RESUMO
The purpose of this study was to evaluate DNA damage in the whole genome of peripheral blood leukocytes from patients with acute myeloid leukemia (AML) compared with a control group using DNA breakage detection-fluorescent in situ hybridization (DBD-FISH). Our results suggest that the DNA damage detected in patients with newly diagnosed AML was similar to that observed for the controls; this might be explained by the stimulation of a repair pathway by the pathogenesis itself. These findings indicate that inhibiting the repair pathway could be proposed to enhance the efficacy of chemotherapy.
Assuntos
Dano ao DNA , Leucemia Mieloide Aguda/fisiopatologia , Adulto , Humanos , México , Pessoa de Meia-IdadeRESUMO
Objectives. To investigate the association between the maternal alcohol consumption during pregnancy and early age leukemia (EAL) in offspring. Methods. Datasets were analyzed from a case-control study carried out in Brazil during 1999-2007. Data were obtained by maternal interviews using a standardized questionnaire. The present study included 675 children (193 acute lymphoid leukemia (ALL), 59 acute myeloid leukemia (AML), and 423 controls). Unconditional logistic regression was performed, and adjusted odds ratios (adj. OR) on the association between alcohol consumption and EAL were ascertained. Results. Alcohol consumption was reported by 43% of ALL and 39% of AML case mothers and 35.5% of controls'. Beer consumption before and during pregnancy was associated with ALL in crude analysis (OR = 1.54, 95% CI, 1.08-2.19), although in adjusted analysis no statistical significance was found. For weekly intake of ≤1 glass (adj. OR = 1.30, 95% CI, 0.71-2.36) and ≥1 glass/week (adj. OR = 1.47, 95% CI, 0.88-2.46) a potential dose-response was observed (P trend < 0.03). Conclusion. This study failed to support the hypothesis of an increased risk of EAL associated with maternal alcohol intake during pregnancy, neither with the interaction with tobacco nor with alcohol consumption.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Leucemia Mieloide Aguda/epidemiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/fisiopatologia , Brasil , Feminino , Humanos , Lactente , Leucemia Mieloide Aguda/fisiopatologia , Masculino , Exposição Materna , Mães , Leucemia-Linfoma Linfoblástico de Células Precursoras/fisiopatologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Fatores de RiscoRESUMO
OBJECTIVE: The aim of this study was to assess the pulmonary function of children with acute leukemia. METHODS: Cross-sectional observational analytical study that enrolled 34 children divided into groups A (17 with acute leukemia in the maintenance phase of chemotherapy) and B (17 healthy children). The groups were matched for sex, age and height. Spirometry was measured using a spirometer Microloop Viasys(®) in accordance with American Thoracic Society and European Respiratory Society guidelines. Maximal respiratory pressures were measured with an MVD300 digital manometer (Globalmed(®)). Maximal inspiratory pressures and maximal expiratory pressures were measured from residual volume and total lung capacity, respectively. RESULTS: Group A showed a significant decrease in maximal inspiratory pressures when compared to group B. No significant difference was found between the spirometric values of the two groups, nor was there any difference between maximal inspiratory pressure and maximal expiratory pressure values in group A compared to the lower limit values proposed as reference. CONCLUSION: Children with acute leukemia, myeloid or lymphoid, during the maintenance phase of chemotherapy exhibited unchanged spirometric variables and maximal expiratory pressure; However, there was a decrease in inspiratory muscle strength.
Assuntos
Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/fisiopatologia , Quimioterapia de Manutenção , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/fisiopatologia , Espirometria , Criança , Estudos Transversais , Feminino , Humanos , MasculinoRESUMO
Protease-activated receptor 1 (PAR-1) is a G-protein-coupled receptor that is overexpressed in solid tumors, being associated with several pro-tumoral responses including primary growth, invasion, metastasis and angiogenesis. Expression of PAR-1 in human leukemic cell lines is reported but the status of its expression in human leukemic patients is currently unknown. In this study we evaluated the expression pattern of PAR-1 in patients with the four main types of leukemia - chronic lymphocytic leukemia subtype B (B-CLL), acute lymphoblastic leukemia subtype B (B-ALL), acute myeloid leukemia (AML) and chronic myeloid leukemia (CML). Flow cytometry analyses show that lymphocytes from B-CLL patients express this receptor at similar levels to healthy individuals. On the other hand, it was observed a significant increase in PAR-1 expression in B-ALL lymphocytes as compared to B-CLL and healthy donors. Flow cytometric and real-time PCR demonstrated a significant increase in PAR-1 expression in granulocytes from CML patients in blast phase (CML-BP) but not in chronic phase (CML-CP) as compared to healthy donors. Finally, a significant increase in PAR-1 expression has been also observed in blasts from AML (subtypes M4 and M5) patients, as compared to monocytes or granulocytes from healthy donors. We conclude that PAR-1 might play an important biological role in aggressive leukemias and might offer additional strategies for the development of new therapies.
