José Carlos Jaime-Pérez

Autonomous University of Nuevo León, San Nicolás de los Garza, Nuevo León, Mexico

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Publications (75)206.96 Total impact

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    ABSTRACT: Abstract Induction to remission (IR) regimens for acute lymphoblastic leukemia (ALL) in adults induces complete remission (CR) in 60% to 90% and cure in 20-40%. A cohort study of newly diagnosed ALL patients treated with mitoxantrone versus doxorubicin was conducted from 2005-2013. The primary endpoint was the proportion of complete remission (CR). Eighty-five patients were included. Fifty-three received induction with doxorubicin and 32 with mitoxantrone. Median follow-up in the cohort was 40.2 months (range 2-95). Twenty-nine patients (90.6%) achieved CR in the mitoxantrone arm compared with 37 (69.8%) in the doxorubicin group (P = 0.032). There was no difference in death or relapse rate (P = 0.095 and 0.075), hematological recovery, P=0.654, incidence of adverse events P = 0.6, in-hospital days during induction, P=0.456, or OS P=0.105. Induction toxicities were comparable. Mitoxantrone can be safely and effectively used as a frontline anthracycline in adults newly diagnosed with ALL.
    Leukemia & lymphoma. 01/2015;
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    ABSTRACT: Blood components transfused to hematoprogenitor stem cell transplant (HSCT) recipients are irradiated to prevent transfusion-associated graft-versus-host disease (TA-GvHD). The effect of transfusing non-irradiated blood products in HSCT outcome, including incidence of transplant complications, bacterial infections, acute and chronic GvHD presentation and characteristics has not been documented. Clinical records as well as blood bank and electronic databases of HSCT patients grafted after reduced intensity conditioning (RIC) who received irradiated vs. non-irradiated blood products, after blood irradiation became unavailable at our center, were scrutinized for transplant outcome, clinical evolution, engraftment characteristics including days to neutrophil and platelet recovery, acute and chronic GvHD, rate and type of infections and additional transplant-related comorbidities. All transfused blood products were leukoreduced. A total of 156 HSCT recipients were studied, 73 received irradiated and 83 non-irradiated blood components. Bacterial infections were significantly more frequent in patients transfused with non-irradiated blood products, p=0.04. Clinically relevant increased rates of fever and neutropenia and mucositis were also documented in these patients. No cases of TA-GvHD occurred. Classical GvHD developed in 37 (50.7%) patients who received irradiated blood products and 36 (43.9%) in the non-irradiated blood products group, p=0.42. Acute GvHD developed in 28 (38.4%) in the blood-irradiated and 33 (39.8%) in the non-irradiation group, p=0.87. The two-year GvHD-free survival was 40% in the irradiated vs. 40.6% in the non-irradiation group, p=0.071. Increased bacterial infections were found in HSCT recipients transfused with non-irradiated blood products, which must be ideally always irradiated. Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
    Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation 12/2014; 21(3). · 3.15 Impact Factor
  • Acta Haematologica 10/2014; 133(2):168-171. · 0.89 Impact Factor
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    ABSTRACT: Introduction The advent of imatinib as a therapeutic option of chronic myeloid leukemia (CML) has transformed this previously highly resistant disease into one that is susceptible to management with oral drugs that now offer high long-term survival rates. However, achieving an adequate adherence to treatment regimes is of critical importance. The characteristics of treatment compliance in Mexican patients have not been determined. Methods We evaluated 38 CML patients, members of the Glivec(®) International Patient Assistance Program (GIPAP). A bimonthly simplified medication adherence questionnaire was applied and the adherence rate was calculated by direct tablet counting. Results Two groups, one of local patients and another of out-of-town patients, were studied using an 85% adherence rate as a cut-off. The overall adherence rate was 85.9%. Fifteen patients were considered non-adherent (39.5%). The group of out-of-town patients presented a higher adherence rate of 92.8% in contrast with 76.3% in the local population (P = 0.021). The probability of achieving a complete cytogenetic response at some point of evolution after 8 years of follow-up was 93% in the adherent group vs. 58% in the group with an adherence rate <85% (P = 0.008). In patients with imatinib failure, the adherence rate was 75.8% compared to 95.5% (P = 0.008) in the optimal response group. Conclusions In Mexican patients with CML, non-adherence to treatment is a cause of the failure to achieve remission or the subsequent loss of a complete cytogenetic and major molecular response.
