Trasplante de células madre hematopoyéticas en pacientes pediátricos con diagnóstico de neoplasias mieloides, experiencia en 15 años / Haematopoietic stem cell transplantation in paediatric patients with myeloid malignancies; 15 years of experience
Rev. colomb. cancerol
; 22(2): 69-75, abr.-jun. 2018. tab, graf
Article
in Spanish
| LILACS
| ID: biblio-959885
Responsible library:
CO40.1
RESUMEN
Resumen Objetivo:
Describir la experiencia en términos de supervivencia y complicaciones de los pacientes llevados a trasplante de células madre hematopoyéticos (TCMH) en los últimos 15 años. Materiales ymétodos:
Se realizó un estudio descriptivo, tipo cohorte retrospectiva en el que se incluyeron pacientes menores de 18 años con diagnóstico de leucemia mieloide aguda (LMA), leucemia mieloide crónica (LMC) y síndrome mielodisplásico (SMD) llevados a TCMH entre enero de 2001 y diciembre de 2015. Los desenlaces fueron supervivencia global, supervivencia libre de evento y las complicaciones relacionadas con el trasplante.Resultados:
Durante el periodo de estudio se trasplantaron 43 pacientes con diagnóstico de neoplasias mieloides; 31 con LMA (72%); 4 con LMC (9%) y 8 con SMD (19%). Se realizaron 11 trasplantes de donante idéntico, 11 haploidénticos, 11 autólogos y 10 de sangre de cordón umbilical. De los pacientes con LMA (31 casos), el 58% fueron sometidos a trasplante en primera remisión completa y el 39% en segunda o subsecuente remisión completa. La supervivencia global y libre de evento a 5 años fue 56% y 38% respectivamente. La mortalidad relacionada al trasplante en el día 100 fue del 15%, la incidencia acumulada de enfermedad injerto contra huésped 59%, la infección por citomegalovirus 39%, las infecciones bacterianas 54% y la cistitis hemorrágica 14%.Conclusión:
La baja tasa de mortalidad y complicaciones relacionadas al trasplante sugiere que el trasplante de células madre hematopoyéticas es una alternativa factible como tratamiento para pacientes con neoplasias mieloides en nuestro medio.ABSTRACT
Abstract Objective:
To describe the experience, in terms of survival and complications, with patients that received a haematopoietic stem cell transplantation (HSCT) in the last 15 years. Materials andmethods:
A descriptive, retrospective, cohort study was conducted on patients less than 18 years-old with a diagnosis of acute myeloid leukaemia (AML), chronic myeloid leukaemia (CML), and myelodysplastic syndrome (MDS) and received HSCT between January 2001 and December 2015. The outcomes were, overall survival, event-free survival, and complications associated with the transplant.Results:
During the study period, a total of 43 patients with myeloid neoplasms received a transplant, of which 31 (72%) had AML, 4 (9%) with CML, and 8 (19%) with MDS. A total of 11 identical donor transplants were performed, as well as 11 haploidentical, 11 autologous, and 10 with umbilical cord blood. Of the patients with AML (31 cases), 58% were subjected to a transplant in the first full remission, and 39% in the second or subsequent full remission. The overall and event-free survival at 5 years was 56% and 38%, respectively. The transplant-related mortality at day 100 was 15%, with an accumulated incidence of graft versus host disease of 59%, cytomegalovirus infection of 39%, with 54% bacterial infections, and 14% haemorrhagic cystitis.Conclusion:
The low mortality and complications rate associated with the transplant suggests that haematopoietic stem cell transplantation is a viable alternative as a treatment for patients with myeloid neoplasms in our country.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Health and Well-Being
/
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
/
SDG3 - Target 3.2 Reduce avoidable death in newborns and children under 5
Health problem:
Target 3.2: Reduce avoidable death in newborns and children under 5
/
Leukemia
/
Noncommunicable Diseases
Database:
LILACS
Main subject:
Myelodysplastic Syndromes
/
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
/
Hematopoietic Stem Cell Transplantation
/
Stem Cell Transplantation
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adolescent
/
Child
/
Child, preschool
/
Humans
Language:
Spanish
Journal:
Rev. colomb. cancerol
Journal subject:
Neoplasias
/
Oncologia
Year:
2018
Document type:
Article
Affiliation country:
Colombia
Institution/Affiliation country:
Fundación Valle del Lili/CO
/
Universidad Icesi/CO