukemia, Myeloid, Acute/diagnosis , Leukemia, Myeloid, Acute/mortality , Mexico/epidemiology , Remission Induction , Treatment FailureABSTRACT
The purpose of this paper is to describe the current advances in the pathogenesis, classification and treatment of acquired aplastic anemia (AA). The therapeutical experience obtained at the Servicio de Hematología, Centro Medico Nacional, Siglo XXI is described. Bone marrow transplantation is the first choice therapy for severe AA. This procedure succeeds in obtaining complete remission in nearly 80% of the cases. Nevertheless, few patients are eligible for such therapy, consequently other treatments should be considered. In this context some immunosuppressive therapies such as antilymphocyte globulin had shown to produce favorable responses in 60% of the patients. In addition, androgens and immunosuppressive drugs like methylprednisolone bolus and cyclosporin A do not have a definitive place in severe AA. Finally, it is important to describe the experience with lymphocytapheresis, a new procedure, that decreases the immunological response against the normal hematopoiesis by removing the population of T-lymphocytes inducing complete remission in a few patients.