    Hematology (Amsterdam, Netherlands) 07/2014; · 1.33 Impact Factor
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    ABSTRACT: The relationship between treatment for hematologic malignancies and risk of developing metabolic syndrome (MS) is controversial; in addition, metabolic changes following hematopoietic stem cell transplantation (HSCT) is an area of growing interest. We documented the presence of MS in patients with hematological malignancies treated with chemotherapy and HSCT. Nutritional status, anthropometrics, and pertinent laboratory parameters were used to evaluate the presence of MS using the Adult Treatment Panel (ATP III) criteria. In the study, 115 patients were included. Using ATP III criteria, MS was identified in 42 (44.7%) patients treated only with chemotherapy and in 8 (33.3%) patients with an HSCT. There was an important but not significant difference in the mean fasting glucose, which was higher in the chemotherapy group (108.32 ± 54.28 vs. 94.48 ± 18.25, P = 0.300). Mean values of biochemical markers and blood pressure were not different between the groups. An increase in central obesity in men with hematological diseases in comparison to the rest of the population was also found (46.7% vs 32.4%). There was no difference in the prevalence of MS between patients with hematologic malignancies receiving an HSCT and those treated with chemotherapy alone.
    Nutrition and Cancer 06/2014; · 2.70 Impact Factor
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    ABSTRACT: Immune thrombocytopenia (ITP) is a disease that results from platelet destruction and production suppression. Eltrombopag belongs to a new class of thrombopoietin mimetic drugs that raise platelet counts in patients with ITP. We performed a single-arm study to assess the response to a single course of dexamethasone (40 mg PO, days 1-4) in combination with eltrombopag (50 mg, days 5-32) in twelve adults with newly diagnosed ITP in an outpatient setting. Median follow-up was 12.5 months. After therapy, day 33, 100% of patients achieved at least ≥30×10(9)/L platelets. Four patients relapsed. Complete response at 6 months (platelets ≥100×10(9)/L) was achieved in 50% of patients and response at 6 months (platelets ≥30<100×10(9)/L) was achieved in other 25%; relapse-free survival was 66.7% at 12 months, with a median response duration of 8.3 months. In conclusion, eltrombopag/dexamethasone is a feasible frontline therapy for ITP. This trial is registered at www.clinicaltrials.gov, identifier: NCT01652599.
    Blood 05/2014; · 9.78 Impact Factor
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    ABSTRACT: Cerebral palsy (CP) is related to severe perinatal hypoxia with permanent brain damage in nearly 50% of surviving preterm infants. Cell therapy is a potential therapeutic option for CP by several mechanisms, including immunomodulation through cytokine and growth factor secretion. In this phase I open-label clinical trial, 18 pediatric patients with CP were included to assess the safety of autologous bone marrow-derived total nucleated cell (TNC) intrathecal and intravenous injection after stimulation with granulocyte colony-stimulating factor. Motor, cognitive, communication, personal-social and adaptive areas were evaluated at baseline and 1 and 6 months after the procedure through the use of the Battelle Developmental Inventory. Magnetic resonance imaging was performed at baseline and 6 months after therapy. This study was registered in ClinicaTrials.gov (NCT01019733). A median of 13.12 × 10(8) TNCs (range, 4.83-53.87) including 10.02 × 10(6) CD34+ cells (range, 1.02-29.9) in a volume of 7 mL (range, 4-10.5) was infused intrathecally. The remaining cells from the bone marrow aspirate were administered intravenously; 6.01 × 10(8) TNCs (range, 1.36-17.85), with 3.39 × 10(6) cells being CD34+. Early adverse effects included headache, vomiting, fever and stiff neck occurred in three patients. No serious complications were documented. An overall 4.7-month increase in developmental age according to the Battelle Developmental Inventory, including all areas of evaluation, was observed (±SD 2.63). No MRI changes at 6 months of follow-up were found. Subarachnoid placement of autologous bone marrow-derived TNC in children with CP is a safe procedure. The results suggest a possible increase in neurological function.
