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1. Primer consenso interinstitucional de neoplasias mieloproliferativas crónicas

Author

Raúl Martínez-Castro, Gilberto Barranco-Lampón, Luara L. Arana-Luna, José L. Álvarez-Vera, Flavio Rojas-Castillejos, Rosalinda Peñaloza-Ramírez, Adrián A. Carballo-Zarate, Irma Olarte-Carrillo, Jaime Israel-García Minamy, Javier López-Salazar, Juan J. Navarrete, Arturo Espinosa-Partida, Yanet Ventura-Enríquez, Josué I. Ruíz-Contreras, Oyuky G. Aguirre-Reyes, Irene Anaya-Cuellar, Jocelyn Aguilar-Luevano, Hugo F. Díaz-Ramírez, Wilfrido Herrera-Olivares, José A. Aguilar-Hidalgo, Luisa M. Alcivar-Cedeño, Álvaro Hernández-Caballero, Lourdes E. Galaz-Cordero, José A. de la Peña-Celaya, Pamela E. Báez-Islas, Ramón A. Bates-Martín, Ana Ma. de la Luz Cano- León, Ma. Eugenia Espitia-Ríos, Diego Barbosa, Javier Morales-Adrián, Martín J. Pacheco, Nancy Delgado-López, Yvette Neme-Yunes, Alba E. Morales-Hernández, Aldo Mújica-Martínez, Alejandra B. Pérez-Lizardi, Karen D. Pérez-Gómez, Gabriel Barragán-Ibáñez, Adolfo Martínez, Karen Flores-Ordúñez, Paulina Ramírez-Hoyos, Ma. de los Ángeles Rosales-López, Brenda L. Acosta-Maldonado, Marco A. Jiménez-Ochoa, Katheryn B. Garzón-Velásquez, Eleazar Hernández-Ruiz, Bosco M. McNally-Guillén, Erick E. Saucedo-Montes, Carolina Aguilar-Andrade, Cindy L. Vivas-Arteaga, Lidia V. Guerra-Alarcón, Andrea I. Milán-Salvatierra, Dafne I. Campa-Monroy, Xóchitl Cota-Rangel, Patricia Estrada-Domínguez, Alinka S. García-Camacho, Carolina García-Castillo, Luisa I. Banda-García, Vania Rodríguez-Sánchez, Luis A. Meillón-García, Elizabeth Urbina-Escalante, Mario A. Martínez-Ramírez, Sergio J. Loera-Fragoso, Jorge Martínez-Coronel, Nidia Zapata-Canto, Sue C. Gómez Cortés, Jesús E. Medina-Coral, Liliana Mójica-Balderas, Juan M. Pérez-Zúñiga, Fernando J. Pérez, José L. López-Arroyo, Juan F. Zazueta-Pozos, Eduardo Romero-Martínez, Hilda Romero-Rodelo, Ana L. Tapia-Enríquez, Emely J. Soriano-Mercedes, Óscar Salazar-Ramírez, Shendel P. Vilchis-González, Fredy Tepepa-Flores, and Martha Alvarado-Ibarra

Subjects
Neoplasia mieloproliferativa. Consenso. Diagnóstico., Public aspects of medicine, RA1-1270, Internal medicine, RC31-1245
Abstract

Objetivo: El objetivo del consenso es poner a disposición de los profesionales de las diferentes instituciones de salud pública en nuestro país, quienes se encuentran a cargo de estas enfermedades, la información más relevante y actualizada acerca de su diagnóstico y tratamiento en la práctica clínica. Con este consenso interinstitucional esperamos contribuir a mejorar la calidad de la atención de los pacientes con neoplasias mieloproliferativas crónicas a todo lo ancho y largo de la República Mexicana, con el fin de unificar criterios tanto en diagnóstico como en tratamiento de las diferentes enfermedades mieloproliferativas.

Published
2022
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2. Trasplante de progenitores hematopoyéticos en la mielofibrosis

Author

Raúl Martínez-Castro, Gilberto Barranco-Lampón, Luara L. Arana-Luna, José L. Álvarez-Vera, Flavio Rojas-Castillejos, Rosalinda Peñaloza-Ramírez, Adrián A. Carballo-Zarate, Irma Olarte-Carrillo, Jaime Israel-García Minamy, Javier López-Salazar, Juan J. Navarrete, Arturo Espinosa-Partida, Yanet Ventura-Enríquez, Josué I. Ruiz-Contreras, Oyuky G. Aguirre-Reyes, Irene Anaya-Cuellar, Jocelyn Aguilar-Luevano, Hugo F. Díaz-Ramírez, Wilfrido Herrera-Olivares, José A. Aguilar-Hidalgo, Luisa M. Alcivar-Cedeño, Álvaro Hernández-Caballero, Lourdes E. Galaz-Cordero, José A. de la Peña-Celaya, Pamela E. Báez-Islas, Ramón A. Bates-Martín, Ana Ma. de la Luz Cano- León, Ma. Eugenia Espitia-Ríos, Diego Barbosa, Javier Morales-Adrián, Martín J. Pacheco, Nancy Delgado-López, Yvette Neme-Yunes, Alba E. Morales-Hernández, Aldo Mújica-Martínez, Alejandra B. Pérez-Lizardi, Karen D. Pérez-Gómez, Gabriel Barragán-Ibáñez, Adolfo Martínez, Karen Flores-Ordúñez, Paulina Ramírez-Hoyos, Ma. de los Ángeles Rosales-López, Brenda L. Acosta-Maldonado, Marco A. Jiménez-Ochoa, Katheryn B. Garzón-Velásquez, Eleazar Hernández-Ruiz, Bosco M. McNally-Guillén, Erick E. Saucedo-Montes, Carolina Aguilar-Andrade, Cindy L. Vivas-Arteaga, Lidia V. Guerra-Alarcón, Andrea I. Milán-Salvatierra, Dafne I. Campa-Monroy, Xóchitl Cota-Rangel, Patricia Estrada-Domínguez, Alinka S. García-Camacho, Carolina García-Castillo, Luisa I. Banda-García, Vania Rodríguez-Sánchez, Luis A. Meillón-García, Elizabeth Urbina-Escalante, Mario A. Martínez-Ramírez, Sergio J. Loera-Fragoso, Jorge Martínez-Coronel, Nidia Zapata-Canto, Sue C. Gómez Cortés, Jesús E. Medina-Coral, Liliana Mojica-Balderas, Juan M. Pérez-Zúñiga, Fernando J. Pérez, José L. López-Arroyo, Juan F. Zazueta-Pozos, Eduardo Romero-Martínez, Hilda Romero-Rodelo, Ana L. Tapía-Enríquez, Emely J. Soriano-Mercedes, Óscar Salazar-Ramírez, Shendel P. Vilchis-González, Fredy Tepepa-Flores, and Martha Alvarado-Ibarra

Subjects
Mielofibrosis. Trasplante alogénico. Supervivencia global. Mortalidad no relacionada a recaída., Public aspects of medicine, RA1-1270, Internal medicine, RC31-1245
Abstract

El objetivo de este trabajo es generar recomendaciones sobre el manejo del trasplante alogénico de células madre (alo-SCT) en la mielofibrosis primaria (MFP). Se utilizó una revisión sistemática integral de artículos publicados entre 1999 y 2015 (enero) como fuente de evidencia científica. Las recomendaciones se produjeron mediante un proceso Delphi en el que participó un panel de 23 expertos designados por la European LeukemiaNet y el European Blood and Marrow Transplantation Group. Las preguntas clave incluyeron la selección de pacientes, la selección de donantes, el manejo previo al trasplante, el régimen de acondicionamiento, el manejo posterior al trasplante, la prevención y el manejo de la recaída después del trasplante. Los pacientes con enfermedad de riesgo intermedio 2 o alto y edad < 70 años deben ser considerados candidatos para alo-SCT. Los pacientes con enfermedad de riesgo intermedio 1 y edad < 65 años deben ser considerados candidatos si presentan anemia refractaria dependiente de transfusiones, o un porcentaje de blastos en sangre periférica > 2%, o citogenética adversa. La esplenectomía previa al trasplante debe decidirse caso por caso. Los pacientes con enfermedad de riesgo intermedio 2 o alto que carecen de un hermano compatible con el antígeno leucocitario humano (HLA) o de un donante no emparentado deben inscribirse en un protocolo que utilice donantes no idénticos de HLA. PB se consideró la fuente más apropiada de células madre hematopoyéticas para trasplantes de hermanos y donantes no emparentados compatibles con HLA. La intensidad óptima del régimen de acondicionamiento aún debe definirse. Se consideraron adecuadas estrategias como la suspensión de los fármacos inmunosupresores, la infusión de linfocitos del donante o ambas para evitar la recaída clínica. En conclusión, proporcionamos recomendaciones basadas en consenso destinadas a optimizar el alo-SCT en MFP. Se destacaron las necesidades clínicas insatisfechas.

