RESUMEN
BACKGROUND: COVID-19 has been associated with negative results in patients with A blood group and with a better evolution in O blood group individuals. AIM: Because the evidence regarding ABO blood groups and COVID was empirically not that clear in our country, we tested the association regarding COVID-19 and blood groups. MATERIAL AND METHODS: Adult patients were enrolled in this prospective, case-control, observational multicenter study. Patients with a confirmed diagnosis of COVID-19 were assigned to one of three groups based on the clinical presentation of the infection. Age, gender, ABO and Rh blood groups, body mass index, history of diabetes mellitus or high blood pressure, and smoking were recorded directly or from their clinical charts. ABO blood group was obtained from 5,000 blood donors (50% each gender). Atherothrombotic variables were compared with a nation-wide data collection. RESULTS: A total of 2,416 patients with COVID-19 were included (women:39.6%; men:60.4%). There were no significant differences between cases and controls in terms of age. O blood group was the most frequently found in healthy donors and COVID-19 patients, but this blood group was significantly higher in COVID-19 patients vs. healthy donors. ABO blood group was not associated with the final health status in COVID-19 patients. Obesity, diabetes mellitus, hypertension and smoking were significantly more frequent among COVID-19 patients. CONCLUSION: The proposed protective effect of the O blood group in COVID-19 patients could not be reproduced in the Mexican population while some atherothrombotic risk factors had a significant effect on the clinical evolution.
Asunto(s)
Sistema del Grupo Sanguíneo ABO , COVID-19 , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Estudios Prospectivos , Estudios Retrospectivos , SARS-CoV-2RESUMEN
BACKGROUND: Despite novel therapies, multiple myeloma (MM) remains an incurable malignancy, daratumumab (DARA) being a major game changer, may be a good option for treatment. AIMED OF THE STUDY: To assess the prescription patterns of DARA in patients with MM in Mexico. METHODS: 47 patients with MM were analyzed in 13 different hospitals in Mexico. RESULTS: Five (10.5%) of patients received DARA as first line therapy, 13 (27.5%) as second line, whereas 29 (62%) received its in ≥3rd line. In 32% DARA was used in combination with dexamethasone, 64% received DARA on a triple combination, and 4% as a 4 drug combination. Eighty three percent of patients had a response, including 32% in complete remission. Progression free survival (PFS) was higher in patients in ISS stage 1, and in patients achieving ≥PR. Overall survival (OS) was lower in patients not achieving ≥PR, in patients having increased LDH, and extramedullary disease. Grade 1-2 infusion related reactions were present in 34%, and grade 3-4 neutropenia and lymphopenia in 25 and 17% of the patients. CONCLUSIONS: In Mexico, 62% of patients with MM received DARA as a third or further line of treatment. DARA employed as a doublet or triplet combination is useful in relapsed/refractory patients with tolerable adverse events.
Asunto(s)
Mieloma Múltiple , Anticuerpos Monoclonales , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Humanos , México , Mieloma Múltiple/tratamiento farmacológico , PrescripcionesRESUMEN
Non-Hodgkin lymphoma comprises a heterogeneous group of haematological malignancies, classified according to their clinic, anatomic-pathological features and, lately, to their molecular biomarkers. Despite the therapeutic advances, nearly half of the patients will die because of this disease. The new diagnostic tools have been the cornerstone to design recent therapy targets, which must be included in the current treatment guidelines of this sort of neoplasms by means of clinical trials and evidence-based medicine. In the face of poor diagnoses devices in most of the Mexican hospitals, we recommend the present diagnose stratification, and treatment guidelines for non-Hodgkin lymphoma, based on evidence. They include the latest and most innovative therapeutic approaches, as well as specific recommendations for hospitals with limited framework and therapy resources.
Asunto(s)
Linfoma no Hodgkin/diagnóstico , Linfoma no Hodgkin/terapia , Humanos , MéxicoRESUMEN
Objetivo: Determinar el valor pronóstico del inmunofenotipo pre B con sus variantes en la respuesta temprana al tratamiento de la leucemia aguda linfoblástica pediátrica, ajustando edad y cifra de leucocitos inicial. Pacientes y método: Se realizó un estudio de casos y controles anidado en una cohorte con pacientes menores de 15 años de edad, de los dos géneros, con leucemia aguda linfoblástica pre B de diagnóstico reciente. Se utilizó un panel de anticuerpos monoclonales específicos de la estirpe B, T, monocito mielocito y megacariocítica. Se evaluó la respuesta después de 14 días de tratamiento mediante aspirado de médula ósea. Resultados: Se incluyeron 54 pacientes. La mediana de edad fue de 7 años (2 m 14 años), la mediana de cifra de leucocitos fue 13,450/mm³ (1200-986,000/mm³). Se identificaron 29 casos con inmunofenotipo Pre B tardío, 19 casos pre B común y 6 casos de pre B precoz. Once pacientes presentaron antígenos mieloides asociados. Se encontró asociación significativa (p=0.034) entre respuesta temprana y la presencia de antígenos mieloides. No se demostró asociación entre las variantes del inmunofenotipo pre B, edad y cifra de leucocitos con la respuesta temprana (p=0.264). Conclusiones: Es necesario estudiar directamente la respuesta tem prana al tratamiento en los niños con leucemia linfoblástica ya que en nuestra muestra de pacientes los factores clínicos y el inmunofenotipo no fueron predictivos de ésta.
Objective: To determine the prognostic value of pre B immunophenotype and its variants on early treatment response among of acute pediatric lymphoblast leukemia. Patients and methods: A case control study nested in a cohort was carried out with male and female patients 15 years and younger with recently diagnosed pre B lymphoblast leukemia. A panel of B, T, monoclonal antibodies of the myelo monocytic and megakaryocytic cell type was used. Response was assessed by bone marrow aspiration 14 days post treatment. Results: 54 patients were included. The median age was 7 years (2 months - 14 years) median leukocyte count was 13,450/mm3 (1200-986,000/mm3). We identified 29 cases with late pre B immune phenotype, 19 cases with common pre B and 6 cases with early pre B immunophenotype. Eleven patients also displayed myeloid antigens. A significant association (p=0.034) was found between early treatment response and the presence of myeloid antigens. No association was found between the pre B immunophenotype, age and leukocyte count with early treatment response (p=0.264). Conclusions: We need to pay special emphasis on early treatment response in children with lymphoblast leukemia as our study did not corroborate the common finding that clinical factors and immune phenotype can be predictive factors.