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Boletín médico del Hospital Infantil de México
Print version ISSN 1665-1146
Abstract
ZAPATA-TARRES, Marta et al. Analysis of complications during treatment of children with acute lymphoblastic leukemia. Bol. Med. Hosp. Infant. Mex. [online]. 2012, vol.69, n.3, pp.218-225. ISSN 1665-1146.
Background. Infectious, hematologic and metabolic complications in children with acute lymphoblastic leukemia (ALL) can be successfully treated. The objective of this study was to determine the clinical characteristics of patients with complications that contribute to mortality in children with ALL and healthcare processes through adherence to the Children's Oncology Group Clinical Guidelines (GCCOG). Methods. We performed a case-control study in nine hospitals affiliated with the Seguro Popular insurance program, analyzing clinical characteristics and treatment of febrile neutropenia, septic shock, severe anemia, hemorrhage, lysis tumoral syndrome and hyperleucocytosis. Results. In patients with septic shock, profound neutropenia and confirmation of fever influences mortality. Antibiotic administration delays treatment and lack of adherence to the clinical guidelines of COG. There were no clinical differences in severe anemia and hemorrhage or in the health care processes. Conclusions. Lack of adherence to clinical guidelines has had an impact on mortality in infectious complications. There is a lack of sys-tematization in some care processes. In certified hospitals, there are reports that patients died from avoidable complications.
Keywords : complications; acute lymphoblastic leukemia; children; clinical treatment guidelines.