Linfoma Anaplásico de Células Grandes en Centro América
un informe desde los centroamericanos Asociación de Oncología Hematológica Pediátrica (AHOPCA)
Resumen
Fondo. Aunque el linfoma anaplásico de células grandes (ALCL) es curable en países de ingresos altos (HIC), faltan datos de países de ingresos bajos y medios (LMIC). Por lo tanto, realizamos un estudio retrospectivo de la experiencia de la Asociación Centroamericana de Hematología Oncológica Pediátrica (AHOPCA) en el tratamiento del ALCL. Procedimiento. Incluimos a todos los pacientes menores de 18 años con diagnóstico reciente de ALCL tratados entre 2000 y 2013 en siete instituciones de AHOPCA. Los datos retrospectivos se extrajeron de la base de datos de la red de oncología pediátrica. Resultados. Treinta y un pacientes cumplieron los criterios de inclusión. Veinticinco (81 %) tenían enfermedad avanzada (estadios III y IV), seis (19 %) fueron tratados con el régimen APO (doxorrubicina, prednisona, vincristina), 15 (49 %) con quimioterapia multifarmacológica diseñada para el linaje de células T neoplasias malignas (protocolo GuatALCL) y 10 (32 %) en regímenes de tratamiento basados en BFM. La supervivencia global libre de eventos y la supervivencia global a cinco años fueron, respectivamente, 67,1 ± 8,6 % y 66,7 ± 8,7 %. Los 10 eventos ocurrieron en pacientes tratados con regímenes de tratamiento basados en BFM o con el protocolo GuatALCL, ninguno en tratamiento con APO: dos pacientes experimentaron una recaída, seis mortalidad relacionada con el tratamiento (TRM) y dos abandonos. Conclusiones. El tratamiento de ALCL en países con recursos limitados es factible con resultados similares a los de HIC, aunque las causas del fracaso del tratamiento difieren. Los regímenes menos intensivos pueden ser preferibles para disminuir la TRM y mejorar los resultados. Son necesarios ensayos clínicos prospectivos que determinen el tratamiento ideal para los niños de ingresos bajos y medianos con ALCL. Cáncer de sangre pediátrico. 2016; 63:78–82. ©Wiley Periodicals, Inc.
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