Factores pronósticos citogenéticos y moleculares de la Leucemia Linfoide Aguda B Pediátrica en el hospital de SOLCA en el periodo 2017 – 2018.

Abstract

Introduction: Acute lymphoid leukemia (ALL) is a clonal proliferation of lymphoid precursors, affecting the blood and bone marrow. (1) It is the most common neoplasm of childhood, (2) with a higher incidence between 3 and 7 years of age. Early and appropriate identification of the prognostic factors present at the time of diagnosis is essential for a targeted treatment and a better response. (3) In addition, this allows the recognition of genetic alterations such as the philadelphia chromosome, described as the most common translocation. (4) Objective: To determine the prevalence of cytogenetic and molecular prognostic factors of pediatric B acute lymphoid leukemia in patients seen at SOLCA Hospital Guayaquil in the period 2017 - 2018. Methodology: This is a prevalence study. A qualitative content analysis was performed by reviewing medical records in relation to clinical manifestations and complementary tests recorded in the SOLCA Guayaquil Hospital database, 2017-2018. Results: Patients diagnosed with B-ALL account for 86% of pediatric acute leukemias. Among the most prevalent prognostic factors were found: leukocytosis (83 cases in the group less than 50 000 leukocytes/mL) (77%), hyperdiploidy (19, 18%), t (9;22) in 15 (14%) patients. Remission after 29 days was achieved by 56 (52%) children; while 51 (48%) individuals presented relapses of their disease. The most common site of extramedullary involvement was the central nervous system with 17 patients (16%). The most prevalent clinical risk group was very high risk with 42 (39%) patients. There were 34 deaths, representing 31.5% of the total. Conclusion: The most prevalent poor prognostic factors were: male sex, negative minimal residual disease in a range ≥ 29 days and the presence of disease relapses. The parameters that showed a significant association with mortality were: age group 10-14 years, pathology relapses and t-translocation (9;22).