    Cytotherapy 03/2014; · 3.06 Impact Factor
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    ABSTRACT: Background/Objective: Acute myeloid leukemia (AML) is the most common acute leukemia in adults. We documented the characteristics and results of treatment of patients with AML at a single reference center. Methods: Patients diagnosed with AML between June 2003 and July 2011 at a university hospital in northeast Mexico were studied. Overall survival (OS) and event-free survival (EFS) were determined, and risk factors were analyzed with respect to their influence on prognosis. Results: A total of 132 AML patients were included. Median age was 32 years. Complete remission (CR) was achieved by 55% of patients. CR was achieved by 65.1% of patients <60 years (n = 109), compared to 8.7% of those >60 years (n = 23; p < 0.001). In all, 39% of patients >60 years suffered an early death, compared to 14.7% of those <60 years (p < 0.001). OS for patients with AML was 35%, whereas EFS was 32%. On multivariate analysis, patients >60 years had a lower OS and EFS (p < 0.001). A total of 28% of patients received a transplant, and they had higher OS and EFS. Conclusions: Our patients were considerably younger and had remarkably lower survival rates than reported for other populations; those >60 years had a higher early death rate, and fewer of these patients achieved CR. © 2014 S. Karger AG, Basel.
    Acta Haematologica 02/2014; 132(2):144-151. · 0.89 Impact Factor
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    ABSTRACT: Autoimmune hemolytic anemia (AIHA) is an infrequent group of diseases defined by autoantibody mediated red blood cell destruction. Correct diagnosis and classification of this condition are essential to provide appropriate treatment. AIHA is divided into warm and cold types according to the characteristics of the autoantibody involved and by the presence of an underlying or associated disorder into primary and secondary AIHA. Due to its low frequency, treatment for AIHA is largely based on small prospective trials, case series, and empirical observations. This review describes in detail the different treatment approaches for autoimmune hemolytic anemia. Warm antibody type AIHA should be treated with steroids, to which most patients respond, although relapse can occur and maintenance doses are frequently required. Splenectomy is an effective second line treatment and can provide long-term remission without medication. Rituximab is a useful alternative for steroid refractory patients, those requiring high maintenance doses and unfavorable candidates for surgery. Promising therapeutic modifications with this monoclonal antibody are emerging including drug combinations, lower doses, and long-term use. Primary cold agglutinin disease has been recognized as having a lymphoproliferative monoclonal origin. It is unresponsive to both steroids and splenectomy. Rituximab is currently the best therapeutic alternative for this condition, and several treatment regimens are available with variable responses.
    Archivum Immunologiae et Therapiae Experimentalis 05/2013; · 2.38 Impact Factor
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    ABSTRACT: OBJECTIVE: The influence of CD34+ cell dose on the outcome of allogeneic peripheral blood stem cell (PBSC) transplantation after reduced intensity conditioning (RIC) remains controversial. The impact of the number of CD34+ hematoprogenitors infused on transplant outcome and on the incidence of graft versus host disease (GVHD) was analyzed. MATERIALS AND METHODS: Data of 138 patients with advanced hematological diseases who received an allogeneic PBSC transplant after RIC were analyzed. Donors were mobilized with granulocyte colony-stimulating factor and underwent one to three apheresis procedures. Incidence of acute and chronic GVHD and overall and event-free survival (OS and EFS) was determined. RESULTS: The median number of CD34+ cells infused was 5.57 × 10(6) kg(-1) (range: 1.1-15.6). There was no relationship between CD34+ cell dose and neutrophil or platelet engraftment. Patients receiving ≥5 × 10(6) kg(-1) CD34+ cells had a 63.1% 5-year OS when compared with 48.2% for those receiving a lower number (P = 0.024). At 5-year follow-up, there was no significant difference in EFS between the groups (44% vs. 42.8%, P = 0.426). No relationship between CD34+ cell dose and acute GVHD was found (P = 0.1). Relapse rate was the same in patients with and without acute GVHD (P = 0.117). A nonsignificant improvement on OS and EFS in patients who developed chronic GVHD was found (P = 0.57 and 0.41). CONCLUSION: A CD34+ cell dose ≥5 × 10(6) kg(-1) was associated with a significantly higher OS, but no improved EFS in high-risk patients. The number of CD34+ progenitors infused had no influence on the incidence of acute or chronic GVHD. J. Clin. Apheresis, 2013. © 2013 Wiley Periodicals, Inc.
