bachelorThesis
Relación entre el conteo plaquetario y linfocitario y la sobrevida en pacientes menores de 18 años con trasplante alogénico de células madre hematopoyéticas
Autor
Chavarriaga Ruíz, Nataly
Estupiñan Calvache, Marcela
Vallejo Rosero, Cristian
Castañeda Figueroa, Ana Maria
Institución
Resumen
Introduction: Hematopoietic stem cell transplantation (SCHT) is used to reestablish hematopoietic function in patients with impaired or damaged bone marrow. In pediatrics 20% of these procedures are performed. Both immune reconstitution and post-transplant platelet count have been shown to be associated with better or worse prognosis, disease relapse, and overall survival. Objective: To assess the association between platelet and lymphocyte count, overall survival, and event-free survival in a pediatric transplant unit with allogeneic transplantation for haemato-oncological diseases and immunodeficiency. Materials and methods: Retrospective observational analytical cohort study, 124 patients under 18 years of age who underwent allogeneic hematopoietic stem cell transplantation between 2010 and 2016 at the Pediatric Hospital of La Misericordia were included; patients who survived without relapse on day 100 were quantified platelet and lymphocyte count and followed up to 3 years. Results: The probability of survival in patients with lymphocytes <1000 a year was 75.36% (95% CI 64.51-88.03%), after two years it was 58.6% (95% CI 46, 45-74.08%) and at three years it was 52.21% (95% CI 39.9-68.2%) vs 85.4% (95% CI 77-94.7%) 77% (95% CI 67.1-88.4%) of 71.9% (95% CI 61.4-84.2%) for the group with> 1000 lymphocytes respectively (Log-Rank = 0.037). The mean survival for patients with platelets <100,000 was 35.2 months (+/- 3.17) and for those with platelets> 100,000 it was 39.3 months (+/- 2.19) p = 0.19. Thrombocytopenia is related to development of acute IECH p = 0.001. Conclusion: The absolute lymphocyte count at day 100 post transplant is an independent factor that directly affects the survival of patients.