[Results of treatment of acute lymphoblastic leukemia in two cohorts of Mexican patients]. / Tratamiento de la leucemia linfoide aguda del adulto. Experiencia de un hospital en la Ciudad de México.

BACKGROUND: GIMEMA ALL 0288 trial was designed to evaluate the impact of a 7-day prednisone (PDN) pretreatment on complete remission of acute lymphoblastic leukemia. We adopted this trial in 2007. AIM: To evaluate the results of treatment in two cohorts of patients with acute lymphoblastic leukemia, treated from 2007 to January 2009 and from February to December 2009. MATERIAL AND METHODS: We studied 99 patients treated in the first period (58 males) and 54 patients treated in the second period (33 males) The age of patients ranged from 16 to 60 years and 70% of patients were of high risk. BCR/ABL fusion transcript was present in 12% of patients. RESULTS: Remission rates were 61 and 51% for patients of the first and second group of treatment, respectively. The main cause of death were infections during the induction period. There were 49 relapses, mainly detected in the blood marrow. Global and event free 34 months survival were 32 and 30% respectively. Multivariate analysis disclosed risk stratification and central nervous system infiltration as risk factors for mortality. CONCLUSIONS: The main obstacles for the treatment of acute lymphoblastic leukemia in these cohorts of patients were the high incidence of infections and the lack of use of growth stimulating factors.

Detection Of Mutations In The Isocitrate Dehydrogenase Genes (IDH1/IDH2) Using castPCRTM In Patients With AML And Their Clinical Impact In Mexico City.

OBJECTIVE: Approximately 40-50% of patients with acute myeloid leukaemia (AML) have been reported to present with a normal karyotype and a variable disease-free period, most likely due to the molecular heterogeneity presented by these patients. A variety of mutations have been identified at the molecular level, such as those in the IDH1/2 gene, which causes a gain of function of the isocitrate dehydrogenase enzyme, generating high levels of the (R)-2-hydroxyglutarate oncometabolite, which competitively inhibits dioxygenase enzymes. Therefore, the objective of this study was to evaluate the incidence of IDH1/2 gene mutations in AML patients and their impact on survival. MATERIALS AND METHODS: A total of 101 patients with a diagnosis of AML were included; mononuclear cells were obtained for DNA extraction and purification. Mutations were detected using TaqMan™ competitive allele-specific probes (castPCR™). Overall survival curves were plotted using IBM SPSS Statistics 23 software. RESULTS: The frequency of IDH gene mutations was 19.8%. For the IDH1 gene, 13.8% of the mutations identified included R132H, V178I, G105G and R132C. The frequency of mutations of the IDH2 gene was 5.9%; the variants included R172K and R140Q. The mean survival time in patients without IDH1 gene mutations was 173.15 days (120.20-226.10), while the mean survival time for patients with mutations was 54.95 days (9.7-100.18), p = 0.001. CONCLUSION: The frequency of IDH1 and IDH2 gene mutations in the sample was similar to that reported in other studies. The analysis of these mutations in AML patients is of great importance as a prognostic factor due to their impact on survival and their use as potential therapeutic targets or as targets of inhibitors of IDH1(Ivosidenib, Tibsovo) and IDH2 (Enasidenib, Idhifa).

Tratamiento de la leucemia linfoide aguda del adulto: Experiencia de un hospital en la Ciudad de México / Results of treatment of acute lymphoblastic leukemia in two cohorts of Mexican patients

Background: GIMEMA ALL 0288 trial was designed to evaluate the impact of a 7-day prednisone (PDN) pretreatment on complete remission of acute lymphoblastic leukemia. We adopted this trial in 2007. Aim: To evaluate the results of treatment in two cohorts of patients with acute lymphoblastic leukemia, treated from 2007 to January 2009 and from February to December 2009. Material and Methods: We studied 99 patients treated in the first period (58 males) and 54 patients treated in the second period (33 males) The age of patients ranged from 16 to 60 years and 70 percent of patients were of high risk. BCR/ABL fusion transcript was present in 12 percent of patients. Results: Remission rates were 61 and 51 percent for patients of the first and second group of treatment, respectively. The main cause of death were infections during the induction period. There were 49 relapses, mainly detected in the blood marrow. Global and event free 34 months survival were 32 and 30 percent respectively. Multivariate analysis disclosed risk stratification and central nervous system infiltration as risk factors for mortality. Conclusions: The main obstacles for the treatment of acute lymphoblastic leukemia in these cohorts of patients were the high incidence of infections and the lack of use of growth stimulating factors.

Estudio citogenético en 22 adultos y tres niños con leucemia linfoblástica aguda / Cytogenetic study in 22 adults and therr children with acute lymphoblastic leukemia

Se presentan los resultados del estudio citogenético realizado en sangre periférica y/o médula ósea de 25 pacientes (22 adultos y 3 niños) con LLA estudiados entre 1987 a 1990. Todos los casos presentaron alteraciones cromosómicas (25/25), aunque en 23 pacientes (23/25) estaba presente una línea celular normal. Entre las aberriguaciones estructurales encontradas están t(17;19) (q11;p13), t(2;9;22)(q34;q34;q11), t(1;7)(p13;q33), t(6;11)(q26;p16), t(3;4)(q24-25;q26), t(1;12)(q23;q34), t(2;18)(q15;p12), t(2;4;)(q23;35) y t(4;11)(q21ñq23). Estos rearreglos fueron indicadores de riesgo y se correlacionaron con la respuesta al tratamiento y la supervivencia de los pacientes. Algunas de estas anomalías no habían sido previamente descritas en LLA; sin embargo, los puntos de ruptura coinciden con los observados en otras neoplasias hematológicas, lo cual suguiere que esas regiones son críticas en la patogénesis de estos desórdenes.