Utilidad pronóstica de la citometría de flujo en líquido cefalorraquídeo al diagnóstico, en adultos con leucemia linfoblástica aguda en el Instituto Nacional de Cancerología entre 2013 y 2018
Autor: Enriquez Ruano, Maira Nataly
Asesor: Saavedra Estupiñan, Myriam
Fecha: 2020-12-16
Programa: Bogotá - Medicina - Especialidad en Medicina Interna
Facultad: Facultad de Medicina

Resumen: Objective: To determine the usefulness of CPM in CSF at diagnosis as a predictor of survival in adults with B-lymphoid precursor ALL in the INC between March 2013 and December 2018.
Methodology: Historical cohort-type analytical observational study of patients diagnosed with B-lymphoid precursor ALL between 2013 and 2018, evaluating the association of absolute values of CMF in CSF with overall survival and relapse-free survival. Overall survival analysis was performed using the Kaplan-Meier curve, a Cox proportional hazards model was constructed to assess the effect of potentially related sociodemographic and clinical covariates.
Results: 132 patients met eligibility criteria; 70 men and 62 women, the median age was 34 years, the common immunophenotype and the genetic abnormality t (9; 22) were more frequently found. The clinical involvement of the CNS at diagnosis was 6.1%, with the pyramidal syndrome most often. In the CSF study, 84.8% of the cytologies and 99.21% of the cytometries were interpretable, with 14.29% of the CC and 25.4% of the CMF positive, with a median value of 0.835. absolute blasts / µl, the minimum value found was 0.03 blasts / µl, and the maximum was 28.9 blasts / µl. Overall and relapse-free survival was discriminated by CMF blast values at diagnosis in quartiles, finding that patients with blasts&gt; 0.085 had a lower probability of overall survival (p 0.047) and a higher risk of relapse (p 0.027 ) being statistically significant.
Conclusions: Absolute blast values in flow cytometry at diagnosis are independent predictors of overall and relapse-free survival in ALL.