Published
2022
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3. Mielofibrosis: diagnóstico y tratamiento

Author

Raúl Martínez-Castro, Gilberto Barranco-Lampón, Luara L. Arana-Luna, José L. Álvarez-Vera, Flavio Rojas-Castillejos, Rosalinda Peñaloza-Ramírez, Adrián A. Carballo-Zarate, Irma Olarte-Carrillo, Jaime Israel-García Minamy, Javier López-Salazar, Juan J. Navarrete, Arturo Espinosa-Partida, Yanet Ventura-Enríquez, Josué I. Ruiz-Contreras, Oyuky G. Aguirre-Reyes, Irene Anaya-Cuellar, Jocelyn Aguilar-Luevano, Hugo F. Díaz-Ramírez, Wilfrido Herrera-Olivares, José A. Aguilar-Hidalgo, Luisa M. Alcivar-Cedeño, Álvaro Hernández-Caballero, Lourdes E. Galaz-Cordero, José A. de la Peña-Celaya, Pamela E. Báez-Islas, Ramón A. Bates-Martín, Ana Ma. de la Luz Cano- León, Ma. Eugenia Espitia-Ríos, Diego Barbosa, Javier Morales-Adrián, Martín J. Pacheco, Nancy Delgado-López, Yvette Neme-Yunes, Alba E. Morales-Hernández, Aldo Mújica-Martínez, Alejandra B. Pérez-Lizardi, Karen D. Pérez-Gómez, Gabriel Barragán-Ibáñez, Adolfo Martínez, Karen Flores-Ordúñez, Paulina Ramírez-Hoyos, Ma. de los Ángeles Rosales-López, Brenda L. Acosta-Maldonado, Marco A. Jiménez-Ochoa, Katheryn B. Garzón-Velásquez, Eleazar Hernández-Ruiz, Bosco M. McNally-Guillén, Erick E. Saucedo-Montes, Carolina Aguilar-Andrade, Cindy L. Vivas-Arteaga, Lidia V. Guerra-Alarcón, Andrea I. Milán-Salvatierra, Dafne I. Campa-Monroy, Xóchitl Cota-Rangel, Patricia Estrada-Domínguez, Alinka S. García-Camacho, Carolina García-Castillo, Luisa I. Banda-García, Vania Rodríguez-Sánchez, Luis A. Meillón-García, Elizabeth Urbina-Escalante, Mario A. Martínez-Ramírez, Sergio J. Loera-Fragoso, Jorge Martínez-Coronel, Nidia Zapata-Canto, Sue C. Gómez Cortés, Jesús E. Medina-Coral, Liliana Mojica-Balderas, Juan M. Pérez-Zúñiga, Fernando J. Pérez, José L. López-Arroyo, Juan F. Zazueta-Pozos, Eduardo Romero-Martínez, Hilda Romero-Rodelo, Ana L. Tapia-Enríquez, Emely J. Soriano-Mercedes, Óscar Salazar-Ramírez, Shendel P. Vilchis-González, Fredy Tepepa-Flores, and Martha Alvarado-Ibarra

Subjects
Andrógenos. Anemia. Hidroxiurea. Inhibidores de la cinasa de Janus. Mielofibrosis. Radioterapia., Public aspects of medicine, RA1-1270, Internal medicine, RC31-1245
Abstract

La mielofibrosis (MF) es una neoplasia mieloproliferativa negativa para BCR-ABL1 caracterizada por mieloproliferación clonal, señalización de cinasa desregulada y liberación de citocinas anormales. En los últimos años se han realizado importantes avances en el conocimiento de la biología molecular y la valoración pronóstica de la MF. El tratamiento convencional tiene un impacto limitado en la supervivencia de los pacientes; incluye un enfoque de espera para pacientes asintomáticos, agentes estimulantes de la eritropoyesis, andrógenos o agentes inmunomoduladores para la anemia, fármacos citorreductores como la hidroxiurea para la esplenomegalia y los síntomas constitucionales, y esplenectomía o radioterapia en pacientes seleccionados. El descubrimiento de la mutación Janus cinasa (JAK) 2 desencadenó el desarrollo de la terapia dirigida molecular de la MF. Los inhibidores de JAK son efectivos tanto en MF con JAK2 positivo como con JAK2 negativo; uno de ellos, el ruxolitinib, es la mejor terapia disponible actualmente para la esplenomegalia y los síntomas constitucionales de la MF. Sin embargo, aunque el ruxolitinib ha cambiado el escenario terapéutico de la MF, no hay indicios claros de un efecto modificador de la enfermedad. El alotrasplante de células madre sigue siendo la única terapia curativa de la MF, pero debido a su morbilidad y mortalidad asociadas, generalmente se restringe a pacientes elegibles con MF de riesgo alto e intermedio 2. Para mejorar los resultados terapéuticos actuales, actualmente se está probando la combinación de inhibidores de JAK con otros agentes y se están investigando fármacos más nuevos.

Published
2022
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4. Policitemia vera

Author

Raúl Martínez-Castro, Gilberto Barranco-Lampón, Luara L. Arana-Luna, José L. Álvarez-Vera, Flavio Rojas-Castillejos, Rosalinda Peñaloza-Ramírez, Adrián A. Carballo-Zarate, Irma Olarte-Carrillo, Jaime Israel-García Minamy, Javier López-Salazar, Juan J. Navarrete, Arturo Espinosa-Partida, Yanet Ventura-Enríquez, Josué I. Ruiz-Contreras, Oyuky G. Aguirre-Reyes, Irene Anaya-Cuellar, Jocelyn Aguilar-Luevano, Hugo F. Díaz-Ramírez, Wilfrido Herrera-Olivares, José A. Aguilar-Hidalgo, Luisa M. Alcivar-Cedeño, Álvaro Hernández-Caballero, Lourdes E. Galaz-Cordero, José A. de la Peña-Celaya, Pamela E. Báez-Islas, Ramón A. Bates-Martín, Ana Ma. de la Luz Cano- León, Ma. Eugenia Espitia-Ríos, Diego Barbosa, Javier Morales-Adrián, Martín J. Pacheco, Nancy Delgado-López, Yvette Neme-Yunes, Alba E. Morales-Hernández, Aldo Mújica-Martínez, Alejandra B. Pérez-Lizardi, Karen D. Pérez-Gómez, Gabriel Barragán-Ibáñez, Adolfo Martínez, Karen Flores-Ordúñez, Paulina Ramírez-Hoyos, Ma. de los Ángeles Rosales-López, Brenda L. Acosta-Maldonado, Marco A. Jiménez-Ochoa, Katheryn B. Garzón-Velásquez, Eleazar Hernández-Ruiz, Bosco M. McNally-Guillén, Erick E. Saucedo-Montes, Carolina Aguilar-Andrade, Cindy L. Vivas-Arteaga, Lidia V. Guerra-Alarcón, Andrea I. Milán-Salvatierra, Dafne I. Campa-Monroy, Xóchitl Cota-Rangel, Patricia Estrada-Domínguez, Alinka S. García-Camacho, Carolina García-Castillo, Luisa I. Banda-García, Vania Rodríguez-Sánchez, Luis A. Meillón-García, Elizabeth Urbina-Escalante, Mario A. Martínez-Ramírez, Sergio J. Loera-Fragoso, Jorge Martínez-Coronel, Nidia Zapata-Canto, Sue C. Gómez Cortés, Jesús E. Medina-Coral, Liliana Mojica-Balderas, Juan M. Pérez-Zúñiga, Fernando J. Pérez, José L. López-Arroyo, Juan F. Zazueta-Pozos, Eduardo Romero-Martínez, Hilda Romero-Rodelo, Ana L. Tapía-Enríquez, Emely J. Soriano-Mercedes, Óscar Salazar-Ramírez, Shendel P. Vilchis-González, Fredy Tepepa-Flores, and Martha Alvarado-Ibarra

Subjects
Eritrocitosis. Policitemia vera. Neoplasias mieloproliferativas., Public aspects of medicine, RA1-1270, Internal medicine, RC31-1245
Abstract

La policitemia vera (PV) se caracteriza principalmente por eritrocitosis, predisposición trombótica y hemorrágica, una variedad de síntomas y riesgos acumulativos de progresión fibrótica y/o evolución leucémica a lo largo del tiempo. El diagnóstico se realiza con base en los criterios de la Organización Mundial de la Salud del 2016. El tratamiento de la PV se centra en reducir rápidamente la masa eritrocitaria, ya sea por medio de flebotomías o con tratamiento citorreductor, y la disminución del riesgo trombótico mediante la corrección de factores de riesgo cardiovascular y el uso de antiagregantes plaquetarios.