    Journal of Clinical Apheresis 05/2013; · 2.27 Impact Factor
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    ABSTRACT: Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) has been developed as an alternative transplant strategy for children with hematological disorders who do not have an HLA-matched donor. We report the analysis of the outcome for 18 consecutive pediatric patients with various hematological diseases, who underwent haplo-HSCT using a reduced-intensity conditioning regimen and CD3/CD19 depletion in an outpatient setting. Twelve of the 18 patients (66.6%) engrafted either transiently or definitively (9 patients engrafted with full donor chimerism and 3 with mixed chimerism). Six patients with acute lymphoblastic leukemia were disease-free between 2 and 35 months (median 25 months) post-HSCT. The overall survival was 33.3% with a median of 25 months (range 2-35). Our results suggest that haplo-HSCT can be a feasible therapeutic alternative for children who do not have a suitable family donor or available cord blood units. These results also demonstrate that it is possible to perform this regimen on an outpatient basis.
    Hematology (Amsterdam, Netherlands) 04/2013; · 1.33 Impact Factor
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    ABSTRACT: Corticosteroids as initial therapy for primary immune thrombocytopenia achieve a low rate of sustained remission. Methods:We prospectively evaluated the efficacy, safety and response duration of low-dose rituximab plus high-dose dexamethasone as front-line therapy in newly diagnosed primary immune thrombocytopenia patients. One cycle of dexamethasone, 40 mg/day/intravenously for 4 consecutive days, plus weekly intravenous rituximab, 100 mg for 4 doses, was delivered. Results:Twenty-one consecutive adults were enrolled. The overall response at day +28 was 90.5%. Complete sustained response at six months and relapse rate were 76.2% and 15.8% respectively, compared with 30% and 62.5% for a historical group who had received standard treatment with prednisone (p= 0.005 and p= 0.004). There was a 9.5% incidence of adverse effects. Conclusions:The combination of low-dose rituximab and high-dose dexamethasone as front-line therapy for adults with primary immune thrombocytopenia was effective, had a high overall response rate and a low incidence of relapse. © 2013 John Wiley & Sons A/S.
    European Journal Of Haematology 03/2013; · 2.41 Impact Factor
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    ABSTRACT: Imatinib has been considered as the gold standard for drug therapy of chronic myelogenous leukemia (CML) because it offers higher cytogenetic response and better quality of life than traditional drugs. In this study we applied the standard 400 mg dose of imatinib in 37 CML Ph (+) Mexican patients, monitoring their cytogenetic response using fluorescent in situ hybridization and carrying out molecular analyses using reverse transcription polymerase chain reaction. The study included 19 male and 18 female patients with a median age of 41 years. The median follow-up time from diagnosis was 56 months. Thirty-six patients (97%) achieved complete hematologic response in a median time of 29 days. Complete cytogenetic response and complete molecular remission was observed in only five (13%) and three (8.1%) patients, respectively, less than the expected rate (50-90%) reported in other studies.
    Hematology (Amsterdam, Netherlands) 02/2013; · 1.33 Impact Factor
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    ABSTRACT: OBJECTIVE AND IMPORTANCE: Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder that needs prompt diagnosis and treatment. Front-line therapy consists of plasma exchange (PEx) and steroids, but, in some instances, this is not enough to achieve a complete and sustained response. CLINICAL PRESENTATION: We report four cases of TTP treated with low-dose rituximab, PEx, and a short course of steroids with an excellent outcome. Three of the patients had primary TTP and another presented an underlying human immunodeficiency virus infection. INTERVENTION: Rituximab, 100 mg intravenously, was initiated on days 2-8 from the start of PEx as first-line therapy in three cases and as salvage therapy for relapsing disease in one. The number of PEx needed ranged from 5 to 12 sessions. All patients achieved complete remission and are currently asymptomatic, with complete response duration of 8-22 months. CONCLUSION: Treatment of TTP with low-dose rituximab, along with PEx and steroids, seems to be as effective as the standard dose of monoclonal antibody.
