Indice pronóstico en linfoma difuso de células grandes B: comparación de R-IPI Y LATAM IPI
Fecha
2022
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Antecedentes: El Linfoma Difuso de células grandes B (LDCGB), es una neoplasia linfocitaria, que presenta una amplia heterogeneidad en sus características biológicas y clínicas. Las diferentes características biológicas se traducen en una amplia variación en la respuesta al tratamiento con el tratamiento estándar. Las escalas pronósticas se han utilizado desde hace 2 décadas con el fin de estratificar grupos de riesgo que determinen decisiones terapéuticas y mejoren la respuesta de los pacientes refractarios. La adición de factores de riesgo de distinta índole a los índices ya establecidos promete mejorar la capacidad predictiva.
Objetivo: Comparar la capacidad predictiva de los índices pronósticos R-IPI e IPI-LATAM, en los pacientes con LDCG-B, atendidos en SOLCA Guayaquil en el periodo comprendido entre 2014-2018
Metodología: Se planteó un estudio observacional, cuantitativo, retrospectivo, en pacientes mayores de 18 años, diagnosticados y tratados con R-CHOP (Rituximab, ciclofosfamida, doxorrubicina, vincristina y prednisona) o esquemas similares en SOLCA Guayaquil. Se valoraron 227 pacientes con el fin de comparar la precisión pronóstica de 2 índices, se valoró la supervivencia global (SG) en cada grupo de riesgo establecido, y a través de la curva de ROC la precisión pronóstica de cada uno.
Resultados: El R-IPI y el LATAM-IPI tienen una alta precisión pronóstica, el R-IPI tiene un AUC de 0,73 mientras que el LATAM-IPI presentó un AUC de 0,66. La mediana de SG del estudio fue de 49,36 meses y la tasa de respuesta completa fue del 47,72 %, además señalamos que en la población de estudio no se identificaron pacientes de buen pronóstico de acuerdo con el LATAM-IPI.
Conclusiones: En la población de estudio el R-IPI presentó mayor precisión pronóstica de SG que el LATAM-IPI, sin embargo, la cantidad baja de pacientes con características de buen pronóstico puede haber contribuido a este hallazgo.
Background: Diffuse large cell B lymphoma (LDCGB), is a lymphocyte neoplasm, which presents a wide heterogeneity in its biological and clinical characteristics. The different biological characteristics translate into a wide variation in the response to treatment. Prognostic scales have been used for 2 decades to stratify risk groups that determine therapeutic decisions and improve the response of refractory patients. The addition of risk factors of different kinds to the already established indices promises to improve predictive capacity Objective: To compare the predictive capacity of the prognostic scores R-IPI and IPI-LATAM, in patients with LDCGB, attended at SOLCA Guayaquil in the period between 2014-2018 Methodology: An observational, quantitative, retrospective cohort study was proposed in patients with LDCGB over 18 years old, diagnosed and treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or similar schemes at the SOLCA Guayaquil institution. 227 patients were evaluated to compare the prognostic accuracy of 2 scores, the overall survival (OS) was established in each established risk group, and through the ROC curve the prognostic accuracy of each one was determined. Results: El R-IPI and LATAM-IPI have a high prognostic accuracy, the R-IPI has an AUC of 0.73 while the LATAM-IPI presented an AUC of 0.66, established in the ROC curves. The median OS of the study was 49.36 months, and the complete response rate was 47.72%, in addition we pointed out that in the study population patients with a good prognosis were not identified according to the LATAM-IPI. Conclusions: In the study population, R-IPI presented greater prognostic accuracy of OS than LATAM-IPI, however, the low number of patients with characteristics of good prognosis may have contributed to this finding
Background: Diffuse large cell B lymphoma (LDCGB), is a lymphocyte neoplasm, which presents a wide heterogeneity in its biological and clinical characteristics. The different biological characteristics translate into a wide variation in the response to treatment. Prognostic scales have been used for 2 decades to stratify risk groups that determine therapeutic decisions and improve the response of refractory patients. The addition of risk factors of different kinds to the already established indices promises to improve predictive capacity Objective: To compare the predictive capacity of the prognostic scores R-IPI and IPI-LATAM, in patients with LDCGB, attended at SOLCA Guayaquil in the period between 2014-2018 Methodology: An observational, quantitative, retrospective cohort study was proposed in patients with LDCGB over 18 years old, diagnosed and treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or similar schemes at the SOLCA Guayaquil institution. 227 patients were evaluated to compare the prognostic accuracy of 2 scores, the overall survival (OS) was established in each established risk group, and through the ROC curve the prognostic accuracy of each one was determined. Results: El R-IPI and LATAM-IPI have a high prognostic accuracy, the R-IPI has an AUC of 0.73 while the LATAM-IPI presented an AUC of 0.66, established in the ROC curves. The median OS of the study was 49.36 months, and the complete response rate was 47.72%, in addition we pointed out that in the study population patients with a good prognosis were not identified according to the LATAM-IPI. Conclusions: In the study population, R-IPI presented greater prognostic accuracy of OS than LATAM-IPI, however, the low number of patients with characteristics of good prognosis may have contributed to this finding
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Linfoma, Neoplasias, Estudio de casos, Supervivencia, Hospital Solca de Guayaquil, Cantón Guayaquil, Ecuador