Published
2022
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5. Trombocitemia esencial

Author

Raúl Martínez-Castro, Gilberto Barranco-Lampón, Luara L. Arana-Luna, José L. Álvarez-Vera, Flavio Rojas-Castillejos, Rosalinda Peñaloza-Ramírez, Adrián A. Carballo-Zarate, Irma Olarte-Carrillo, Jaime Israel-García Minamy, Javier López-Salazar, Juan J. Navarrete, Arturo Espinosa-Partida, Yanet Ventura-Enríquez, Josué I. Ruiz-Contreras, Oyuky G. Aguirre-Reyes, Irene Anaya-Cuellar, Jocelyn Aguilar-Luevano, Hugo F. Díaz-Ramírez, Wilfrido Herrera-Olivares, José A. Aguilar-Hidalgo, Luisa M. Alcivar-Cedeño, Álvaro Hernández-Caballero, Lourdes E. Galaz-Cordero, José A. de la Peña-Celaya, Pamela E. Báez-Islas, Ramón A. Bates-Martín, Ana Ma. de la Luz Cano- León, Ma. Eugenia Espitia-Ríos, Diego Barbosa, Javier Morales-Adrián, Martín J. Pacheco, Nancy Delgado-López, Yvette Neme-Yunes, Alba E. Morales-Hernández, Aldo Mújica-Martínez, Alejandra B. Pérez-Lizardi, Karen D. Pérez-Gómez, Gabriel Barragán-Ibáñez, Adolfo Martínez, Karen Flores-Ordúñez, Paulina Ramírez-Hoyos, Ma. de los Ángeles Rosales-López, Brenda L. Acosta-Maldonado, Marco A. Jiménez-Ochoa, Katheryn B. Garzón-Velásquez, Eleazar Hernández-Ruiz, Bosco M. McNally-Guillén, Erick E. Saucedo-Montes, Carolina Aguilar-Andrade, Cindy L. Vivas-Arteaga, Lidia V. Guerra-Alarcón, Andrea I. Milán-Salvatierra, Dafne I. Campa-Monroy, Xóchitl Cota-Rangel, Patricia Estrada-Domínguez, Alinka S. García-Camacho, Carolina García-Castillo, Luisa I. Banda-García, Vania Rodríguez-Sánchez, Luis A. Meillón-García, Elizabeth Urbina-Escalante, Mario A. Martínez-Ramírez, Sergio J. Loera-Fragoso, Jorge Martínez-Coronel, Nidia Zapata-Canto, Sue C. Gómez Cortés, Jesús E. Medina-Coral, Liliana Mojica-Balderas, Juan M. Pérez-Zúñiga, Fernando J. Pérez, José L. López-Arroyo, Juan F. Zazueta-Pozos, Eduardo Romero-Martínez, Hilda Romero-Rodelo, Ana L. Tapia-Enríquez, Emely J. Soriano-Mercedes, Óscar Salazar-Ramírez, Shendel P. Vilchis-González, Fredy Tepepa-Flores, and Martha Alvarado-Ibarra

Subjects
Trombocitemia esencial. Neoplasias mieloproliferativas. Trombocitosis., Public aspects of medicine, RA1-1270, Internal medicine, RC31-1245
Abstract

La trombocitemia esencial (TE) es una neoplasia mieloproliferativa crónica Filadelfia negativa que tiene su principal involucro en la línea megacariopoyética, generando trombocitosis sostenida en la sangre periférica y un incremento en el número de megacariocitos maduros en médula ósea. Además de una marcada trombocitosis, se caracteriza por un mayor riesgo trombótico o hemorrágico y la presencia de síntomas constitucionales. Los pacientes con TE tienen un riesgo bajo, pero conocido, de evolución de la enfermedad a mielofibrosis y/o leucemia aguda. El diagnóstico se realiza con base en los criterios de la Organización Mundial de la Salud del 2016. Los tratamientos actualmente disponibles para los pacientes con TE están dirigidos principalmente a minimizar el riesgo de trombosis y/o hemorragia.

Published
2022
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6. Control de los síntomas

Author

Raúl Martínez-Castro, Gilberto Barranco-Lampón, Luara L. Arana-Luna, José L. Álvarez-Vera, Flavio Rojas-Castillejos, Rosalinda Peñaloza-Ramírez, Adrián A. Carballo-Zarate, Irma Olarte-Carrillo, Jaime Israel-García Minamy, Javier López-Salazar, Juan J. Navarrete, Arturo Espinosa-Partida, Yanet Ventura-Enríquez, Josué I. Ruiz-Contreras, Oyuky G. Aguirre-Reyes, Irene Anaya-Cuellar, Jocelyn Aguilar-Luevano, Hugo F. Díaz-Ramírez, Wilfrido Herrera-Olivares, José A. Aguilar-Hidalgo, Luisa M. Alcivar-Cedeño, Álvaro Hernández-Caballero, Lourdes E. Galaz-Cordero, José A. de la Peña-Celaya, Pamela E. Báez-Islas, Ramón A. Bates-Martín, Ana Ma. de la Luz Cano- León, Ma. Eugenia Espitia-Ríos, Diego Barbosa, Javier Morales-Adrián, Martín J. Pacheco, Nancy Delgado-López, Yvette Neme-Yunes, Alba E. Morales-Hernández, Aldo Mújica-Martínez, Alejandra B. Pérez-Lizardi, Karen D. Pérez-Gómez, Gabriel Barragán-Ibáñez, Adolfo Martínez, Karen Flores-Ordúñez, Paulina Ramírez-Hoyos, Ma. de los Ángeles Rosales-López, Brenda L. Acosta-Maldonado, Marco A. Jiménez-Ochoa, Katheryn B. Garzón-Velásquez, Eleazar Hernández-Ruiz, Bosco M. McNally-Guillén, Erick E. Saucedo-Montes, Carolina Aguilar-Andrade, Cindy L. Vivas-Arteaga, Lidia V. Guerra-Alarcón, Andrea I. Milán-Salvatierra, Dafne I. Campa-Monroy, Xóchitl Cota-Rangel, Patricia Estrada-Domínguez, Alinka S. García-Camacho, Carolina García-Castillo, Luisa I. Banda-García, Vania Rodríguez-Sánchez, Luis A. Meillón-García, Elizabeth Urbina-Escalante, Mario A. Martínez-Ramírez, Sergio J. Loera-Fragoso, Jorge Martínez-Coronel, Nidia Zapata-Canto, Sue C. Gómez Cortés, Jesús E. Medina-Coral, Liliana Mojica-Balderas, Juan M. Pérez-Zúñiga, Fernando J. Pérez, José L. López-Arroyo, Juan F. Zazueta-Pozos, Eduardo Romero-Martínez, Hilda Romero-Rodelo, Ana L. Tapia-Enríquez, Emely J. Soriano-Mercedes, Óscar Salazar-Ramírez, Shendel P. Vilchis-González, Fredy Tepepa-Flores, and Martha Alvarado-Ibarra

Subjects
Síntomas. Neoplasias mieloproliferativas. Prurito., Public aspects of medicine, RA1-1270, Internal medicine, RC31-1245
Abstract

Además de la sintomatología secundaria a la esplenomegalia, a las alteraciones microvasculares y a las complicaciones trombohemorrágicas, los pacientes con neoplasias mieloproliferativas (NMP) pueden experimentar una importante carga sintomática atribuida a un aumento de citocinas inflamatorias circulantes. Estos síntomas pueden ser severos y limitar la calidad de vida. Por ello, además de la prevención de las complicaciones, uno de los objetivos del tratamiento de las NMP es el control de los síntomas.

Published
2022
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7. Eventos trombóticos

Author

Raúl Martínez-Castro, Gilberto Barranco-Lampón, Luara L. Arana-Luna, José L. Álvarez-Vera, Flavio Rojas-Castillejos, Rosalinda Peñaloza-Ramírez, Adrián A. Carballo-Zarate, Irma Olarte-Carrillo, Jaime Israel-García Minamy, Javier López-Salazar, Juan J. Navarrete, Arturo Espinosa-Partida, Yanet Ventura-Enríquez, Josué I. Ruiz-Contreras, Oyuky G. Aguirre-Reyes, Irene Anaya-Cuellar, Jocelyn Aguilar-Luevano, Hugo F. Díaz-Ramírez, Wilfrido Herrera-Olivares, José A. Aguilar-Hidalgo, Luisa M. Alcivar-Cedeño, Álvaro Hernández-Caballero, Lourdes E. Galaz-Cordero, José A. de la Peña-Celaya, Pamela E. Báez-Islas, Ramón A. Bates-Martín, Ana Ma. de la Luz Cano- León, Ma. Eugenia Espitia-Ríos, Diego Barbosa, Javier Morales-Adrián, Martín J. Pacheco, Nancy Delgado-López, Yvette Neme-Yunes, Alba E. Morales-Hernández, Aldo Mújica-Martínez, Alejandra B. Pérez-Lizardi, Karen D. Pérez-Gómez, Gabriel Barragán-Ibáñez, Adolfo Martínez, Karen Flores-Ordúñez, Paulina Ramírez-Hoyos, Ma. de los Ángeles Rosales-López, Brenda L. Acosta-Maldonado, Marco A. Jiménez-Ochoa, Katheryn B. Garzón-Velásquez, Eleazar Hernández-Ruiz, Bosco M. McNally-Guillén, Erick E. Saucedo-Montes, Carolina Aguilar-Andrade, Cindy L. Vivas-Arteaga, Lidia V. Guerra-Alarcón, Andrea I. Milán-Salvatierra, Dafne I. Campa-Monroy, Xóchitl Cota-Rangel, Patricia Estrada-Domínguez, Alinka S. García-Camacho, Carolina García-Castillo, Luisa I. Banda-García, Vania Rodríguez-Sánchez, Luis A. Meillón-García, Elizabeth Urbina-Escalante, Mario A. Martínez-Ramírez, Sergio J. Loera-Fragoso, Jorge Martínez-Coronel, Nidia Zapata-Canto, Sue C. Gómez Cortés, Jesús E. Medina-Coral, Liliana Mójica-Balderas, Juan M. Pérez-Zúñiga, Fernando J. Pérez, José L. López-Arroyo, Juan F. Zazueta-Pozos, Eduardo Romero-Martínez, Hilda Romero-Rodelo, Ana L. Tapia-Enríquez, Emely J. Soriano-Mercedes, Óscar Salazar-Ramírez, Shendel P. Vilchis-González, Fredy Tepepa-Flores, and Martha Alvarado-Ibarra

