[Inflammatory indexes during remission induction of pediatric acute leukemia]. / Índices inflamatorios durante la inducción a la remisión de leucemia aguda pediátrica.

Background: Inflammatory indexes can reflect the severity of serious diseases such as acute leukemia (AL), which is why they can predict mortality. Objective: To evaluate the prognostic value of mortality of inflammatory indexes during the remission induction stage in patients with pediatric AL. Material and methods: Observational, longitudinal, analytical and retrolective study. Patients aged 0 to 17 years, with a recent and confirmed diagnosis of AL, who had basal (at diagnosis, before the start of treatment) and final (at the end of remission induction, or, in the cases of death, during the period prior to this outcome) complete blood count were included. Results: We included 78 patients, 67 with acute lymphoblastic leukemia (ALL), and 11 with acute myeloblastic leukemia (AML), with 11 and 2 deaths, respectively. Regarding ALL, no index showed significant cut-off points to distinguish deaths. Concerning AML, the indices whose cut-off points distinguished the patients who died in the basal measurement, were the monocyte-lymphocyte ratio (MLR) ≥ 3.11 (sensitivity [Se] 100%, specificity [Sp] 66.67%, AUC 0.8333, p 0.03), and, at the final measurement, the neutrophil-lymphocyte ratio (NLR) ≥ 1.30 and MLR ≥ 0.57 (both with Se 100% and Sp 88.89%, AUC 1.0, p < 0.00001) and systemic immune index (SII) ≥ 246612 (Se 100%, Sp 88.89%, AUC 0.9444, p < 0.0001). With bivariate analysis, only the latter demonstrated an increase in the risk of mortality (p = 0.02). Conclusions: The basal MLR and the final NLR, MLR and SII are prognostic inflammatory indices of mortality in patients with AML undergoing remission induction.

Introducción: los índices inflamatorios pueden reflejar la severidad de padecimientos graves como la leucemia aguda (LA), con lo que pueden predecir la mortalidad. Objetivo: evaluar el valor pronóstico de mortalidad de los índices inflamatorios durante la etapa de inducción a la remisión en pacientes con LA pediátrica. Material y métodos: estudio observacional, longitudinal, analítico y retrolectivo. Se incluyeron pacientes de 0 a 17 años, con diagnóstico reciente y confirmado de LA, que contaron con citometría hemática basal (al diagnóstico, antes del inicio de tratamiento) y final (al término de la inducción a la remisión o en los casos de defunción, en el periodo previo a este desenlace). Resultados: incluimos 78 pacientes, 67 con leucemia linfoblástica aguda (LLA) y 11 con leucemia mieloblástica aguda (LMA), con 11 y 2 defunciones, respectivamente. En la LLA ningún índice mostró puntos de corte significativos para distinguir muertes. En la LMA, los índices cuyos puntos de corte distinguieron a los pacientes que fallecieron en la medición basal fueron el índice monocito linfocito (IML) ≥ 3.11 (sensibilidad [S] 100%, especificidad [E] 66.67%, AUC 0.8333, p 0.03) y en la medición final, el índice neutrófilo linfocito (INL) ≥ 1.30 y el IML ≥ 0.57 (ambos con S 100% y E 88.89%, AUC 1.0, p < 0.00001) y el índice inmunosistémico (IIS) ≥ 246612 (S 100%, E 88.89%, AUC 0.9444, p < 0.0001). Con análisis bivariado solo este último mostró incremento del riesgo de mortalidad (p = 0.02). Conclusiones: el IML basal y el INL, IML e IIS finales son índices inflamatorios pronósticos de mortalidad en pacientes con LMA en inducción a la remisión.

Batch and Flow Synthesis of CeO2 Nanomaterials Using Solid-State Microwave Generators.

Microwave-assisted synthesis in combination with flow synthesis offers an interesting approach to develop faster and more sustainable procedures for the preparation of homogeneous nanomaterials. Recently, solid-state generators of microwaves appeared as a tool with improved control over power and frequency. Cerium oxide, despite its excellent catalytic activity, has not been prepared before using solid-state generators or microwave-assisted flow chemistry. We report a procedure for the preparation of nanoparticulated CeO2 (around 4 nm) under 2.45 GHz microwaves in only 30 s. The materials are further calcined at 800 °C to increase particle size, with a better defined particle size and crystallinity. The procedure was tested in batch at pH 11 and 12 and diverse potencies, and the products were characterized by TEM, XRD, DLS, and N2 adsorption-desorption isotherms. The materials were similar at the diverse pH values and potencies. XRD confirms the crystallinity of the CeO2 material with a fluorite-like structure. They are composed of particles around 40 nm that aggregate as structures of around 100 nm. The procedure was successfully adapted to flow synthesis, obtaining materials with structure and properties equivalent to batch synthesis. The batch and flow materials offer peroxidase properties, opening the door for their use as ROS scavengers.