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Boletín médico del Hospital Infantil de México
versión impresa ISSN 1665-1146
Resumen
LEPE-ZUNIGA, José L.; MENDEZ-CIGARROA, Adriana O.; JERONIMO-LOPEZ, Francisco J. y HERNANDEZ-ORANTES, Jorge G.. Childhood acute leukemia overall survival at the Hospital de Especialidades Pediátricas in Chiapas, México. Bol. Med. Hosp. Infant. Mex. [online]. 2018, vol.75, n.6, pp.338-351. ISSN 1665-1146. https://doi.org/10.24875/bmhim.18000013.
Background:
At the 10th anniversary of the Hospital de Especialidades Pediátricas in Chiapas, Mexico, it was important to assess the 5-year acute leukemia overall survival under the Seguro Popular program (Popular Insurance).
Methods:
A descriptive and survival study of 210 acute leukemia patients diagnosed and treated during 2008-2012 was performed. Kaplan-Meier survival curves were developed for all patients, each leukemia type (B, T and myeloid) and for B type related to risk group, age, sex, leukocytes, cell markers, DNA index, karyotype, and translocations.
Results:
Age, gender and proportion of leukemia types (B = 85%; M = 10%; T = 5%), were similar to other parts of the country. At the end of the 5-year treatment, 20% of the patients were alive, 53% had died and 27% had abandoned the treatment. Global survival was 42% (B = 45%; T = 20%; M = 10%) (median: 38.8 months; confidence interval of 95% = 28.9-48.7). Very high-risk median survival was 7.7 versus 47 months. There was no difference between standard and high-risk groups. The initial leukocyte count < 50,000/µL and CD10 positive were related to better B survival; no other variables were related. At the time of death, 29% of patients were in remission.
Conclusions:
Global survival of acute leukemia at Hospital de Especialidades Pediátricas under the Seguro Popular during its first 5 years was surprisingly poor given the medical resources available through the insurance. Early mortality, death during remission and high desertion rates contributed to these results. A detailed revision of treatment protocols and reasons for abandoning treatment is mandatory.
Palabras llave : Childhood acute leukemia; Leukemia survival; Chiapas; Popular insurance; Mexico.