Assuntos
Regulação Leucêmica da Expressão Gênica , Leucemia/fisiopatologia , Receptor PAR-1/metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Leucemia Linfocítica Crônica de Células B/fisiopatologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/fisiopatologia , Leucemia Mieloide Aguda/fisiopatologia , Masculino , Pessoa de Meia-Idade , Leucemia-Linfoma Linfoblástico de Células Precursoras/fisiopatologia , Receptor PAR-1/genética , Adulto JovemRESUMO
The granulocyte colony-stimulating factor (G-CSF) plays an important role in normal granulopoiesis. Its functions are mediated by specific receptors on the surface of responsive cells and, upon ligand binding, several cytoplasmic tyrosine kinases are activated. The cytoplasmic region proximal to the membrane of the G-CSF receptor (G-CSF-R) transduces proliferative and survival signals, whereas the distal carboxy-terminal region transduces maturation signals and suppresses the receptor's proliferative signals. Mutations in the G-CSF-R gene resulting in truncation of the carboxy-terminal region have been detected in a subset of patients with severe congenital neutropenia who developed acute myelogenous leukemia (AML). In addition, the AML1-ETO fusion protein, expressed in leukemic cells harboring the t(8;21), disrupt the physiological function of transcription factors such as C/EBPalpha and C/EBPepsilon, which in turn deregulate G-CSF-R expression. The resulting high levels of G-CSF-R and G-CSF-dependent cell proliferation may be associated with pathogenesis of AML with t(8;21). Moreover, in vitro and in vivo studies demonstrated that G-CSF may act as a co-stimulus augmenting the response of PML-RARalpha acute promyelocytic leukemia cells to all-trans-retinoic acid treatment. Finally, in the PLZF-RARalpha acute promyelocytic leukemia transgenic model, G-CSF deficiency suppressed leukemia development. Altogether, these data suggest that the G-CSF signaling pathway may play a role in leukemogenesis.
Assuntos
Fator Estimulador de Colônias de Granulócitos/fisiologia , Leucemia Mieloide Aguda/fisiopatologia , Cromossomos Humanos Par 21 , Cromossomos Humanos Par 8 , Humanos , Recém-Nascido , Leucemia Mieloide Aguda/genética , Neutropenia/fisiopatologia , Translocação GenéticaRESUMO
En las últimas décadas la medicina evolucionó hacia un enfoque molecular en la búsqueda de blancos específicos que permitan seguir adecuadamente la progresión de las patologías neoplásicas y desarrollar terapias exitosas. El conocimiento y comprensión de que la matriz extracelular (MEC) que rodea a un tumor influye sobre el comportamiento del mismo, reveló la importancia que cumplen las metaloproteinasas (MMPs) en la regulación de los componentes de la MEC, y por lo tanto en el desarrollo tumoral. Es por ello que actualmente se está evaluando la eficacia de inhibidores sintéticos de estas enzimas en ensayos clínicos, algunos ya en fase clínica III de investigación. También se propone que estas MMPs podrían ser utilizadas como marcadores bioquímicos, permitiendo evaluar la progresión de la enfermedad en pacientes que sufren patologías neoplásicas, e incluso dar un valor pronóstico. Es en este punto en que el laboratorio de análisis clínicos cumplirá un papel fundamental y deberá contar con los conocimientos y las herramientas necesarias para evaluar la presencia y actividad de estas enzimas. En este trabajo se expone el conocimiento actual de la estructura y funciones biológicas de las MMPs así como los antecedentes que muestran el papel que cumplen en las enfermedades neoplásicas, en especial en leucemias y linfomas (AU)
Assuntos
