RESUMO
BACKGROUND: Treating B-non-Hodgkin lymphoma (B-NHL) in lower-income countries is challenging because of imprecise diagnosis, the increased risk of fatal toxicity associated with advanced disease at presentation, and limited supportive care. PROCEDURE: Central American patients with newly diagnosed stage I or II B-NHL received a modified Berlin-Frankfurt-Münster (BFM) regimen including a prephase (prednisone, cyclophosphamide) followed by A/B/A courses (A: cytarabine, dexamethasone, etoposide, ifosfamide, methotrexate, and intrathecal therapy; B: cyclophosphamide, dexamethasone, doxorubicin, methotrexate, and intrathecal therapy). Those with stage III or IV NHL received additional courses (B/A/B), intensified for stage IV disease by additional vincristine and methotrexate doses. Patients in poor condition received a second prephase treatment before their chemotherapy courses. RESULTS: Between March 2004 and June 2016, of 405 patients with B-NHL, 386 (109 females) were eligible for treatment. Immunohistochemistry was performed in 177 cases (47.4%) and characterized the disease as mature B-cell lymphoma. Stage distribution was as follows: I/II, 31 (8.1%); III, 252 (65.3%); IV, 93 (24.1%); 10 (2.6%) not available. The 3-year overall survival was 70% for the whole group (86% for stages I/II, 75% for stage III, 58% for stage IV). Events included death during induction (34 patients, 8.8%), relapse/progression (46, 11.9%), death in remission (9, 2.3%), second malignancy (1, 0.26%), and death of unknown cause (1, 0.26%). Twenty-three (6%) patients abandoned or refused therapy. CONCLUSIONS: Approximately 70% of children with B-NHL from Central America experienced long-term, disease-free survival with a modified BFM schedule. Toxic death and relapse/resistant disease were the main reasons for treatment failure.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma não Hodgkin/mortalidade , Adolescente , América Central , Criança , Pré-Escolar , Feminino , Seguimentos , Hematologia , Humanos , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/patologia , Masculino , Prognóstico , Taxa de SobrevidaRESUMO
Se realizó un estudio descriptivo, transversal y de prevalencia para la deteminación de la frecuencia de la hemoglobinopatía "S" (Hb S) en la población de raza negra que acudió al Hospital Paredes de Trujillo, Colón, de Septiembre de 1990 a Marzo de 1991. Se muestrearon a un total de 829 pacientes de dicha raza distribuidos de la siguiente manera: 266 (32.09//) correspondieron al sexo masculino y 563 (67.91//) al sexo femenino; El mayor porcentaje de pacientes estudiados estaba comprendido entre los 1 y los 29 años de edad con 648 (78.17//) muestras. A todas las muestras se les practicó la prueba de inducción de drepanocitos con metabisulfito de sodio encontrándose un total de 69 (8.32//) muestras positivas a las cuales posteriormente se les realizaron hemolizados con tolueno y luego la prueba de electroforesis de hemoglobina en acetato de celulosa. De las 69 muestras, 54(6.51//) presentaban alteraciones en sus patrones electroforéticos correspondiendo 44 (5.30//) a la hemoglobinopatía SA (HB SA), 9 (1.08//) a la hemoglobinopatía SS (Hb SS) y 1 (0.12//) a la hemoglobinopatía doble heterocigota SC (Hb SC). Los 15 casos restantes presentaron patrones electroforáticos normales