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Lopez Facundo N.A.,Institute Seguridad Social Del Estado Of Mexico Y Municipios Issemym | Tejocote Romero I.,Institute Seguridad Social Del Estado Of Mexico Y Municipios Issemym | Rodriguez Castillejos C.,Servicio de Hematologia Pediatrica | Jaimes Garcia Y.,Institute Seguridad Social Del Estado Of Mexico Y Municipios Issemym
Gaceta Mexicana de Oncologia | Year: 2015

Introduction: In Mexico, childhood cancer and obesity are public health problems. Malnutrition, but not obesity, has been associated with a lower probability of survival and increased risk of relapse. Objective: To assess the impact of obesity on the prognosis of survival and relapse in children with Acute Lymphoblastic Leukaemia (ALL). Material and methods: Children with ALL were included in a cohort. An assessment was made of the nutritional status at diagnosis, according to BMI values in children, searching for an association of obesity and other factors with disease relapse and survival using Kaplan-Meier curves and Cox regression. Results: A total of 161 patients were studied, of which 70% were males with obesity, and of these, 43% had very high risk ALL. Obesity increased the risk for relapse (OR: 3.6; 95% CI: 1.7-7.6, p=.001) and death (OR: 3.4; 95% CI: 1.51-7.48, p=.002), and limited 77-month survival to 52%. An Exp β of 3.35 was obtained in the Cox regression for patients with obesity and a very high risk leukaemia. Discussion: Obesity influences the prognosis of relapse and survival time, due to a considerable increase in toxicity and some growth factors that induce chemoresistance in neoplastic cells. Biological factors influencing the prognosis of the disease may not be modifiable; however, it is essential to establish health policies aimed at early diagnosis, as well as at obesity and overweight prevention. © 2015 Sociedad Mexicana de Oncología. Source


Bekker-Mendez V.C.,Instituto Mexicano del Seguro Social IMSS | Miranda-Peralta E.,Laboratorio Of Biologia Molecular | Nunez-Enriquez J.C.,Instituto Mexicano del Seguro Social IMSS | Olarte-Carrillo I.,Laboratorio Of Biologia Molecular | And 21 more authors.
BioMed Research International | Year: 2014

Mexico has one of the highest incidences of childhood leukemia worldwide and significantly higher mortality rates for this disease compared with other countries. One possible cause is the high prevalence of gene rearrangements associated with the etiology or with a poor prognosis of childhood acute lymphoblastic leukemia (ALL). The aims of this multicenter study were to determine the prevalence of the four most common gene rearrangements [ETV6-RUNX1, TCF3-PBX1, BCR-ABL1, and MLL rearrangements] and to explore their relationship with mortality rates during the first year of treatment in ALL children from Mexico City. Patients were recruited from eight public hospitals during 2010-2012. A total of 282 bone marrow samples were obtained at each child's diagnosis for screening by conventional and multiplex reverse transcription polymerase chain reaction to determine the gene rearrangements. Gene rearrangements were detected in 50 (17.7%) patients. ETV6-RUNX1 was detected in 21 (7.4%) patients, TCF3-PBX1 in 20 (7.1%) patients, BCR-ABL1 in 5 (1.8%) patients, and MLL rearrangements in 4 (1.4%) patients. The earliest deaths occurred at months 1, 2, and 3 after diagnosis in patients with MLL, ETV6-RUNX1, and BCR-ABL1 gene rearrangements, respectively. Gene rearrangements could be related to the aggressiveness of leukemia observed in Mexican children. © 2014 Vilma Carolina Bekker-Méndez et al. Source


Perez-Saldivar M.L.,Instituto Mexicano Of Seguridad Social Imss | Fajardo-Gutierrez A.,Instituto Mexicano Of Seguridad Social Imss | Bernaldez-Rios R.,Servicio de Hematologia | Martinez-Avalos A.,Instituto Nacional Of Pediatria Inp | And 22 more authors.
BMC Cancer | Year: 2011

