RESUMEN
BACKGROUND: In Mexico, patients with hematologic malignancies (HMs) are characterized by being at high risk and advanced stages at diagnosis and by having a low cure rate; yet information on their experiences with health care and health-related quality of life (HRQL) is scarce. We aimed to evaluate experiences with health care and HRQL of patients with HMs and the association between these patient-reported measures. METHODS: We conducted a cross-sectional survey in two public oncology hospitals in Mexico City. The study included outpatient cancer patients aged ≥18 years with a diagnosis of leukemia, lymphoma, or multiple myeloma. We used a patient-centered quality of cancer care questionnaire to assess patient experiences with receiving 1) timely care; 2) clear information; 3) information for treatment decision-making; 4) care to address biopsychosocial needs; and 5) respectful and coordinated care. We applied the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) to measure HRQL. We performed a multiple linear regression to evaluate the association between patient-reported experiences (independent variables) and the QLQ-C30 summary score (dependent variable). RESULTS: Of the 515 participating HM patients, 46.6% had lymphoma, 34% leukemia, and 19.4% multiple myeloma; 70.9% were at advanced stages or at high risk. Additionally, 15.1% had anxiety and 12.8% had depression. Over one third (35.9%) reported receiving clear information, 28.5% timely care, 20.6% information for treatment decision-making, 23.7% care that addressed their biopsychosocial needs, and 31% respectful and coordinated care. The mean QLQ-C30 summary score was 71.9 points. Timely care, clear information, and care that addresses biopsychosocial needs were associated with higher HRQL. CONCLUSIONS: Health care services for HM patients at public oncology hospitals in Mexico need improvement. Notably, providing timely care, clear information, and care that addresses patients' biopsychosocial needs can increase the likelihood of better HRQL. Health care providers should measure and improve the experiences of HM patients with health care.
Asunto(s)
Neoplasias Hematológicas/epidemiología , Atención Dirigida al Paciente/estadística & datos numéricos , Calidad de la Atención de Salud/estadística & datos numéricos , Calidad de Vida , Adulto , Anciano , Ansiedad/epidemiología , Estudios Transversales , Atención a la Salud , Depresión/epidemiología , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
BACKGROUND: The incidence of acute leukemia (AL) has increased. Its prognosis is variable and depends on several baseline characteristics with a highly heterogeneous presentation. In Mexico, large-scale descriptive studies have not yet been published; the objective of this study was to analyze the initial basic characteristics of patients diagnosed with AL in our population. PATIENTS AND METHODS: In this multicenter, retrospective study, 1018 patients ≥ 16 years of age and diagnosed with AL between 2009 and 2014, were included. We described age, gender, complete blood count, and AL subtype according to flow cytometry analysis. RESULTS: Acute lymphoblastic leukemia (ALL) was as common as acute myeloid leukemia (AML) (51% vs. 49%). The median age was 31 years. Only 9.6% of patients with ALL were positive for the Philadelphia chromosome. No gender differences were observed. The median age at presentation of AML was 43 years. Acute promyelocytic leukemia was the most frequent AML subtype (38.3%), with a median age of 37 years. CONCLUSION: ALL is equally as frequent as AML in patients ≥16 years of age. Philadelphia-positive prevalence is less frequent than that reported in literature. AML cases occur in a younger age in comparison with other countries. There is a higher rate of acute promyelocytic leukemia among our patients compared with other non-Latin American populations. This study is the largest ever performed in Mexico regarding descriptive AL data.
Asunto(s)
Leucemia Mieloide Aguda/epidemiología , Enfermedad Aguda/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Incidencia , Leucemia Mieloide Aguda/genética , Masculino , México , Persona de Mediana Edad , Cromosoma Filadelfia , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiología , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Pronóstico , Estudios Retrospectivos , Adulto JovenRESUMEN
OBJECTIVE: to compare the frequency of acute leukemia in two periods of study in a reference Hospital at Mexico City. METHODS: it was an observational study. There were registered 250 cases with the morphology diagnostic criterion of acute leukemia. RESULTS: 63 cases versus 92 of acute lymphoid leukemia (ALL) and 16 versus 79 acute myeloid leukemia (AML) of 1990-1992 versus 2008-2009 respectively was observed; corresponding to 62 % in total of ALL in both periods and 38 % of AML. The ALL was the most frequent variant (62 % versus 38 %). The median age was 26 years, male 52 %. It showed a significant increase in the number of admissions in the period of 2008-2009 and acute promyelocytic leukemia also showed an increase (p = 0.001). CONCLUSIONS: acute leukemia is the main cause of admission, mortality and morbidity. Our study differs slightly from the literature; the leukemia that diagnostic with major frequency was the acute lymphoid leukemia increasing his number in the period of 2008-2009. The significant rise due to an increase use of new diagnostic tools such as the flow cytometry and molecular biology.