Efectividad del tratamiento de la leucemia promielocítica aguda con ácido transretinoico en pacientes del hospital universitario “Arnaldo Milián Castro”
Fecha
2018
Autores
Balmaseda Pérez, Mayara
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Editor
Universidad Central “Marta Abreu” de Las Villas. Facultad de Química Farmacia. Departamento de Farmacia
Resumen
El ácido all-transretinoico (ATRA) es uno de los mayores avances en el tratamiento de las leucemias promielocíticas agudas (LPA). En el Servicio de Hematología del Hospital Universitario Clínico Quirúrgico “Arnaldo Milián Castro” no existen estudios que avalen la efectividad del tratamiento con ATRA para esa patología; por ello se realizó un estudio observacional, descriptivo, transversal y retrospectivo para evaluar la efectividad del tratamiento de inducción con ácido transretinoico en pacientes con LPA. El estudio incluyó 19 pacientes que cumplieron con los criterios de inclusión y recibían tratamiento con ATRA como terapia de inducción, siete pertenecían al sexo masculino y 12 al sexo femenino. La edad promedio de aparición de la enfermedad fue de 40,4 años (rango de 25-61 años) y predominó en pacientes de 31-40 años, lo que representó el 42,1% del total de la muestra estudiada. En el 100% de los pacientes, el ATRA fue indicado correctamente para el tratamiento de la LPA, en correspondencia con el protocolo institucional LPM-04. Además, se determinó que 15 de los pacientes en tratamiento con el fármaco durante la inducción manifestaron reacciones adversas, siendo el síndrome de diferenciación la que más se manifestó en la muestra estudiada, presentándose en 11 pacientes. Finalmente se comprobó la efectividad del tratamiento con ATRA durante la inducción con un tiempo promedio de remisión completa de 43 días, un bajo porcentaje de mortalidad precoz (1%) y una elevada supervivencia libre de eventos y supervivencia total a los dos años (98 % ± 2 % y 91± 3, respectivamente).
All-transretinoic acid (ATRA) is one of the greatest advances in the treatment of acute promyelocytic leukemia (APL). In the Hematology Service of the University Hospital "Arnaldo Milián Castro", there are no studies that support the effectiveness of ATRA treatment for this pathology; therefore, an observational, descriptive, cross-sectional and retrospective study was conducted to evaluate the effectiveness of the induction treatment with transretinoic acid in patients with APL. The study included 19 patients who met the inclusion criteria and received treatment with ATRA as induction therapy; seven belonged to the male sex and 12 to the female sex. The average age of onset of the disease was 40,4 years (range of 25-61 years) and it predominated in patients aged 31-40 years, which represented 42,1% of the total sample studied. In 100% of patients, ATRA was correctly indicated for the treatment of APL, in correspondence with the institutional protocol LPM-04. In addition, it was determined that 15 of the patients in treatment with the drug during the induction showed adverse reactions, being the differentiation syndrome the one that manifested the most in the studied sample, presenting itself in 11 patients. Finally, the effectiveness of ATRA treatment during induction was proven with an average time of complete remission of 43 days, a low percentage of early mortality (1%) and a high event-free survival and total survival at two years (98% ± 2% and 91 ± 3, respectively).
All-transretinoic acid (ATRA) is one of the greatest advances in the treatment of acute promyelocytic leukemia (APL). In the Hematology Service of the University Hospital "Arnaldo Milián Castro", there are no studies that support the effectiveness of ATRA treatment for this pathology; therefore, an observational, descriptive, cross-sectional and retrospective study was conducted to evaluate the effectiveness of the induction treatment with transretinoic acid in patients with APL. The study included 19 patients who met the inclusion criteria and received treatment with ATRA as induction therapy; seven belonged to the male sex and 12 to the female sex. The average age of onset of the disease was 40,4 years (range of 25-61 years) and it predominated in patients aged 31-40 years, which represented 42,1% of the total sample studied. In 100% of patients, ATRA was correctly indicated for the treatment of APL, in correspondence with the institutional protocol LPM-04. In addition, it was determined that 15 of the patients in treatment with the drug during the induction showed adverse reactions, being the differentiation syndrome the one that manifested the most in the studied sample, presenting itself in 11 patients. Finally, the effectiveness of ATRA treatment during induction was proven with an average time of complete remission of 43 days, a low percentage of early mortality (1%) and a high event-free survival and total survival at two years (98% ± 2% and 91 ± 3, respectively).
Descripción
Palabras clave
Ácido All-Transretinoico (ATRA), Agentes Anticancerígenos, Farmacología Clínica, Diagnóstico, Hospital Universitario Clínico Quirúrgico “Arnaldo Milián Castro”, Villa Clara, Leucemia