Background: Worldwide, acute leukemia is the most common type of childhood cancer. It is particularly common in the Hispanic populations residing in the United States, Costa Rica, and Mexico City. The objective of this study was to determine the incidence of acute leukemia in children who were diagnosed and treated in public hospitals in Mexico City.Methods: Included in this study were those children, under 15 years of age and residents of Mexico City, who were diagnosed in 2006 and 2007 with leukemia, as determined by using the International Classification of Childhood Cancer. The average annual incidence rates (AAIR), and the standardized average annual incidence rates (SAAIR) per million children were calculated. We calculated crude, age- and sex-specific incidence rates and adjusted for age by the direct method with the world population as standard. We determined if there were a correlation between the incidence of acute leukemias in the various boroughs of Mexico City and either the number of agricultural hectares, the average number of persons per household, or the municipal human development index for Mexico (used as a reference of socio-economic level).Results: Although a total of 610 new cases of leukemia were registered during 2006-2007, only 228 fit the criteria for inclusion in this study. The overall SAAIR was 57.6 per million children (95% CI, 46.9-68.3); acute lymphoblastic leukemia (ALL) was the most frequent type of leukemia, constituting 85.1% of the cases (SAAIR: 49.5 per million), followed by acute myeloblastic leukemia at 12.3% (SAAIR: 6.9 per million), and chronic myeloid leukemia at 1.7% (SAAIR: 0.9 per million). The 1-4 years age group had the highest SAAIR for ALL (77.7 per million). For cases of ALL, 73.2% had precursor B-cell immunophenotype (SAAIR: 35.8 per million) and 12.4% had T-cell immunophenotype (SAAIR 6.3 per million). The peak ages for ALL were 2-6 years and 8-10 years. More than half the children (58.8%) were classified as high risk. There was a positive correlation between the average number of persons per household and the incidence of the pre-B immunophenotype (Pearson's r, 0.789; P = 0.02).Conclusions: The frequency of ALL in Mexico City is among the highest in the world, similar to those found for Hispanics in the United States and in Costa Rica. © 2011 Pérez-Saldivar et al; licensee BioMed Central Ltd. Source


Arellano-Galindo J.,Servicio de Hematologia Pediatrica | Arellano-Galindo J.,Laboratorio Of Virologia | Arellano-Galindo J.,University of Tubingen | Vazquez-Meraz E.,Servicio de Hematologia Pediatrica | And 7 more authors.
Pediatric Transplantation | Year: 2011

We aimed to identify those pediatric patients undergoing ABMT with CMV EOD who developed GCV resistance. Forty-seven patients were analyzed following ABMT. Prospective post-transplant CMV monitoring was performed weekly for the detection of viral leukocyte DNAaemia, viral plasma DNAaemia, and viral DNAuria by PCR. Plasma DNAaemia was confirmed from whole blood by the detection of CMV pp67 late mRNA using NASBA technology. In the cases of persistence of viral DNA in plasma, and positive viral RNA detection in blood, CMV drug resistance screening by comprehensive PCR-based RFLP and sequencing of the viral UL97 gene were performed retrospectively. Thirty of the 47 (63.82%) patients showed active CMV infection with 27/30 (74.4%) patients belonging to the D+R+ group and 25/30 with proven viral replication. In total, 2/30 (6.6%) children developed CMV pneumonia proven by immunohistochemistry. Screening of the viral UL97 gene revealed in one of these two cases (1/30, 3.3%) the simultaneous presence of two point mutations in codon 460 (M460V, M460I) conferring GCV resistance. The CMV seroprevalence (81%) and the incidence of active infection (63.8%) in Mexican children undergoing ABMT are very high. © 2010 John Wiley & Sons A/S. Source


Aguilera R.P.,Servicio de Hematologia Pediatrica | Santiago N.L.,Servicio de Hematologia Pediatrica | Orozco A.M.,Instituto Nacional Of Pediatria | Daza D.C.,Instituto Nacional Of Pediatria | Salazar-Bailon J.L.,Servicio de Hematologia Pediatrica
Boletin Medico del Hospital Infantil de Mexico | Year: 2012

Background. Hermansky-Pudlak syndrome is a genetic disorder characterized by albinism and bleeding of varying degrees due to alteration in the structure of the platelets. The disorder may be accompanied by pulmonary, intestinal or kidney involvement. Identification of several genetic alterations in this syndrome has been reported. Case reports. We present two cases: the first of an adolescent male with mucocutaneous albinism and renal involvement. Bleeding episodes started after being subjected to invasive studies and venipunctures, developing a perinephric hematoma. After severe sepsis, the patient developed hemoperitoneum and pulmonary hemorrhage, which precipitated the patient's death. Diagnosis was made postmortem. In the second case, a female patient was diagnosed during infancy due to albinism and bleeding episodes, with progressive pulmonary fibrosis that to date has limited her vital lung capacity. Conclusions. Early diagnosis of the syndrome as well as the correct approach may prevent the development of complications or limit the evolution. It is still under debate whether the genetic alterations described are associated with the expression of any particular clinical manifestation. Source

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