Subjects
Trombosis. Neoplasia mieloproliferativa. Anticoagulación. Profilaxis., Public aspects of medicine, RA1-1270, Internal medicine, RC31-1245
Abstract

Las complicaciones trombóticas mayores en las neoplasias mieloproliferativas (NMP) representan un importante problema clínico debido a su elevada morbilidad, la complejidad de su manejo y su mortalidad asociada. La aparición de una trombosis comporta una estratificación de alto riesgo trombótico de la NMP y determina el inicio o la optimización del tratamiento citorreductor y el uso de terapia antiplaquetaria o anticoagulante como profilaxis secundaria. La incidencia de trombosis en el momento del diagnóstico es mayor que durante la evolución de la enfermedad, localizándose en territorio arterial en el 60-70% casos. Una vez se ha producido una trombosis, hasta el 20-33% de los pacientes sufre una recurrencia trombótica en el mismo territorio vascular inicial.

Published
2022
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8. Embarazo en neoplasias mieloproliferativas

Author

Raúl Martínez-Castro, Gilberto Barranco-Lampón, Luara L. Arana-Luna, José L. Álvarez-Vera, Flavio Rojas-Castillejos, Rosalinda Peñaloza-Ramírez, Adrián A. Carballo-Zarate, Irma Olarte-Carrillo, Jaime Israel-García Minamy, Javier López-Salazar, Juan J. Navarrete, Arturo Espinosa-Partida, Yanet Ventura-Enríquez, Josué I. Ruiz-Contreras, Oyuky G. Aguirre-Reyes, Irene Anaya-Cuellar, Jocelyn Aguilar-Luevano, Hugo F. Díaz-Ramírez, Wilfrido Herrera-Olivares, José A. Aguilar-Hidalgo, Luisa M. Alcivar-Cedeño, Álvaro Hernández-Caballero, Lourdes E. Galaz-Cordero, José A. de la Peña-Celaya, Pamela E. Báez-Islas, Ramón A. Bates-Martín, Ana Ma. de la Luz Cano- León, Ma. Eugenia Espitia-Ríos, Diego Barbosa, Javier Morales-Adrián, Martín J. Pacheco, Nancy Delgado-López, Yvette Neme-Yunes, Alba E. Morales-Hernández, Aldo Mújica-Martínez, Alejandra B. Pérez-Lizardi, Karen D. Pérez-Gómez, Gabriel Barragán-Ibáñez, Adolfo Martínez, Karen Flores-Ordúñez, Paulina Ramírez-Hoyos, Ma. de los Ángeles Rosales-López, Brenda L. Acosta-Maldonado, Marco A. Jiménez-Ochoa, Katheryn B. Garzón-Velásquez, Eleazar Hernández-Ruiz, Bosco M. McNally-Guillén, Erick E. Saucedo-Montes, Carolina Aguilar-Andrade, Cindy L. Vivas-Arteaga, Lidia V. Guerra-Alarcón, Andrea I. Milán-Salvatierra, Dafne I. Campa-Monroy, Xóchitl Cota-Rangel, Patricia Estrada-Domínguez, Alinka S. García-Camacho, Carolina García-Castillo, Luisa I. Banda-García, Vania Rodríguez-Sánchez, Luis A. Meillón-García, Elizabeth Urbina-Escalante, Mario A. Martínez-Ramírez, Sergio J. Loera-Fragoso, Jorge Martínez-Coronel, Nidia Zapata-Canto, Sue C. Gómez Cortés, Jesús E. Medina-Coral, Liliana Mojica-Balderas, Juan M. Pérez-Zúñiga, Fernando J. Pérez, José L. López-Arroyo, Juan F. Zazueta-Pozos, Eduardo Romero-Martínez, Hilda Romero-Rodelo, Ana L. Tapia-Enríquez, Emely J. Soriano-Mercedes, Óscar Salazar-Ramírez, Shendel P. Vilchis-González, Fredy Tepepa-Flores, and Martha Alvarado-Ibarra

Subjects
Neoplasia mieloproliferativa. Embarazo. Trombosis., Public aspects of medicine, RA1-1270, Internal medicine, RC31-1245
Abstract

Las neoplasias mieloproliferativas (NMP) están asociadas a un riesgo notable de trombosis y el entorno de hipercoagulabilidad propio del embarazo aumenta este riesgo. Las complicaciones gestacionales más frecuentes consisten en: aborto espontáneo, trombosis, sangrado y enfermedad hipertensiva del embarazo. El tratamiento depende del riesgo trombótico, trimestre gestacional y neoplasia mieloproliferativa.

Published
2022
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9. Riesgo en los procedimientos invasivos

Author

Raúl Martínez-Castro, Gilberto Barranco-Lampón, Luara L. Arana-Luna, José L. Álvarez-Vera, Flavio Rojas-Castillejos, Rosalinda Peñaloza-Ramírez, Adrián A. Carballo-Zarate, Irma Olarte-Carrillo, Jaime Israel-García Minamy, Javier López-Salazar, Juan J. Navarrete, Arturo Espinosa-Partida, Yanet Ventura-Enríquez, Josué I. Ruiz-Contreras, Oyuky G. Aguirre-Reyes, Irene Anaya-Cuellar, Jocelyn Aguilar-Luevano, Hugo F. Díaz-Ramírez, Wilfrido Herrera-Olivares, José A. Aguilar-Hidalgo, Luisa M. Alcivar-Cedeño, Álvaro Hernández-Caballero, Lourdes E. Galaz-Cordero, José A. de la Peña-Celaya, Pamela E. Báez-Islas, Ramón A. Bates-Martín, Ana Ma. de la Luz Cano- León, Ma. Eugenia Espitia-Ríos, Diego Barbosa, Javier Morales-Adrián, Martín J. Pacheco, Nancy Delgado-López, Yvette Neme-Yunes, Alba E. Morales-Hernández, Aldo Mújica-Martínez, Alejandra B. Pérez-Lizardi, Karen D. Pérez-Gómez, Gabriel Barragán-Ibáñez, Adolfo Martínez, Karen Flores-Ordúñez, Paulina Ramírez-Hoyos, Ma. de los Ángeles Rosales-López, Brenda L. Acosta-Maldonado, Marco A. Jiménez-Ochoa, Katheryn B. Garzón-Velásquez, Eleazar Hernández-Ruiz, Bosco M. McNally-Guillén, Erick E. Saucedo-Montes, Carolina Aguilar-Andrade, Cindy L. Vivas-Arteaga, Lidia V. Guerra-Alarcón, Andrea I. Milán-Salvatierra, Dafne I. Campa-Monroy, Xóchitl Cota-Rangel, Patricia Estrada-Domínguez, Alinka S. García-Camacho, Carolina García-Castillo, Luisa I. Banda-García, Vania Rodríguez-Sánchez, Luis A. Meillón-García, Elizabeth Urbina-Escalante, Mario A. Martínez-Ramírez, Sergio J. Loera-Fragoso, Jorge Martínez-Coronel, Nidia Zapata-Canto, Sue C. Gómez Cortés, Jesús E. Medina-Coral, Liliana Mójica-Balderas, Juan M. Pérez Zúñiga, Fernando J. Pérez, José L. López-Arroyo, Juan F. Zazueta-Pozos, Eduardo Romero-Martínez, Hilda Romero-Rodelo, Ana L. Tapia-Enríquez, Emely J. Soriano-Mercedes, Óscar Salazar-Ramírez, Shendel P. Vilchis-González, Fredy Tepepa-Flores, and Martha Alvarado-Ibarra

Subjects
Cirugía. Neoplasias mieloproliferativas. Sangrado. Trombosis., Public aspects of medicine, RA1-1270, Internal medicine, RC31-1245
Abstract

Los pacientes con neoplasias mieloproliferativas tienen un riesgo incrementado de trombosis y sangrado. Se debe identificar dicho riesgo, así como individualizar la estrategia terapéutica previo a los procedimientos invasivos; una adecuada citorreducción disminuye el riesgo de complicaciones.

