Leucemia Linfática Aguda en niños con Síndrome de Down: Sobrevida en un hospital de Lima, Perú
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AdvisorsPereyra Elías, Reneé
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Citation1. Alvarez-Manassero D. Leucemia Linfática Aguda en niños con Síndrome de Down : Sobrevida en un hospital de Lima , Perú [Internet]. Universidad Peruana de Ciencias Aplicadas (UPC); 2017. Available from: http://hdl.handle.net/10757/621845
AbstractBackground: Down Syndrome (DS) is the most common chromosomal abnormality in humans. Acute Lymphocytic Leukemia (ALL) is the leading cause of cancer in the pediatric population. In children with DS, the risk of developing ALL is increased up to 40 times fold compared to pediatric population. In Peru, children with DS and ALL are treated using the standard Berlin-Frankfurt-Münster protocol (BFM) for patients without DS. We did not identify any published investigation about the therapeutic approach or survival in patients with DS and ALL. Objective: To describe the Disease Free Survival (DFS) and Overall Survival (OS) rates in pediatric patients with DS and ALL diagnosed and treated at the Pediatric Hematology Unit of the Department of Hematology at the Edgardo Rebagliati Martins National Hospital (HNERM) between 1999 and 2016. Methods: The study design is a retrospective cohort type, constructed with data from the registry system of the Pediatric Hematology Unit of the HNERM, a high complexity hospital located in Lima, Peru. We studied 57 pediatric patients with DS and ALL treated using the standard BFM protocol from 1999 to 2016, according to the associated risk stratification. Results: Five-year survival was 36.7% and 44.9%, respectively, with disease-free survival (DFS) and overall survival (OS). High and very high risks were classified as 61.4% and 28.1% respectively. 100% of patients achieved complete post-induction remission. The relapse rate was 12.2 per 1000 person / month follow-up (95% CI: 8.0 to 15.7). Although the overall survival of males was lower than in females, this difference was not statistically significant (p = 0.142). No association with other variables was found. Conclusion: Patients with DS and ALL treated in a high complex hospital in Lima, Peru from 1999 to 2016 using the standard BFM protocol, showed lower index for DFS and OG than those reported internationally. Further research is needed in order to identify associated variables with the indicators evaluated.
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