    Hematology (Amsterdam, Netherlands) 02/2013; · 1.33 Impact Factor
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    ABSTRACT: BACKGROUND: The impact of obesity on hematopoietic stem cell transplantation (HSCT) outcome remains controversial and has been considered a relative contraindication for the procedure. We investigated the influence of Body Mass Index (BMI) on the clinical course of adults undergoing an ambulatory HSCT after a non-myeloablative conditioning regimen. METHODS: Adults with hematologic diseases undergoing an autologous or allogeneic HSCT after reduced intensity conditioning (RIC) and supported exclusively with enteral nutrition (EN) were studied. BMI and body fat were sequentially determined. Patients were divided into three BMI subgroups: underweight; normal, and overweight/obese. RESULTS: Seventy-seven patients with a median follow-up of 21months were evaluated. Fourteen (18.2%) were underweight, 21 (27.3%) had a normal weight, and 42 (54.5%) were overweight/obese. A significant weight loss was observed among all three weight groups after HSCT (P=0.014). No correlation was found between time to engraftment and BMI (P=0.91), serum albumin (P=0.387), and fasting glucose (P=0.64), nor between BMI and acute (P=0.456) or chronic (P=0.209) graft versus host disease (GVHD). On multivariate analysis a higher overall survival (OS) was documented for obese patients (P=0.037). DISCUSSION: A BMI >30/kg/m(2) was independently associated with a higher survival rate after HSCT. Obese patients should not be excluded as transplant candidates based only on this parameter.
    Blood Cells Molecules and Diseases 02/2013; · 2.33 Impact Factor
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    ABSTRACT: There is little information regarding the serologic status of umbilical cord blood (UCB) donors. Cytomegalovirus (CMV) is the most frequent agent transmitted by blood products and studies have reported that CMV can inhibit myelopoiesis, however, its effects on the cellular content of UCB have not been documented. We investigated, retrospectively, the prevalence of serological evidence of infection in 857 women donating their UCB at a public university hospital and studied the influence of acute CMV exposure on UCB content of CD34+ cells. The biological characteristics of UCB from serology positive-donors were compared with those of women with negative tests. We found that 51 of 857 (6%) UCB units were positive for infectious disease markers; anti-CMV IgM was the most prevalent marker, 43 of 51 (86%) of cases with infectious markers. UCB collected from anti-CMV IgM-positive donors more frequently met rejection criteria for use as a transplanation product. The CD34+ cell count was the most often affected, 2.48×10(6) in anti-CMV IgM-positive donors compared to 1.48×10(6) in unaffecetd donors( p=0.006). The probability of a UCB meeting a CD34+ cell content≥2×10(6) was significantly lower in units from IgM anti-CMV+ women compared to unaffecetd donors [Odds ratio (OR)=0.428 (95% CI 0.182-0.632; p=0.015]; the total nucleated cell count (TNC) was lower but not statistically significant [p=0.068]. UCB donated by anti-CMV IgM-positive women has a high probability of not meeting the criteria required for cryopreservation for future use as a transplantation product, because of the low number of CD34+ cells.
    Blood Cells Molecules and Diseases 07/2012; 49(3-4):166-9. · 2.33 Impact Factor
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    ABSTRACT: BACKGROUND: Umbilical cord blood (UCB) represents an alternative source of stem cells for transplantation for the treatment of hematologic malignancies and genetic disorders. There is scarce information detailing cord blood bank (CBB) collection and transplantation activities from developing countries. We documented our experience at a public university hospital in northeast Mexico. STUDY DESIGN AND METHODS: We carried out a retrospective and descriptive analysis of our CBB activity during an 8-year period from May 2002 to September 2010. Collection, processing, and cryopreservation of CB were carried out following standard operating procedures. The minimum volume and total nucleated cell (TNC) content for cryopreservation were 80 mL and 8.0 × 10(8) , respectively. RESULTS: A total of 1256 UCB units were collected; 428 (34%) were banked and 828 (66%) were discarded. The main reason for exclusion was biologic: low volume and/or low number of TNC accounted for 84% of the total discarded units. Cryopreserved cord blood units (CBUs) had a median volume of 113.8 mL (range, 80-213.2 mL) and 13.0 × 10(8) (range, 8 × 10(8) -36.6 × 10(8) ) TNCs. Cell viability was 99.3% (88-100%). The median CD34+ cell content was 4.0 × 10(6) (0.46 × 10(6) -19.38 × 10(6) ). Sixteen units have been released for transplantation, leading to a utilization rate of 3.7%. CONCLUSION: CBB demands considerable human and financial resources; it is then essential for centers at developing countries to share their experience, results, and databases to increase the probability of finding matching units for their patients. Efforts to create and maintain CBBs allow to offer this therapeutic option at an affordable cost.