Published
2022
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10. COVID‐19 in a country with a very high prevalence of diabetes: The impact of admission hyperglycaemia on mortality

Author

Carlos Martínez‐Murillo, Christian Ramos Peñafiel, Lourdes Basurto, Lourdes Balcázar‐Hernández, Karen Pellón, Eder Flores López, Beatriz Li Gómez, Mercedes Estefania Ledesma, Rodrigo Rivera Tapia, Elizabeth Madera Maldonado, Monica Bejarano Rosales, Gilberto Barranco Lampon, and Juan Francisco Zazueta

Subjects
COVID‐19, diabetes, hyperglycaemia, mortality, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Abstract Aims To evaluate the frequency of diabetes and admission hyperglycaemia in Mexican COVID‐19 patients, to describe the clinical and biochemical characteristics of patients with admission hyperglycaemia and to determinate the impact of diabetes and admission hyperglycaemia on COVID‐19 severity and mortality. Methods A multicentric study was performed in 480 hospitalized patients with COVID‐19. Clinical and biochemical characteristics were evaluated in patients with admission hyperglycaemia and compared with non‐hyperglycaemic patients. The effect of diabetes and admission hyperglycaemia on severity and risk of death were evaluated. Results Age was 50.7 ± 13.6 years; 68.3% were male. Some 48.5% (n = 233) had admission hyperglycaemia; 29% (n = 139) of these patients had pre‐existing diabetes. Patients with admission hyperglycaemia had more requirement of invasive mechanical ventilation (IMV), higher levels of urea, D‐dimer and neutrophil‐lymphocyte ratio (NLR), as well as lower lymphocyte count. An association between admission hyperglycaemia with IMV and D‐dimer with glucose was found. Age ≥50 years (OR 2.09; 95%CI 1.37–3.17), pre‐existing diabetes (OR 2.38; 95%CI 1.59–5.04) and admission hyperglycaemia (OR 8.24; 95%CI 4.74–14.32) were risk factors for mortality. Conclusions Admission hyperglycaemia is presented in 48.5% of COVID‐19 patients. Diabetes and admission hyperglycaemia are associated with the severity of disease and mortality. This study shows the devastating conjunction of hyperglycaemia and COVID‐19. Clinical trial registration: Clinical characteristics of patients with COVID‐19, DI/20/204/04/41 (Hospital General de Mexico) and NR‐13‐2020 (Hospital Regional de Alta Especialidad Ixtapaluca).

Published
2021
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11. COVID-19 en pacientes con patologías hematológicas

Author

Gilberto Barranco-Lampón, Yubelka Baltodano-Martínez, Carlos Martínez-Murillo, Humberto B. Castellanos-Sinco, Christian Ramos-Peñafiel, Francisco Zazueta-Pozos, Manuel de la Mora-Estrada, Katherine Rodríguez-Fuentes, Efreen Montaño-Figueroa, Karen Pellón-Téllez, Juan Muñoz-Vega, Mario Tapia-Bravo, and Claudia Tellería-Arispe

Subjects
Public aspects of medicine, RA1-1270, Internal medicine, RC31-1245
Published
2021
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13. Anormalidades hematológicas en pacientes con el SARS-CoV-2 (COVID-19) y sus implicaciones pronósticas

Author

Humberto B. Castellanos-Sinco, Karen Pellón-Téllez, Katherine Rodríguez-Fuentes, Marino Mendoza-Oliva, Yubelka Baltodano-Martínez, Juan Muñoz-Vega, Mario Tapia-Bravo, Claudia Tellería-Arispe, Manuel de la Mora-Estrada, Christian Ramos-Peñafiel, Francisco Zazueta-Pozos, Gilberto Barranco-Lampón, Efreen Montaño-Figueroa, and Carlos Martínez-Murillo

Subjects
Public aspects of medicine, RA1-1270, Internal medicine, RC31-1245
Published
2021
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15. Osteopontin expression and its relationship with prognostic factors in diffuse large B-cell lymphoma

Author

Gilberto Barranco, Edith Fernández, Silvia Rivas, Roxana Quezada, Dolores Nava, José Aguilar, Abelardo García, Horacio Astudillo, Carmen Lome, and Erika Ruiz

Subjects
osteopontin, lymphoma, prognosis, Diseases of the blood and blood-forming organs, RC633-647.5
Abstract

The aim of this study is to explore the expression of osteopontin (OPN) and its relationship with prognostic factors and survival in diffuse large B cell lymphoma (DLBCL). A tissue microarray was performed for immunohistochemical evaluation. Contingency tables were analyzed for trends; chi-square test was used to determine differences between groups. Univariate and multivariate Cox proportional hazards-regression analyses were performed to evaluate the impact of prognostic factors on survival. Expression of OPN was observed in 28%. It was different in non-germinal center DLBCL (P=0.04). The mean overall survival (OS) was lower in patients with positive OPN expression (19.762; CI 95% 14.269-25.255) it was not significant (P=0.123). It is not possible to establish a clear relationship between the expression by immunohistochemistry of osteopontin and a poor prognosis but it would be important to complement the analysis with other techniques as PCR or NGS that allow us to assess the influence of the isoforms and post-translational modifications of OPN on the biological behavior of DLBCL. Our findings indicate that OPN expression could be associated with a more aggressive variant of lymphoma: non-germinal center DLBCL.

Published
2019
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16. Impact of a Guaranteed Access Program to Imatinib on the Survival of Patients with Chronic Myeloid Leukemia

Author

Lampon, Gilberto Barranco, primary, Vidal, Itzel, additional, Gama, Dulce, additional, Martínez, Carlos, additional, Acosta, Brenda, additional, Ramos, Christian, additional, Martínez, Emmanuel, additional, Zazueta, Juan, additional, Olarte, Irma, additional, Martínez, Adolfo, additional, Cervera, Eduardo, additional, Mendoza, Iveth, additional, Arcos, Diana, additional, and Cruz, Judith, additional

Published
2023
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17. Impact of a Guaranteed Access Program to Imatinib on the Survival of Patients with Chronic Myeloid Leukemia

Author

Gilberto Barranco Lampon, Itzel Vidal, Dulce Gama, Carlos Martínez, Brenda Acosta, Christian Ramos, Emmanuel Martínez, Juan Zazueta, Irma Olarte, Adolfo Martínez, Eduardo Cervera, Iveth Mendoza, Diana Arcos, and Judith Cruz

Abstract

Purpose: This work aimed to evaluate the impact of a guaranteed access program to Imatinib on the survival of patients with Chronic Myeloid Leukemia Methods: We carried out a retrospective, observational, and analytical study of the database of patients diagnosed with Chronic Myeloid Leukemia of the Instituto Nacional de Cancerología and the Hospital General de México Dr. Eduardo to assess overall survival based on guaranteed access or not to Imatinib. Results: With an average follow-up of 99 months, the estimated 20-year overall survival for all patients was 72% (95% CI, 76-67). A significant difference was found in the 20-year survival probability in favor of patients with guaranteed access 76% (95% CI, 81-71) vs. 61% (95% CI, 69-52) (pConclusion: CML is the most frequent chronic leukemia in Mexico, it mainly affects the economically active population (mean age 40), and the prognosis in our country has improved, emulating developed countries; however, the results depend on access to treatment as well as proper monitoring.

Published
2023
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19. COVID-19 en pacientes con patologías hematológicas

Author

Gilberto Barranco-Lampón, Yubelka Baltodano-Martínez, Carlos Martínez-Murillo, Humberto B. Castellanos-Sinco, Christian Ramos-Peñafiel, Francisco Zazueta-Pozos, Manuel de la Mora-Estrada, Katherine Rodríguez-Fuentes, Efreen Montaño-Figueroa, Karen Pellón-Téllez, Juan Muñoz-Vega, Mario Tapia-Bravo, and Claudia Tellería-Arispe

Subjects
General Medicine
Published
2023
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21. Anormalidades hematológicas en pacientes con el SARS-CoV-2 (COVID-19) y sus implicaciones pronósticas

Author

Humberto B. Castellanos-Sinco, Karen Pellón-Téllez, Katherine Rodríguez-Fuentes, Marino Mendoza-Oliva, Yubelka Baltodano-Martínez, Juan Muñoz-Vega, Mario Tapia-Bravo, Claudia Tellería-Arispe, Manuel de la Mora-Estrada, Christian Ramos-Peñafiel, Francisco Zazueta-Pozos, Gilberto Barranco-Lampón, Efreen Montaño-Figueroa, and Carlos Martínez-Murillo

Subjects
General Medicine
Published
2023
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23. Lymphomatoid granulomatosis in one patient with newly diagnosed HIV infection and Kaposi’s sarcoma: a case report and literature review

Author

Silvia Sánchez, Ana Ramirez, Pamela Alatorre, Carmen Lome, Gilberto Barranco, Sindy Gutiérrez, and Johanna Cevallos

Subjects
medicine.medical_specialty, Histology, Lymphomatoid granulomatosis, medicine.medical_treatment, Case Report, Disease, medicine.disease_cause, Pathology and Forensic Medicine, Epstein–Barr virus, 03 medical and health sciences, 0302 clinical medicine, Medicine, Lymphoproliferative syndrome, Kaposi's sarcoma, business.industry, Standard treatment, Immunosuppression, Hematology, medicine.disease, Lung nodes, Dermatology, Lymphoma, 030220 oncology & carcinogenesis, Differential diagnosis, business, 030215 immunology
Abstract

Lymphomatoid granulomatosis is a very rare B cell lymphoproliferative disease associated with Epstein–Barr virus infection. It is related to states of immunosuppression and affects the lung in more than 90% of cases, forcing the clinician to establish a differential diagnosis with other diseases such as infections, Wegener’s granulomatosis, lymphoma, or lung metastases. There is no standard treatment for this disease. In this paper, we describe a rare case of a patient with grade 3 lymphomatoid granulomatosis with newly diagnosed HIV infection who started antiretroviral treatment with a gradual improvement of the lesions.