Humanos , Biomarcadores Tumorais , Neoplasias/fisiopatologia , Neoplasias Experimentais/fisiopatologia , Leucemia/fisiopatologia , Linfoma/fisiopatologia , Neovascularização Patológica/etiologia , Fatores de Crescimento Endotelial/sangue , Neoplasias/enzimologia , Neoplasias/irrigação sanguínea , Neoplasias Experimentais/enzimologia , Leucemia/enzimologia , Linfoma/enzimologia , Progressão da Doença , Neovascularização Patológica/fisiopatologia , Regulação Neoplásica da Expressão Gênica , Invasividade Neoplásica/fisiopatologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/enzimologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/fisiopatologia , Leucemia Mieloide Aguda/enzimologia , Leucemia Mieloide Aguda/fisiopatologia , Transtornos Linfoproliferativos , Metástase Neoplásica/fisiopatologiaAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Citarabina/farmacologia , Etoposídeo/farmacologia , Folículo Piloso/efeitos dos fármacos , Folículo Piloso/crescimento & desenvolvimento , Idarubicina/farmacologia , Leucemia Mieloide Aguda/tratamento farmacológico , Pré-Escolar , Feminino , Humanos , Leucemia Mieloide Aguda/fisiopatologiaRESUMO
CONTEXT: Malnutrition in childhood cancer is commonly a serious problem. Changes in blood zinc and copper have also been found in malignant diseases. OBJECTIVE: To describe the protein-energy nutritional status and serum zinc and copper of children with newly diagnosed leukemia. DESIGN: Cross-sectional study. SETTING: University referral center. PARTICIPANTS: 23 children with newly diagnosed acute lymphocytic leukemia (ALL) or acute non-lymphocytic leukemia (ANLL) between the ages of 1 and 10 years. The control subjects were 31 healthy school children of similar age from local schools. MAIN MEASURES: Anthropometric measurements of height/age and weight/height, food intake and serum levels of zinc and copper. RESULTS: Almost the entire group of children were eutrophic. Zinc and copper intake were below the recommended values. Serum zinc levels were significantly lower and serum copper levels were significantly higher in the leukemic group when compared to normal children. CONCLUSION: At the time of diagnosis the children suffering from leukemia were not overtly malnourished but blood analysis showed alterations in concentrations of the trace elements zinc and copper.
Assuntos
Cobre/sangue , Leucemia Mieloide Aguda/sangue , Avaliação Nutricional , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Zinco/sangue , Distribuição por Idade , Antropometria , Criança , Pré-Escolar , Estudos Transversais , Proteínas Alimentares/administração & dosagem , Ingestão de Energia , Feminino , Humanos , Lactente , Recém-Nascido , Leucemia Mieloide Aguda/fisiopatologia , Masculino , Estado Nutricional , Leucemia-Linfoma Linfoblástico de Células Precursoras/fisiopatologiaRESUMO
OBJECTIVE: To evaluate the association of somatic growth from birth through diagnosis with the development of childhood cancer. METHODS: The weights and heights of 1718 children with cancers were determined and converted into standard deviation (SD) scores, both at birth and at diagnosis, by using the means and SD values of the general population. RESULTS: Among patients with neuroblastoma and acute lymphoblastic leukemia, the percentages of children with body weight and height over mean + 2 SDs were significantly higher at diagnosis than the expected value in the general population. The percentage of children with neuroblastoma and body weight over mean + 2 SD increased significantly from birth through diagnosis (P =.04). Although the medians of weight SD scores decreased from birth through diagnosis in patients with representative cancers except for neuroblastoma, the value significantly increased in patients with neuroblastoma diagnosed before 1 year of age (P =.03), especially in those whose cancer was detected by mass screening at 6 months of age (P <.01). CONCLUSIONS: Rapid somatic growth from birth through diagnosis in patients with neuroblastoma diagnosed before 1 year of age suggests a possible involvement of certain growth factors in these patients.
