Perfil de pacientes pediátricos con leucemia atendidos en el Instituto Médico de Alta Tecnología (IMAT) - Oncomédica, 2017-2019

Abstract

leukemia is a disease characterized by the infiltration of malignant cells of the hematopoietic system into the bone marrow and other tissues. 95% of childhood leukemias are acute, of which 75% are lymphoid and 25% myeloblastic. In Colombia and Latin America there are few studies that characterize pediatric leukemias; knowledge of a profile of patients suffering from this disease and its associated factors would help improve health interventions in this population. Objective: to describe the clinical, genetic and epidemiological profile of a retrospective cohort of pediatric patients with leukemia at the IMAT ONCOMÉDICA High Technology Medical Institute. Methodology: An observational study of a retrospective cohort was carried out in all subjects who met the diagnostic criteria. Categorical variables were described with frequencies and continuous variables with summary measures. The identification of the factors associated with the type of leukemia (lymphoid or acute myeloid) was performed using Pearson's Chi-square and Mann-Whitney U; multivariate adjustment was performed using logistic regression. Analyzes were performed in SPSS 27.0 Results: 54.8% of the diagnosed patients were male, with the highest proportion between 1-5 years (38.7%). The most prevalent signs and symptoms were fever (73.4%), paleness (33.1%), asthenia (27.4%) and adynamia (21.8%); 79.8% presented splenomegaly and 4.8% central nervous system alteration. 83.1% corresponded to acute lymphoblastic leukemia and 14.5% to acute myeloid leukemia. The most frequent cytogenetic and molecular alteration was the t (9; 22) that generates the BCR / ABL fusion gene. The type of leukemia was statistically associated with the presence of splenomegaly (higher in ALL), risk classification (higher in AML), and hemoglobin and leukocyte levels (higher in ALL). Conclusion: a higher proportion of ALL with precursor B predominance was found, relevant sociodemographic and clinical characteristics were identified to prioritize some groups and generate hypotheses about possible risk factors for subsequent etiological studies that complement the medical knowledge of this population. In addition, the findings of this health profile can contribute to improving clinical and public health programs in this group, in order to guarantee a more timely diagnosis and care, avoid complications in patients and the progression of the disease, reduce cost overruns of care and improve the prognosis and survival of patients.