Quimioterapia intensiva asociada a imatinib en Leucemia Linfoblástica Aguda del adulto, Philadelphia positivo. Experiencia en un hospital público.
Palabras clave:
Cohort Studies, Imatinib, Imatinib Mesylate, Philadelphia Chromosome, Precursor Cell Lymphoblastic Leukemia-LymphomaResumen
Background: Before the advent of tyrosine kinase inhibitors (TKIs), patients with Philadelphia-positive Acute Lymphoblastic Leukemia (Ph+ALL) had a poor prognosis. The association of TKIs to intensive chemotherapy (CT) improved outcome. Aim: To evaluate results of an intensive CT protocol including TKI in a public hospital in Santiago, Chile. Material and methods: All patients with Ph+ALL diagnosed between January 2010 and February 2019, and who met inclusion criteria for intensive CT, received the Ph+ALL national protocol in association with imatinib and were included in this analysis. Results: Thirty-five patients aged 15 to 59 years received treatment. Complete response (CR) was obtained in 97%. Measurable residual disease (MRD) was negative in 61% (19/31 evaluable cases) during follow-up, and 55% (16/29) were MRD(-) before three months. Relapse was observed in 13 cases. Three patients underwent allogeneic hematopoietic stem cell transplant (HSCT), two in CR1. The overall survival (OS) and event-free survival (EFS) at three years were 52 and 34%, respectively. In patients who achieved MRD negativity before three months, no statistically significant differences in OS (64 and 42% respectively, p=0.15) or EFS (35 and 32% respectively, p=0.37) were observed. Conclusions: The prognosis of Ph+ALL improved with the association of imatinib to intensive CT. MRD-negative status before three months in this series was not significantly associated with better outcomes. Our series suggests that the Ph+ALL national protocol associated to TKI is a therapeutic alternative with high CR and acceptable MRD(-) rates.Descargas
Publicado
2021-06-01
Cómo citar
Benavente, R., Cid, F., Puga, B., Molina, J., Bass, F., Andrade, A., Monardes, V., Encina, A., & Cabrera, M. E. (2021). Quimioterapia intensiva asociada a imatinib en Leucemia Linfoblástica Aguda del adulto, Philadelphia positivo. Experiencia en un hospital público. Revista Médica De Chile, 149(9). Recuperado a partir de https://revistamedicadechile.cl/index.php/rmedica/article/view/9114
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Artículos de Investigación