CARACTERIZACIÓN MOLECULAR DE LA LEUCEMIA LINFOBLÁSTICA AGUDA EN PACIENTES PEDIÁTRICOS, EN SOLCA, GUAYAQUIL, TRATADOS DESDE FEBRERO 2018 A SEPTIEMBRE 2019

Abstract

INTRODUCTION: Acute lymphoblastic leukemia (ALL) is characterized by cytogenetic alterations, which are associated with different sensitivity to initial conventional therapy. Response to therapy is assessed by measuring minimal residual disease (MRD). OBJECTIVES: To indicate the cytogenetic alterations found, establish the fluctuation of the EMR at days 15 and 30, establish the initial percentage of blasts in relation to the EMR and the relationship of cytogenetic alterations and susceptibility to initial treatment. METHODS: Descriptive, cross-sectional, retrospective, and analytical study with pediatric patients with ALL seen at SOLCA, Guayaquil seen between 2018 and 2019. A sample of 98 patients was studied. RESULTS: Of the 98 patients, 61 were male (62.24%) and 37 female (37.76%), with a mean age of 8.65 ± 4.22 years. All had ALL of phenotype B and 50% had at least one chromosomal alteration. Of these, the most frequent qualitative: t (9; 22) -BCR-ABL (41.46%), t (12; 21) -TEL-AML1 (41.46%), t (1; 19) -E2A -PBX1 (9.76%); and the quantitative ones, 45 XY hypodiploidy (37.5%), trisomies (31.25%) and tetrasomies (12.5%). The initial blast percentage was> 25% in 89.8%, the EMR day 15 was positive in 71.43% and the EMR day 30, positive in 51.02%. CONCLUSION: The chromosomal alterations found were: t (9; 22) -BCR-ABL (41.46%), t (12; 21) -TEL-AML1 (41.46%), t (1; 19) -E2A -PBX1 (9.76%), t (4; 11) (4.88%) and t (15; 17) (2.44%), 45 XY (37.5%), trisomies (31.25%) , tetrasomies (12.5%), 46 XX -9, + 22 (12.5%) and hyperdiploidy 57 XY (6.25%). The most frequent qualitative and quantitative alterations in this study, t (9; 22) -BCR-ABL (41.46%) and 45 XY hypodiploidy (37.5%), were of unfavorable prognosis.