Assuntos
Crescimento , Neuroblastoma/fisiopatologia , Peso ao Nascer , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Japão/epidemiologia , Leucemia Mieloide Aguda/epidemiologia , Leucemia Mieloide Aguda/fisiopatologia , Masculino , Neuroblastoma/diagnóstico , Neuroblastoma/epidemiologia , Fatores de Risco , Estatísticas não ParamétricasRESUMO
Context: Malnutrition in childhood cancer is commonly a serious problem. Changes in blood zinc and copper have also been found in malignant diseases. Objective: To describe the protein-energy nutritional status and serum zinc and copper of children with newly diagnosed leukemia. Design: Cross-sectional study. Setting: University referral center. Participants: 23 children with newly diagnosed acute lymphocytic leukemia (ALL) or acute non-lymphocytic leukemia (ANLL) between the ages of 1 and 10 years. The control subjects were 31 healthy school children of similar age from local schools. Main measures: Anthropometric measurements of height/age and weight/height, food intake and serum levels of zinc and copper. Results: Almost the entire group of children were eutrophic. Zinc and copper intake were below the recommended values. Serum zinc levels were significantly lower and serum copper levels were significantly higher in the leukemic group when compared to normal children. Conclusion: At the time of diagnosis the children suffering from leukemia were not overtly malnourished but blood analysis showed alterations in concentrations of the trace elements zinc and copper.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Zinco/sangue , Leucemia Mieloide Aguda/fisiopatologia , Avaliação Nutricional , Cobre/sangue , Leucemia-Linfoma Linfoblástico de Células Precursoras/fisiopatologia , Ingestão de Energia , Proteínas Alimentares , Transtornos da Nutrição Infantil , Transtornos da Nutrição do Lactente , Estudos TransversaisRESUMO
La necrosis de la médula ósea (NMO) es rara: frecuentemente es un hallazgo post-mórtem que ocurre en pacientes afectados por neoplasias hematológicas, en especial leucemia aguda. Descubrimos aquí NMO en dos pacientes con leucemia aguda mielobástica (LAM) y uno con leucemia aguda linfoblástica (LAL), en quienes se realizó el diagnóstico de NMO en vida. Dos pacientes fallecieron por hemorragia intracraneal; el paciente con diagnóstico de LMA M5 desarrolló NMO una semana después de recibir el segundo ciclo de quimioterapia: su recuperación fue total y está en remisión completa después de casi cinco años del diagnóstico. El diagnóstico de NMO puede ser difícil por lo que se requiere sospecharla para establecer un diagnóstico temprano y brindar tratamiento de apoyo, ya que no necesariamente se asocia a un resultado fatal
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Hemorragia Cerebral/etiologia , Hemorragia Cerebral/mortalidade , Leucemia-Linfoma Linfoblástico de Células Precursoras/fisiopatologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade , Leucemia Mieloide Aguda/mortalidade , Leucemia Mieloide Aguda/fisiopatologia , Medula Óssea/patologia , NecroseRESUMO
OBJECTIVE: To examine the impact of bone marrow transplantation (BMT), using high-dose chemotherapy and hyperfractionated total body irradiation, on gonadal function in survivors of acute leukemia treated during childhood. STUDY DESIGN: We conducted a retrospective study of 33 subjects (17 boys) who underwent a BMT for acute leukemia (acute lymphoblastic leukemia, n = 20; acute myelogenous leukemia, n = 13) at a single institution. All patients were prepubertal at the time of BMT (median age, 7.1 years (3.7 to 11.6 years)); at the time of their last examination the boys were a median of 14 years (10.4 to 17.1 years) of age and the girls were a median of 16.9 years (9.5 to 21.9 years) of age. RESULTS: Of 17 boys, 14 (82%) entered puberty spontaneously and 13 demonstrated age-appropriate plasma concentrations of testosterone. Two boys (aged 10.5 and 11 years) remain clinically and hormonally prepubertal, and one boy has overt Leydig cell failure requiring androgen replacement therapy. Thirty-six percent of pubertal boys have elevated plasma concentrations of luteinizing hormone and 64% have raised levels of follicle-stimulating hormone. Boys with increased levels of luteinizing hormone were significantly younger at BMT (5.4 +/- 0.8 vs 7.8 +/- 0.8 years; p = 0.024). Of 16 girls, 9 (56%) had spontaneous puberty with onset of menarche at a median age of 13 years (9.5 to 15.8 years). Though six (67%) of these nine girls have had increased plasma concentrations of luteinizing and follicle-stimulating hormones, normalization has occurred in two during a period of 4 to 7 years. The remaining seven subjects required hormone replacement because of clinical and biochemical evidence of ovarian failure. One of these subjects has recovered ovarian function after 5 1/2 years. Female patients with ovarian failure were significantly older at BMT compared with female patients with spontaneous puberty/menarche (8.6 +/- 23 years vs 6.1 +/- 1.8; p = 0.03). CONCLUSION: Our results indicate that most prepubertal boys undergoing BMT with chemotherapy and hyperfractionated total body irradiation can expect to enter and progress normally through puberty. For prepubertal girls treated with these regimens, at least 50% retain adequate ovarian function to enter puberty and menstruate regularly.