Published
2021

25. Branched clonal evolution: nodal follicular lymphoma and primary diffuse large B-cell lymphoma of the central nervous system

Author

Sara Fernández, Juan F. García, Adolfo de la Fuente, Mónica Estévez, Julia González-Rincón, Ana Teijo, Carlos Montalbán, Fernando J. Pinedo, Gilberto Barranco, Rebeca Iglesias, Margarita Sánchez-Beato, Ángel Martínez-Ramírez, Francisca I. Camacho, Raquel de Oña, and Lucia Pedrosa

Subjects
Central nervous system, Follicular lymphoma, Hematology, Gene rearrangement, Biology, medicine.disease, Somatic evolution in cancer, Phenotype, Lymphoma, medicine.anatomical_structure, Cancer research, medicine, Online Only Articles, NODAL, Diffuse large B-cell lymphoma
Abstract

Cancers of the same histotype may show profound differences in clinical behavior because they can arise from cells having acquired multiple mutations, which presumably occur over many years.[1][1] In contrast, it is well known that cancers with different morphologies and phenotypes, and those that

Published
2019
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26. Mucormycosis, COVID-19 and Acute Lymphoid Leukemia: Case Report

Author

Gilberto Barranco-Lampón, Carlos Martínez-Murillo, Adrián Santoyo-Sánchez, Christian Omar Ramos-Peñafiel, Edgar L. Cordero-Hernández, and Itsel Arias-Castro

Subjects
Pathology, medicine.medical_specialty, Acute lymphoid leukemia, Coronavirus disease 2019 (COVID-19), business.industry, Mucormycosis, medicine, medicine.disease, business
Abstract

Introduction: During the era of COVID-19, an increase has surged in the number of cases of mucormycosis; the use of high doses of steroids, and states of immunosuppression such as diabetes are the main related risk factors. In the treatment of acute leukemia, it is recommended to reduce the dose of chemotherapy, postponing highly myeloablative schemes and the use of caution with monoclonal antibodies. Case presentation: We present the case of a patient (25 years-old male) with acute lymphoblastic leukemia and COVID-19 confirmed infection who developed rhino-cerebral mucormycosis during the induction stage. Conclusion: In the age of COVID-19, taking samples through a nasal swab should be avoided in individuals with risk of infection from mucormycosis, such as diabetes, cancer, or individuals treated with high doses of steroids.

Published
2021
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27. Evaluation of the MD Anderson tumor score for diffuse large B-cell lymphoma in the rituximab era

Author

Andres Lopez, Armando López-Guillermo, Alejandro Martín, José Antonio Queizán, Fernando Cabanillas, Mariana Bastos-Oreiro, Jose María Sanchez Pina, Antonio Salar, Marta García-Recio, Jose Rodriguez, Ruben Fernandez, Raul Cordoba, Mª José Rodriguez-Salazar, Juan F. García, Leyre Bento, Antonio Díaz-López, Hugo Luzardo, Daniel F. Garcia, Jordina Rovira, Sonia González de Villambrosia, Antonio Gutierrez, Mario Gutiérrez Rodríguez, Fatima De la Cruz, Mónica Baile, Juan-Manuel Sancho, Jordi Sastre-Serra, Silvana Novelli, Olga García, Carlos Montalbán, Ivan Dlouhy, and Gilberto Barranco

Subjects
Male, Oncology, Antineoplastic Agents, Immunological, 0302 clinical medicine, Risk groups, International Prognostic Index, hemic and lymphatic diseases, Antineoplastic Combined Chemotherapy Protocols, score, Registries, Stage (cooking), international prognostic index, Standard treatment, Hematology, General Medicine, Middle Aged, Prognosis, Treatment Outcome, Vincristine, 030220 oncology & carcinogenesis, Female, Original Article, Rituximab, Lymphoma, Large B-Cell, Diffuse, medicine.drug, Adult, medicine.medical_specialty, Adolescent, diffuse large B-cell lymphoma, Young Adult, 03 medical and health sciences, Internal medicine, medicine, Humans, Cyclophosphamide, Aged, Neoplasm Staging, business.industry, diffuse large B‐cell lymphoma, Cancer, Original Articles, tumor score, medicine.disease, Survival Analysis, Lymphoma, Doxorubicin, Prednisone, prognosis, Neoplasm Grading, business, Diffuse large B-cell lymphoma, 030215 immunology
Abstract

Objectives Diffuse large B-cell lymphoma (DLBCL) is an aggressive heterogeneous lymphoma with standard treatment. However, 30%-40% of patients still fail, so we should know which patients are candidates for alternative therapies. IPI is the main prognostic score but, in the rituximab era, it cannot identify a very high-risk (HR) subset. The MD Anderson Cancer Center reported a score in the prerituximab era exclusively considering tumor-related variables: Tumor Score (TS). We aim to validate TS in the rituximab era and to analyze its current potential role. Methods From GELTAMO DLBCL registry, we selected those patients homogeneously treated with R-CHOP (n = 1327). Results Five-years PFS and OS were 62% and 74%. All variables retained an independent prognostic role in the revised TS (R-TS), identifying four different risk groups, with 5-years PFS of 86%, 71%, 50%, and very HR (28%). With a further categorization of three variables of the original TS (Ann Arbor Stage, LDH and B2M), we generated a new index that allowed an improvement in HR assessment. Conclusions (a) All variables of the original TS retain an independent prognostic role, and R-TS remains predictive in the rituximab era; (b) R-TS and additional categorization of LDH, B2M, and AA stage (enhanced TS) increased the ability to identify HR subsets.

Published
2020

28. Usefulness of two clinical (CBC and PETHEMA) scores for predicting early death in patients with acute promyelocytic leukemia: A single-center study in Mexico City

Author

Christian Omar Ramos-Peñafiel, Humberto Castellanos-Sinco, Gilberto Barranco-Lampón, Etta Rozen-Fuller, Juan Francisco Zazueta-Pozos, Adolfo Martínez-Tovar, Adrián Santoyo-Sánchez, Efreen Horacio Montaño-Figueroa, and Irma Olarte-Carrillo

Subjects
Acute promyelocytic leukemia, medicine.medical_specialty, business.industry, Internal medicine, Mexico city, medicine, Early death, In patient, General Medicine, Single Center, business, medicine.disease
Published
2019
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29. New prognosis score including absolute lymphocyte/monocyte ratio, red blood cell distribution width and beta-2 microglobulin in patients with diffuse large B-cell lymphoma treated with R-CHOP: Spanish Lymphoma Group Experience (GELTAMO)

Author

Mario Gutiérrez Rodríguez, Jose Rodriguez, Sonia González de Villambrosia, Mariana Bastos, Hugo Luzardo, Leyre Bento, Marta García-Recio, Azueg Hong, Raul Cordoba, Raquel Del Campo, Pau Abrisqueta, Ana M. Martín-Moreno, Gilberto Barranco, Pilar Roca, Antonio Salar, Jordi Martinez-Serra, José María Sánchez-Pina, Mónica Baile, Olga García, Juan M. Sancho, Antonio Gutierrez, Alejandro Martín, Daniel García, Jorge Sastre-Serra, M José Rodríguez-Salazar, Antonio Díaz-López, and Silvana Novelli

Subjects
Male, Lymphocyte, Gastroenterology, Monocytes, 0302 clinical medicine, International Prognostic Index, Risk Factors, hemic and lymphatic diseases, Antineoplastic Combined Chemotherapy Protocols, Lymphocytes, Stage (cooking), Aged, 80 and over, education.field_of_study, Hematology, Middle Aged, Prognosis, medicine.anatomical_structure, Vincristine, 030220 oncology & carcinogenesis, Female, Lymphoma, Large B-Cell, Diffuse, Rituximab, complete blood cell counts, index, Adult, medicine.medical_specialty, Adolescent, Population, diffuse large B-cell lymphoma, 03 medical and health sciences, Young Adult, Internal medicine, medicine, Humans, education, Cyclophosphamide, Aged, Beta-2 microglobulin, business.industry, Red blood cell distribution width, medicine.disease, Lymphoma, Blood Cell Count, Doxorubicin, Prednisone, prognosis, business, beta 2-Microglobulin, beta 2-microglobulin, Diffuse large B-cell lymphoma, 030215 immunology
Abstract

The International Prognostic Index (IPI) is the most widely used score for non-Hodgkin lymphoma but lacks the ability to identify a high-risk population in diffuse large B-cell lymphoma (DLBCL). Low absolute lymphocyte count and high monocytes have proved to be unfavourable factors. Red-cell distribution width (RDW) has been associated with inflammation and beta-2 microglobulin (B2M) with tumour load. The retrospective study included 992 patients with DLBCL treated with R-CHOP. In the multivariate analysis, age, Eastern Cooperative Oncology Group performance status (ECOG-PS), stage, bulky mass, B2M, RDW, and lymphocyte/monocyte ratio (LMR) were independently related to progression-free survival (PFS). A new prognosis score was generated with these variables including age categorized into three groups (0, 1, 2 points); ECOG ≥ 3-4 with two; stage III/IV, bulky mass, high B2M, LMR 2·25 and RDW 0·96 with one each; for a maximum of 9. This score could improve the discrimination of a very high-risk subgroup with five-year PFS and overall survival (OS) of 19% and 24% versus 45% and 59% of R (revised)-IPI respectively. This score also showed greater predictive ability than IPI. A new score is presented including complete blood cell count variables and B2M, which are readily available in real-life practice without additional tests. Compared to R-IPI, it shows a more precise high-risk assessment and risk discrimination for both PFS and OS.

