Diagnóstico inmunofenotípico y relación citogenética-molecular en el pronóstico de la leucemia mieloide aguda en Solca 2014-2017
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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La Leucemia Mieloide Aguda es una proliferación clonal anormalmente diferenciada de las células hematopoyéticas de estirpe mieloide. Los linajes que derivan de esas células la convierten en una enfermedad muy heterogénea y a pesar de los avances tecnológicos, aplicados a su diagnóstico y pronóstico, aún conserva una tasa alta de mortalidad con una sobrevida a 5 años entre el 30 y 40% de los casos.
El objetivo de esta investigación es establecer el rol de la Citometría de Flujo en el diagnóstico; y, de la Citogenética y Biología molecular en el pronóstico de los pacientes con LMA. La presente investigación se realiza en el Instituto Oncológico Nacional-Solca Guayaquil obteniendo datos retrospectivos de los pacientes diagnosticados con LMA desde enero del 2014 a Junio del 2017, recopilando los datos obtenidos por Citometría de Flujo, Citogenética y Biología Molecular, de acuerdo a los criterios de inclusión establecidos.
De 116 pacientes obtenidos en el registro 89 cumplieron los criterios de inclusión, se observa que hay un predominio de la población menor de 18 años en la muestra; la raza, sexo y comorbilidad no influyen en la mortalidad, no así la edad. La CF se establece como el método más efectivo para el diagnóstico de LMA y sus tipos. La mortalidad es alta independientemente del grupo de riesgo CG. Los resultados de los estudios de BM no son concluyentes debido a la falta de protocolización de las pruebas y a la población en la cual se obtuvo resultados efectivos.
Se concluye entonces que la Citometría de Flujo es el método de elección en el diagnóstico inicial de LMA. Son necesarias más investigaciones para establecer el verdadero valor pronóstico de la Citogenética y la Biología molecular en el pronóstico de las LMA.
Acute myeloid leukemia is a clonal proliferation abnormally differentiated from hematopoietic cells of myeloid origin. The lineages that derive from these cells make it a very heterogeneous disease and despite technological advances, applied to its diagnosis and prognosis; it still maintains a high mortality rate with a 5 year survival between 30 and 40% worldwide. The objective of this research is to establish the role of Flow Cytometry in diagnosis; and, of Cytogenetics and Molecular Biology in the prognosis of patients with Acute Myeloid Leukemia (AML). The present investigation is carried out in the National Oncology Institute-Solca Guayaquil obtaining retrospective data of the patients diagnosed with AML from January 2014 to June 2017, collecting the data obtained by Flow Cytometry, Cytogenetics and Molecular Biology, according to the criteria of established inclusion. Of 116 patients obtained in the register 89 met the inclusion criteria, within this percentage it is observed that there is a predominance of the population under 18 years in the sample; race, sex and comorbidity do not influence mortality, but not age. CF is established as the most effective method for diagnosing AML and its types. Mortality is high independently of the Cytogenetic risk group of the population, and the results of the molecular Biology studies are inconclusive due to the lack of protocolization of the tests and the population in which effective results were obtained. It is concluded that Flow Cytometry is the method of choice in the initial diagnosis of AML. More research is needed to establish the true prognostic value of Cytogenetics and molecular biology in the prognosis of AML.
Acute myeloid leukemia is a clonal proliferation abnormally differentiated from hematopoietic cells of myeloid origin. The lineages that derive from these cells make it a very heterogeneous disease and despite technological advances, applied to its diagnosis and prognosis; it still maintains a high mortality rate with a 5 year survival between 30 and 40% worldwide. The objective of this research is to establish the role of Flow Cytometry in diagnosis; and, of Cytogenetics and Molecular Biology in the prognosis of patients with Acute Myeloid Leukemia (AML). The present investigation is carried out in the National Oncology Institute-Solca Guayaquil obtaining retrospective data of the patients diagnosed with AML from January 2014 to June 2017, collecting the data obtained by Flow Cytometry, Cytogenetics and Molecular Biology, according to the criteria of established inclusion. Of 116 patients obtained in the register 89 met the inclusion criteria, within this percentage it is observed that there is a predominance of the population under 18 years in the sample; race, sex and comorbidity do not influence mortality, but not age. CF is established as the most effective method for diagnosing AML and its types. Mortality is high independently of the Cytogenetic risk group of the population, and the results of the molecular Biology studies are inconclusive due to the lack of protocolization of the tests and the population in which effective results were obtained. It is concluded that Flow Cytometry is the method of choice in the initial diagnosis of AML. More research is needed to establish the true prognostic value of Cytogenetics and molecular biology in the prognosis of AML.
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Leucemia mieloide aguda, Citometria de flujo, Biología celular, Anatomía patologíca, Hospital Solca de Guayaquil, Cantón Guayaquil, Ecuador