Descripción de las causas de la recaída del linfoma de Hodgkin en pediatría
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2021
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Antecedentes: En el Ecuador, el Linfoma de Hodgkin es la segunda causa de cáncer pediátrico, con más alta tasa de curación, alrededor del 80%. Pero, aún se desconocen las causas precisas de recaída o refractariedad. Objetivo General: Reconocer de manera oportuna los signos y síntomas relacionados al Linfoma de Hodgkin pediátrico recaído/ refractario, para alcanzar un diagnóstico temprano. Metodología: Se realizó un estudio retrospectivo - descriptivo de los pacientes con Linfoma de Hodgkin pediatrico en el Instituto Oncológico de Cáncer de Guayaquil, ION SOLCA de Guayaquil, atendidos durante el período comprendido desde el año 2.014 al 2.018, en el lapso de 5 años. Se revisaron 76 historias clinicas con diagnóstico histológico de Linfoma de Hodgkin, de los cuales se seleccionaron 51 casos clinicos. Y se excluyeron a 25 pacientes, que ya habian recibido tratamiento fuera del instituto. Resultados: La sobrevida libre de enfermedad fue del 52.9%. La recaída global fue del 37.3%. La mortalidad global fue del 9.8%. Conclusiones: Dentro de los factores pronósticos desfavorables con alto riesgo de recaida, se destacan el género masculino, estadio clínico al debut, presencia de los síntomas B o masa Bulky y pet-tac inter-in en progresión. El tratamiento del Linfoma de Hodgkin infantil recaído/ refractario es la quimioterapia de rescate de segunda línea, asociado o no a inmunoterapia, previo al trasplante autólogo de células progenitoras hematopoyéticas
BACKGROUND: In Ecuador, the Hodgkin lymphoma is the second cause of chilhood cancer, with high rate of curability, around 80%. But it is unclear, the specific causes of relapse or refractoriness. GENERAL OBJECTIVES: Recognize in a timely manner the signs and symptoms related to pediatric relapsed or refractory Hodgkin lymphoma, to reach an early diagnosis. SPECIFIC OBJECTIVES: Identify risk groups of Hodgkin lymphoma in children and young people, to initiate appropiate treatment, and thus avoid a relapse in the future. METHODOLOGY: A retrospective and descriptive study was conducted at the patients of pediatric in the Hodgkin lymphoma in the Cancer Oncology Institute of Guayaquil, ION SOLCA of Guayaquil, taken care of during the period covered since the year 2.014 to 2.018, within 5 years. 76 medical records were reviewed, with histologic diagnosis of Hodgkin lymphoma, of which selected 51 clinical cases. And 25 patients were excluded, who had already received treatment outside the Institute. RESULTS: The survival free diseases was 52.9%. The overall relapse was 37.3%. Overall mortality was 9.8%. CONCLUSIONS: Within unfavourable prognostic factors, involving a relapse high risk, highlight the male gender, clinical stage at diagnosis, presence of B symptoms, or Bulky size and inter- in progression pet-tac. The treatment of pediatric relapsed or refractory Hodgkin lymphoma, is the second line salvage chemotherapy, associated or no with immunotherapy, prior to autologous stem cell trasplant
BACKGROUND: In Ecuador, the Hodgkin lymphoma is the second cause of chilhood cancer, with high rate of curability, around 80%. But it is unclear, the specific causes of relapse or refractoriness. GENERAL OBJECTIVES: Recognize in a timely manner the signs and symptoms related to pediatric relapsed or refractory Hodgkin lymphoma, to reach an early diagnosis. SPECIFIC OBJECTIVES: Identify risk groups of Hodgkin lymphoma in children and young people, to initiate appropiate treatment, and thus avoid a relapse in the future. METHODOLOGY: A retrospective and descriptive study was conducted at the patients of pediatric in the Hodgkin lymphoma in the Cancer Oncology Institute of Guayaquil, ION SOLCA of Guayaquil, taken care of during the period covered since the year 2.014 to 2.018, within 5 years. 76 medical records were reviewed, with histologic diagnosis of Hodgkin lymphoma, of which selected 51 clinical cases. And 25 patients were excluded, who had already received treatment outside the Institute. RESULTS: The survival free diseases was 52.9%. The overall relapse was 37.3%. Overall mortality was 9.8%. CONCLUSIONS: Within unfavourable prognostic factors, involving a relapse high risk, highlight the male gender, clinical stage at diagnosis, presence of B symptoms, or Bulky size and inter- in progression pet-tac. The treatment of pediatric relapsed or refractory Hodgkin lymphoma, is the second line salvage chemotherapy, associated or no with immunotherapy, prior to autologous stem cell trasplant
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LINFOMA DE HODGKIN, RECAIDA, PEDIATRIA, INMUNOTEAPIA, EPIDEMIOLOGIA DESCRIPTIVA, ESTUDIOS RETROSPECTIVOS, HOSPITAL SOLCA DE GUAYAQUIL, CANTON GUAYAQUIL, ECUADOR