    Transfusion 04/2012; · 3.57 Impact Factor
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    ABSTRACT: Classification of acute lymphoblastic leukemia (ALL) by flow cytometric immunophenotyping characterizes the disease and delineates potential therapeutic intervention. We retrospectively analyzed CD20 expression in 143 patients with newly diagnosed precursor B-cell ALL. CD20 was observed in 61% of patients at diagnosis. There was no correlation between CD20 expression and age, white blood cell count, or cytogenetic abnormalities. Despite the fact that CD20-positive ALL patients had a tendency toward a worse outcome, there was no significant difference between patients with and without CD20 expression in 3-year overall survival 65 vs. 82% (P = 0.14), and cumulative incidence of relapse 36 vs. 18% (P = 0.3) in pediatric patients and 51 vs. 53% (P = 0.31) and 35 vs. 38% (P = 0.6) in adults, respectively. In conclusion, CD20 expression appears to be more common in Mexican patients with newly diagnosed precursor B-cell ALL higher than in Caucasian populations and lacks prognostic value.
    Hematology (Amsterdam, Netherlands) 03/2012; 17(2):66-70. · 1.33 Impact Factor
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    ABSTRACT: Antibodies have been the cornerstone of treatment of acquired aplastic anemia for more than 25 years. Treatment with antithymocyte globulin (ATG) is considered pivotal and the addition of cyclosporine improves the overall response rate. This antibody is heterogeneous and horse ATG is apparently more effective than rabbit ATG. Several issues remain unsolved in relation to the combination of ATG and cyclosporine: cost, toxicity and late clonal disorders. In recent years, alternative immunosuppressive therapy has been proposed and new antibodies have emerged: porcine ATG, alemtuzumab, daclizumab, and rituximab. Experience with these antibodies is limited to a few studies with alemtuzumab being the most promising, but the results are interesting and provocative. More studies are needed to find the perfect antibody.
    Archivum Immunologiae et Therapiae Experimentalis 02/2012; 60(2):99-106. · 2.38 Impact Factor
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    ABSTRACT: Acute lymphoblastic leukemia is the most common malignancy in pediatric patients; its diagnosis is usually easy to establish as malignant lymphoblasts invade the bone marrow and peripheral blood. Some acute lymphoblastic leukemia patients may initially present with pancytopenia and a hypoplastic bone marrow leading to the initial diagnosis of aplastic anemia. In most of these patients clinical improvement occurs, with normalization of the complete blood count within six months, although recovery can also develop a few weeks after initiating steroid therapy. The etiologic relationship between the aplastic anemia features and the subsequent overt development of acute lymphoblastic leukemia has not been established. We describe the cases of two children who presented with severe infection and signs and symptoms of aplastic anemia confirmed by bone marrow aspirate and bone marrow biopsy that developed acute lymphoblastic leukemia thereafter. No specific therapy for aplastic anemia was administered, nevertheless a full spontaneous recovery was observed in both cases. Acute lymphoblastic leukemia was successfully treated with standard chemotherapy, both children remaining in complete remission 16 and 17 months after their initial aplastic anemia diagnosis.
    Revista brasileira de hematologia e hemoterapia. 01/2012; 34(2):165-7.

Publication Stats

455 Citations
206.96 Total Impact Points

Institutions

  • 1999–2014
    • Autonomous University of Nuevo León
      • • Facultad de Medicina
      • • Hospital Universitario "Dr. José Eleuterio Gonzalez"
      San Nicolás de los Garza, Nuevo León, Mexico
  • 2001–2011
    • Biological Laboratories and Reagents of Mexico
      Ciudad de México, Mexico City, Mexico
  • 2001–2002
    • Universidad de Monterrey
      Monterrey, Nuevo León, Mexico
  • 1995
    • Hospital of UANL University
      San Nicolás de los Garza, Nuevo León, Mexico