Assuntos
Transplante de Medula Óssea/efeitos adversos , Leucemia Mieloide Aguda/terapia , Ovário/fisiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Testículo/fisiologia , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Transplante de Medula Óssea/métodos , Criança , Pré-Escolar , Terapia Combinada , Feminino , Seguimentos , Humanos , Lactente , Leucemia Mieloide Aguda/fisiopatologia , Masculino , Ovário/efeitos dos fármacos , Ovário/efeitos da radiação , Leucemia-Linfoma Linfoblástico de Células Precursoras/fisiopatologia , Puberdade/efeitos dos fármacos , Puberdade/efeitos da radiação , Estudos Retrospectivos , Testículo/efeitos dos fármacos , Testículo/efeitos da radiação , Irradiação Corporal Total/efeitos adversosRESUMO
A prospective study was undertaken to elucidate the clinical and laboratory differences between de novo acute myeloid leukemia (AML) and AML with trilineage myelodysplasia (AML-TMDS). One hundred and seven patients with AML were diagnosed at the University Hospital between January 1987 and July 1992, and were followed until July 1995. TMDS was identified in 17 of them (16%). With regard to age and sex distribution no difference was found between AML patients with and without TMDS (p = 0.43, p = 0.54, respectively). The duration of symptoms at presentation in AML-TMDS was similar to those observed in de novo AML (p = 0.29). Hemoglobin values and platelet counts were similar in both groups of patients (p = 0.45, p = 0.44, respectively). However, peripheral white blood cell and neutrophil counts, as well as blast counts in AML-TMDS patients were lower than those observed in AML without TMDS patients (p < 0.001 for all of them). Bone marrow blast counts in de novo AML were higher than the values observed in AML-TMDS patients (p < 0.001). TMDS occurred predominantly in M2 and M6 FAB types, and was absent in the M3 type. Bone marrow histology showed no particular feature that could be of diagnostic relevance. The remission rates were similar in both groups of patients (p = 0.55). The same was true for the probability of disease-free survival and overall survival during the period of study (p = 0.50, p = 0.33, respectively). These results suggest that: 1) in AML-TMDS patients, leukemia transformation occurs in a more undifferentiated pluripotent stem cell, leading to a dysplastic residual hemopoiesis besides the blast proliferation; 2) the incidence of TMDS in our group of patients did not influence the clinical outcome after treatment of the disease.
Assuntos
Leucemia Mieloide Aguda/fisiopatologia , Síndromes Mielodisplásicas/fisiopatologia , Adulto , Idoso , Células Sanguíneas/patologia , Feminino , Humanos , Leucemia Mieloide Aguda/sangue , Leucemia Mieloide Aguda/patologia , Leucemia Mieloide Aguda/terapia , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/sangue , Síndromes Mielodisplásicas/patologia , Síndromes Mielodisplásicas/terapia , Estudos ProspectivosAssuntos
Transplante de Medula Óssea/efeitos adversos , Doença Enxerto-Hospedeiro/patologia , Leucemia Mieloide Aguda/terapia , Terapia PUVA , Esclerodermia Localizada/tratamento farmacológico , Esclerodermia Localizada/patologia , Adulto , Doença Crônica , Diagnóstico Diferencial , Doença Enxerto-Hospedeiro/complicações , Doença Enxerto-Hospedeiro/diagnóstico , Humanos , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/fisiopatologia , Masculino , Esclerodermia Localizada/complicaçõesRESUMO
In normal adult mammals, blood cell production, hemopoiesis, takes place within the medullary cavity. There, hemopoietic cell proliferation and differentiation are regulated by a network of stromal/accessory cells and their products (ie cytokines and extracellular matrix molecules), known as the hemopoietic microenvironment. Recent in vitro studies indicate that both cell composition and functional abnormalities of the hemopoletic microenvironment are present in a proportion of patients with myeloid leukemia, both chronic (CML) and acute (AML). Cell composition abnormalities have been primarily observed in a subset of patients with AML; these abnormalities include reduced numbers of fibroblast progenitors and, in some cases, reduced numbers of macrophages and adipocytes. In terms of function, it has been shown that the marrow stromal cells from a significant number of both CML and AML patients, possess a deficient hemopoletic supportive capacity in vitro. This seems to be related to the presence of functionally abnormal, malignant macrophages. The mechanisms by which these macrophages alter the hemopoietic function of the marrow stroma, as a whole, are still not fully understood. Whereas in AML, a macrophage-derived soluble inhibitory activity (containing tumor necrosis factor alpha) has been described; in CML, a direct, macrophage-mediated cell-to-cell contact mechanism for hemopoietic inhibition seems to be involved. To date, however, it is not clear whether the abnormalities in the hemopoietic microenvironment are secondary to myeloid leukemia or if they precede clinical CML/AML. Furthermore, it is not known to what extent the functional abnormalities observed in vitro contribute to the hematologic dysfunction that characterizes myeloid leukemia and to the in vivo progression of the disease.