Published
2019

30. Association between traumatic lumbar puncture and the risk of central nervous system relapse in adults with acute lymphoblastic leukaemia

Author

Juan Collazo-Jaloma, Humberto Castellanos-Sinco, Gilberto Barranco-Lampón, I. Olarte-Carrilo, Etta Rozen-Fuller, Adrián Santoyo-Sánchez, Christian Omar Ramos-Peñafiel, Guadalupe León-González, and Adolfo Martínez-Tovar

Subjects
medicine.medical_specialty, Traumatic lumbar puncture, Spinal puncture, Disease-free survival, Central nervous system, Recurrencia, Intrathecal, Recurrence, Internal medicine, medicine, Leukaemia, Supervivencia sin enfermedad, Leucemia, In patient, Risk factor, lcsh:R5-920, business.industry, Retrospective cohort study, General Medicine, Punción espinal, Surgery, medicine.anatomical_structure, Sistema nervioso central, Chemoprophylaxis, Lymphoblastic leukaemia, lcsh:Medicine (General), business
Abstract

Intrathecal chemoprophylaxis prevents central nervous system relapses in patients with acute lymphoblastic leukaemia (ALL) but few studies have addressed the predictive markers of relapse. Among these, traumatic lumbar puncture (TLP) has been associated with lower disease-free survival (DFS). To investigate the risk posed by TLP on relapse and DFS, we assembled a retrospective cohort including 79 patients with ALL who received intrathecal chemoprophylaxis during 2009 to 2013. One TLP per patient was recorded in 49 cases, and more than one TLP in 3. Mean follow-up was 283 (22–1118) days with an overall DFS of 68%. DFS was significantly lower in the group that had experienced TLP (58% vs 100% [ P = .070]). Multiple TLP posed a greater risk of relapse than single TLP ( P = .001). In conclusion, TLP in adults constitutes a major risk factor, greater than that reported in the large paediatric series.

Published
2015
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31. Differential prognostic impact of GELTAMO-IPI in cell of origin subtypes of Diffuse Large B Cell Lymphoma as defined by the Hans algorithm

Author

Carlos, Montalbán, Antonio, Díaz-López, Alejandro, Martín, Mónica, Baile, José M, Sanchez, Juan M, Sancho, Olga, García, Silvana, Novelli, Anna, Monter-Rovira, Antonio, Salar, Mariana, Bastos, Antonio, Gutiérrez, Leyre, Bento, Raul, Córdoba, Teresa, Arquero, Sonia, González de Villambrosia, Gilberto, Barranco, Raquel, De Oña, Armando, López Guillermo, María J, Rodriguez Salazar, Juan F, Domínguez, Rubén, Fernández, José A, Queizan, José, Rodríguez, Victor, Abraira, Juan F, García, and María, Casanova

Subjects
Adult, Male, Cell of origin, Risk Assessment, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, International Prognostic Index, Risk groups, Risk Factors, hemic and lymphatic diseases, Antineoplastic Combined Chemotherapy Protocols, medicine, Overall survival, cell of origin subtyping, Humans, Aged, Proportional hazards model, business.industry, GELTAMO-IPI, Hematology, Middle Aged, medicine.disease, Germinal Center, Prognosis, diffuse large B cell lymphoma, Survival Rate, 030220 oncology & carcinogenesis, immunohistochemistry, Immunohistochemistry, Female, Immunotherapy, Lymphoma, Large B-Cell, Diffuse, business, Diffuse large B-cell lymphoma, Algorithm, Algorithms, Hans algorithm, 030215 immunology
Abstract

The Grupo Espanol de Linfomas y Trasplantes de Medula Osea International Prognostic Index (GELTAMO-IPI) stratifies four risk groups in diffuse large B cell lymphoma (DLBCL) patients treated with immunochaemotherapy: low (LR), low-intermediate (LIR), high-intermediate (HIR), and high (HR). The present study explores the effect of GELTAMO-IPI in the DLBCL subtypes defined by the immunohistochaemistry-based Hans algorithm, Germinal Centre B (GCB) and non-GCB. A multivariate Cox regression model including GELTAMO-IPI risk groups, cell of origin (COO) subtypes and their product was developed to evaluate interaction between the two variables. The COO subtype was available in 839 patients (380 GCB; 459 non-GCB) and both the GELTAMO-IPI and the COO subtype in 780 (353 GCB; 427 non-GCB). There were no differences in 5-year overall survival (OS) between the two subtypes. The Cox model revealed interaction between the GELTAMO-IPI risk groups and the COO subtypes (P = 0·005), indicating that GELTAMO-IPI has a different effect in the two subtypes. Three risk groups were stratified in both COO subtypes: in the GCB subtype, LR, LIR and the combined HIR+HR had 5-year OS of 100%, 75% and 52%, respectively. In the non-GCB subtype, LR, the combined LIR+HIR and HR had a 5-year OS of, 97%, 82% and 35% respectively. GELTAMO-IPI identifies a genuine poor outcome group of patients in the DLBCL non-GCB subtype.

Published
2018

32. New Prognosis Score Including Absolute Lymphocytes/Monocytes Ratio and Beta2microglobulin in Patients with Diffuse Large B Cell Lymphoma (DLBCL) Treated with R-CHOP: Spanish Lymphoma Group Experience (GELTAMO)

Author

Mariana Bastos, Mario Gutiérrez Rodríguez, Azueg Hong, Gilberto Barranco, Juan-Manuel Sancho, José María Sánchez-Pina, Raul Cordoba, Jordi Martinez-Serra, Mónica Baile, Silvana Novelli, Ana Maria Martin Moreno, Alejandro Martín, Antonio Díaz-López, Pau Abrisqueta, Jose Rodriguez, Leyre Bento, Hugo Daniel Luzardo Henriquez, Daniel F. Garcia, Antonio Gutierrez, Sonia González de Villambrosia, Maria J. Rodriguez-Salazar, Marta Garcia Recio, Raquel Del Campo, Olga García, and Antonio Salar

Subjects
0301 basic medicine, Oncology, medicine.medical_specialty, education.field_of_study, Proportional hazards model, business.industry, Immunology, Population, Red blood cell distribution width, Cell Biology, Hematology, medicine.disease, Biochemistry, Log-rank test, 03 medical and health sciences, 030104 developmental biology, Median follow-up, Internal medicine, medicine, Progression-free survival, business, education, Diffuse large B-cell lymphoma, Survival analysis
Abstract

Introduction DLBCL is the most common non-Hodgkin lymphoma and a heterogeneous subtype from the biological and clinical point of view. 20-40% of the patients relapse so it is important to identify a high risk population that could benefit from different therapeutic approaches. For this purpose, several scores have been developed. The IPI has been the most widely used but lacks the ability to identify this very high risk population in Rituximab era. Low absolute lymphocyte count and high levels of blood monocytes have shown to be unfavorable risk factors. The red cell distribution width (RDW) has been associated with aging and active inflammatory processes and beta-2-microglobulin (B2M) with tumor load and proliferation as well as comorbidities such as kidney failure. All these variables are easily obtainable at the time of diagnosis. Patients and methods From the national database of GELTAMO-IPI Project, we selected those patients with DLBCL homogeneously treated with R-CHOP ± radiotherapy. The complete blood count (CBC) values were standardized using the normal reference values of each centre. The survival analysis was estimated with Kaplan-Meier method. The comparison between variables was performed through Log-Rank test and multivariate analysis with Cox regression. The CBC quantitative variables cut points were calculated through MAXSTAT. A new prognosis score was generated taking into account the results of multivariate analysis for progression free survival (PFS), spliting the sample in two cohorts (discovery and validation). Results Nine hundred and ninety-two patients with DLBCL were retrospectively analyzed with a median follow up of 55 months (12-185). The characteristic of the patients are summarized in table 1. In the multivariate analysis, age, ECOG, stage, bulky mass, B2M, RDW and lymphocytes/monocytes ratio (LMR) were significantly independent variables for PFS. A new prognosis score was generated with these variables including age categorized in 3 groups (18-64, 65-80 y >80) with 0, 1 y 2 points, ECOG>3-4 with 2 points, stage III-IV, bulky mass, high B2M, LMR0.96 with 1 point each for a maximum of 9. This score could improve the discrimination of a very high risk subgroup with a 5-year PFS of 17% (Figure 1) versus 45%, 52%, 32% or 29% of R-IPI, NCCN-IPI, R-TS and GELTAMO-IPI, respectively and 5-year overall survival (OS) of 20% (Figure 2) versus 59%, 46%, 45% and 40% for R-IPI, NCCN-IPI, R-TS and GELTAMO-IPI. Conclusion A new prognosis score including easily obtainable CBC variables (LMR and RDW) and B2M is presented. This score identifies a high risk population both for PFS and OS in comparison with other scores for DLBCL. The addition of other biological or image markers could improve these results. Disclosures Martín: Roche: Consultancy, Honoraria, Other: Travel expenses; Janssen: Honoraria, Other: Travel expenses; Celgene: Consultancy, Honoraria, Other: Travel expenses; Servier: Honoraria, Other: Travel expenses. Sancho:SERVIER: Honoraria; JANSSEN: Honoraria, Speakers Bureau; MUNDIPHARMA: Honoraria; SANOFI: Honoraria; GILEAD: Honoraria, Research Funding; KERN FHARMA: Honoraria, Speakers Bureau; CELGENE: Honoraria; ROCHE: Honoraria, Speakers Bureau.

