ABSTRACT
Abstract Introduction: To date, many studies have validated the Hematopoietic Cell Transplantation Specific Comorbidity Index (HCT-CI) scoring system in allogeneic hematopoietic stem cell transplantation (allo-HSCT), but studies from developing countries remain scarce. Objective: The aim of this study was to evaluate and categorize Mexican patients using the HCT-CI at a referral center. Methods: One hundred and nineteen consecutive patients undergoing allo-HSCT at the National Institute of Medical Sciences and Nutrition in Mexico City were included. Patients were classified according to the HCT-CI scores. Results: The median age was 31 years and most were males (56%). Most patients had hematological malignancies (73%) and a low HCT-CI score (72%). The non-relapse mortality and survival were predicted according to the score. Conclusions: This is one of the few studies to evaluate the HCT-CI in adults with HLA-matched donors in a developing country and our findings suggest that the high percentage of patients with a low HCT-CI scores, contrary to international reports, could be explained by different comorbidities and demographics, but mainly due to stricter filters applied to HSCT candidates and consequently, a potential selection bias caused by limited resources.
Subject(s)
Hematopoietic Stem Cell Transplantation , Comorbidity , Developing Countries , MexicoABSTRACT
INTRODUCTION: To date, many studies have validated the Hematopoietic Cell Transplantation Specific Comorbidity Index (HCT-CI) scoring system in allogeneic hematopoietic stem cell transplantation (allo-HSCT), but studies from developing countries remain scarce. OBJECTIVE: The aim of this study was to evaluate and categorize Mexican patients using the HCT-CI at a referral center. METHODS: One hundred and nineteen consecutive patients undergoing allo-HSCT at the National Institute of Medical Sciences and Nutrition in Mexico City were included. Patients were classified according to the HCT-CI scores. RESULTS: The median age was 31 years and most were males (56%). Most patients had hematological malignancies (73%) and a low HCT-CI score (72%). The non-relapse mortality and survival were predicted according to the score. CONCLUSIONS: This is one of the few studies to evaluate the HCT-CI in adults with HLA-matched donors in a developing country and our findings suggest that the high percentage of patients with a low HCT-CI scores, contrary to international reports, could be explained by different comorbidities and demographics, but mainly due to stricter filters applied to HSCT candidates and consequently, a potential selection bias caused by limited resources.
ABSTRACT
INTRODUCTION: Objective: the exact prevalence of obesity in Mexico is not well known and varies between sources, but more than 30% of Mexico's population are obese. Obesity is associated with several diseases such as metabolic syndrome; the latter, along with cancer, have become public health concerns worldwide, and their association has been widely studied in developed countries. The aim of this study was to identify the overall prevalence of metabolic syndrome and to describe its characteristics among first-time cancer patients at a referral center in Mexico. Methods: a prospective, observational, cohort study of first-time patients of the National Cancer Institute of Mexico in the period of September 2016-2017. We identified 1,165 first-time patients, and 316 patients with known or recently diagnosed metabolic syndrome were included. Results: median age was 55 years old and most were female (81%). The most frequent tumors were breast, gynecological, and hematological. Obesity (class 1-3) and abnormal glucose and/or previous diabetes mellitus diagnosis were mostly observed in patients with skin and soft tissue tumors; dyslipidemia, high triglycerides, and/or low HDL-cholesterol were mostly observed in patients with gastrointestinal tumors. Conclusion: the prevalence of metabolic syndrome among first-time cancer patients was 27%. As obesity and cancer are of public concern in Mexico, the implementation of preventive strategies for metabolic syndrome patients, focusing on the first level of care during early stages in order to reduce the risk of cancer, is needed.
INTRODUCCIÓN: Objetivo: la prevalencia de la obesidad en México es mayor del 30% de la población total. La obesidad se asocia con diversas enfermedades, entre ellas el síndrome metabólico; este y el cáncer se han convertido en problemas de salud pública a nivel mundial, y su asociación ha sido ampliamente estudiada en países desarrollados. El objetivo de este estudio fue identificar la prevalencia del síndrome metabólico y describir las características entre pacientes oncológicos de primera vez en un hospital de tercer nivel en México. Métodos: estudio prospectivo, observacional y de cohortes que incluye a pacientes oncológicos atendidos por primera vez en el Instituto Nacional de Cancerología durante el periodo de septiembre 2016 a 2017. Identificamos 1165 pacientes; 316 tenían el diagnóstico de síndrome metabólico y fueron incluidos en el presente estudio. Resultados: la mediana de edad fue de 55 años y la mayoría de los pacientes eran del sexo femenino (81%). Las neoplasias más frecuentes fueron las de mama, ginecológicas y hematológicas. La obesidad (clase 1-3) y la glucosa anormal y/o un diagnóstico previo de diabetes mellitus se observaron mayormente en pacientes con neoplasias de piel y tejidos blandos; los pacientes con neoplasias gastrointestinales presentaron mayormente dislipidemia, triglicéridos elevados y/o HDL bajo. Conclusiones: la prevalencia del síndrome metabólico en nuestros pacientes oncológicos fue de 27%. Al ser la obesidad y el cáncer problemas de salud pública en México, la implementación de medidas preventivas para pacientes con síndrome metabólico debe enfocarse en el primer nivel de atención, durante etapas tempranas, para poder reducir el riesgo de cáncer.