Assuntos
Medula Óssea/patologia , Hematopoese , Leucemia Mieloide/patologia , Adipócitos/patologia , Adulto , Medula Óssea/metabolismo , Medula Óssea/fisiopatologia , Citocinas/metabolismo , Fibroblastos/patologia , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/metabolismo , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/fisiopatologia , Leucemia Mieloide/metabolismo , Leucemia Mieloide/fisiopatologia , Leucemia Mieloide Aguda/metabolismo , Leucemia Mieloide Aguda/patologia , Leucemia Mieloide Aguda/fisiopatologia , Macrófagos/patologia , Células Estromais/patologiaAssuntos
Humanos , Masculino , Feminino , Anemia Hipocrômica/diagnóstico , Anemia Hipocrômica/fisiopatologia , Anemia Hipocrômica/tratamento farmacológico , Anemia Falciforme/fisiopatologia , Anemia Falciforme/diagnóstico , Anemia Falciforme/tratamento farmacológico , Anemia Hemolítica Autoimune/diagnóstico , Anemia Hemolítica Autoimune/fisiopatologia , Anemia Hemolítica Autoimune/tratamento farmacológico , Anemia Megaloblástica/diagnóstico , Anemia Megaloblástica/fisiopatologia , Anemia Megaloblástica/tratamento farmacológico , Esferocitose Hereditária/diagnóstico , Esferocitose Hereditária/fisiopatologia , Esferocitose Hereditária/tratamento farmacológico , Leucemia/classificação , Leucemia/diagnóstico , Leucemia/fisiopatologia , Doença Aguda , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/fisiopatologia , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Linfoide/diagnóstico , Leucemia Linfoide/fisiopatologia , Leucemia Linfoide/tratamento farmacológico , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/fisiopatologia , Mieloma Múltiplo/tratamento farmacológico , Púrpura Trombocitopênica/diagnóstico , Púrpura Trombocitopênica/tratamento farmacológico , Policitemia Vera/diagnóstico , Policitemia Vera/fisiopatologia , Policitemia Vera/tratamento farmacológico , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/fisiopatologia , Linfoma não Hodgkin/tratamento farmacológico , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/fisiopatologia , Doença de Hodgkin/tratamento farmacológico , Transplante de Medula ÓsseaRESUMO
Se describe a un paciente de 15 años que fué hospitalizado en el Instituto Nacional de Pediatría (INP) por presentar un cuadro clínico sugestivo de un padecimiento mieloproliferativo. Los estudios de médula ósea y sangre periférica no fueron confirmativos, pero el paciente evolucionó hacia sangrados masivos, daño neurológico, falleciendo al noveno día de internamiento. El estudio cromosómico en médula ósea reveló alteraciones complejas que comprometían a los cromosomas 1, 9, 7 y 17 y que sugerían una leucemia aguda no linfoblástica con mal pronóstico. El estudio postmortem corroboró la invasión a múltiples órganos de células inmaduras de la serie blanca, sugestiva de leucemia aguda de la serie mieloide.