Published
2018
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33. [Isolated bacteria from nasal cultures. Are they important in patients with acute leukemia?]

Author

Gilberto, Barranco-Lampón, Carlos Alberto, Mendoza-García, Silvia, Cabrera-Osuna, Irma, Olarte-Carrillo, Yanet, Ventura, Mario, Gutiérrez-Romero, Carlos, Martínez-Murillo, Adolfos, Martínez-Tovar, and Christian Omar, Ramos-Peñafiel

Subjects
Leukemia, Myeloid, Acute, Nasal Mucosa, Cross-Sectional Studies, Bacteria, Humans, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Retrospective Studies
Abstract

The nasal colonization by Staphylococcal (epidermidis or aureus) is frequent and it has importance when it is associated to bacteremia in immunocompromised patients. The objective was to determine the frequency of strains that colonize the nasal mucosa in patients with leukemia and its relationship with peripheral blood cultures.A retrospective, observational, transversal, retrolective study was done. We analyzed the weekly results of nasal cultures and peripheral blood cultures in patients with leukemia undergoing chemotherapy. The chi-squared test and odds ratio value were estimated in the statistical analysis.We included 67 patients, 55 of them with acute lymphocytic leukemia (ALL); 28.5 % of the cultures (n = 47) corresponded to a positive nasal culture. Staphylococcus epidermidis and Staphylococcus aureus were the most isolated bacteria. During the first week of treatment, the positive cultures were the most frequently. All the samples isolated were sensitive to vancomycin or linezolid. It was established only the association between negative nasal cultures and negative peripheral blood cultures (p = 0.0005). Odds ratio for positive nasal cultures and the risk of bacteremia was 0.0269.The frequency of the positive bacteria culture was low, with an adequate sensitivity measure. The presence of bacteria in nasal culture was not identified as a risk factor for the occurrence of bacteremia.INTRODUCCIÓN: la colonización nasal por Staphylcoccus epidermidis y Staphylococcus aureus es frecuente y se ha relacionado con bacteremia en huéspedes inmunocomprometidos. En la investigación que se presenta, los objetivos fueron determinar la frecuencia de cepas que colonizan la mucosa nasal en pacientes en tratamiento de leucemia aguda y su relación con los cultivos de sangre periférica. MÉTODOS: estudio retrospectivo, observacional, transversal, retrolectivo de cultivos nasales obtenidos durante cuatro semanas. La relación con los hemocultivos se estableció mediante chi cuadrada; se calculó razón de momios.se estudiaron 67 casos, en su mayoría con leucemia linfoblástica aguda (n = 55). De 165 cultivos nasales, 28.5 % fue positivo (n = 47). Las principales bacterias identificadas fueron Staphylcoccus epidermidis y Staphylococcus aureus. La primera semana de tratamiento fue el principal momento de aislamiento. Todas las cepas fueron sensibles a vancomicina o linezolid. Se estableció relación entre los cultivos nasales y los hemocultivos negativos (p = 0.0005). La razón de momios para los cultivos nasales positivos respecto a los hemocultivos y el riesgo de bacteremia fue de 0.0269 (IC 95 % = 0.0016, 0.4484).se aislaron pocas bacterias en la mucosa nasal, y la sensibilidad de estas a los antibióticos fue adecuada. La presencia de bacterias en la mucosa nasal no fue un factor de riesgo para la aparición de bacteremia.

Published
2014

34. Relapsed ACUTE Leukemia after Hematopoietic STEM CELL Transplantation

Author

Jhohan Estuardo Vásquez Diaz, Luis Manuel Valero-Saldaña, Gilberto Barranco, Silvia Rivas-Vera, and Brenda Lizeth Acosta-Maldonado

Subjects
medicine.medical_specialty, Acute leukemia, Allogeneic transplantation, business.industry, medicine.medical_treatment, Immunology, Cell Biology, Hematology, Hematopoietic stem cell transplantation, medicine.disease, Biochemistry, Gastroenterology, Minimal residual disease, Chemotherapy regimen, Surgery, Transplantation, Regimen, Leukemia, Internal medicine, medicine, business
Abstract

BACKGROUND In recent decades the results in the treatment of acute leukemia's have improved, this due to the optimization of chemotherapy regimens, risk stratification, monitoring of minimal residual disease, development of new agents and best supportive care. Allogeneic hematopoietic stem cell transplantation (HSCT) is a standard option for patients at high risk of relapse. Allogeneic hematopoietic stem cell transplantation (HSCT) is a standard option for patients at high risk relapse. However, patients who relapse after transplantation have a poor prognosis because of subsequent treatments do not confer a success survival. The EBMT has reported a 5.5 months median survival after relapse, overall survival of 8% of ALL and 10-20% to AML to 3 years. AIMS Report outcomes of patients with relapsed acute leukemia after hematopoietic stem cell transplantation (HSCT). METHODS Retrospective analysis of our hematopoietic stem cell transplantation database was undertaken, containing 81 patients with acute leukemia presenting of a period of 10 years. RESULTS We Identified 81 patients, 47 (58%) were men. Median age for ALL was 20 years (7-55 yr) and for AML patients was 34 (15-64yr). ALL was the most frequent diagnosis (61%), 28 patients had AML (35%), other leukemias (4%). 44% patients with ALL had Ph'Chr+. 60% of all patients underwent myeloablative regimen transplantation in first CR and 30% in second remission. The 95% of HSCT was performed allogeneic transplantation and the rest was autologous. In most cases the source of stem cells was peripheral blood. Post-transplant relapse occurred in 51% and 54% of patients with ALL and AML, 10 and 12 months respectively. A total of 6 patients was underwent to second transplant with reduce intensity regimen with very poor response. Table 1 was shows the principal features of patients. Table 1. CHARACTERISTIC ALL=49 % (n) AML =28 % (n) Other leukemia =3 % (n) Age at HSCTMedian (Range) 22 (15-55) 34 (17-64) 18 (16-35) Response before HSCT First CR 63 (31) 53 (15) 100 (3) Second CR 29 (14) 36 (10) 0 Third or more CR 2 (1) 4 (1) 0 Active disease 2 (1) 7 (2) 0 Allogeneic 98% (48) 93 (26) 66.7 (2) Autologous 2 (1) 7.1 (2) 33.2 (1) GVHD Acute 26.5 (13) 17.9 (5) 22.2 (1) Chronic 22.9 (11) 39.3 (11) 0 Relapsed Media time at relapsed 51 (25) 10 months 53.6 (15) 12 months 66.7 (2) Post-Relapse Treatment Without treatment Palliative CT Cytotoxic CT 32 (8) 24 (6) 44 (11) 26.7 (4) 13.3 (2) 60 (9) 0 100 (2) Response after re-induction CT CR Active disease 20 (5) 48 (12) 32 (8) 33.3 (5) 33.3 (5) 33.3 (5) 0 100 (2) 0 Second HSCT 4.1 (2) 14.3 (4) Relapsed at second HSCT 50 (1) 50 (2) Outcome Alive Dead 55.1 (27) 44.9 (22) 39.3 (11) 60.7 (17) 33.3 (1) 66.7 (2) 3-years OS 5-years OS Median 56% 43% 50 months A 3 years 44% A 5 years 34% 36 months 20 months RFS 1-year Median 56% 22 months 28% 5 Months 33% 10 months NRM Mortality to relapse 9.5 (2) 90.5 (19) 23.5 (4) 76.5 (13) O 100 (2) CONCLUSION Our results confirm that treatment options for high risk acute leukemic patients who relapse early after HSCT are limited with extremely poor prognosis, special in patient relapsed early post-transplant. More studies are needed to determinate the best treatment option for patient who relapse after HSCT. Disclosures No relevant conflicts of interest to declare.

Published
2015
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