Asociación de las puntuaciones de riesgo con la sobrevida global y libre de enfermedad en adultos que reciben TPH en una institución colombiana de alta complejidad
Introducción: El trasplante de progenitores hematopoyéticos (TPH) es una estrategia potencialmente curativa para una serie de enfermedades malignas y no malignas que afectan el sistema hematopoyético y algunos tumores sólidos. Sin embargo, se asocia con complicaciones a corto y largo plazo. El Índic...
- Autores:
-
Rivera Castillo, Karina Esther
- Tipo de recurso:
- Fecha de publicación:
- 2024
- Institución:
- Universidad Autónoma de Bucaramanga - UNAB
- Repositorio:
- Repositorio UNAB
- Idioma:
- spa
- OAI Identifier:
- oai:repository.unab.edu.co:20.500.12749/25329
- Acceso en línea:
- http://hdl.handle.net/20.500.12749/25329
- Palabra clave:
- Internal medicine
Medicine
Medical sciences
Health sciences
Hematopoietic stem cell transplantation
HCT-CI index
Overall survival
Non-relapse mortality
Health institutions
Comorbidity
Epidemiology
Public health
Medicina
Ciencias médicas
Medicina interna
Instituciones de salud
Comorbilidad
Epidemiología
Salud pública
Ciencias de la salud
Trasplante de progenitores hematopoyéticos
Índice HCT-CI
Score de riesgo del EBMT
Mortalidad sin recaída
Supervivencia global
Sobrevida libre de evento
- Rights
- License
- http://creativecommons.org/licenses/by-nc-nd/2.5/co/
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| dc.title.spa.fl_str_mv |
Asociación de las puntuaciones de riesgo con la sobrevida global y libre de enfermedad en adultos que reciben TPH en una institución colombiana de alta complejidad |
| dc.title.translated.spa.fl_str_mv |
Asociación de las puntuaciones de riesgo con la sobrevida global y libre de enfermedad en adultos que reciben TPH en una institución colombiana de alta complejidad |
| title |
Asociación de las puntuaciones de riesgo con la sobrevida global y libre de enfermedad en adultos que reciben TPH en una institución colombiana de alta complejidad |
| spellingShingle |
Asociación de las puntuaciones de riesgo con la sobrevida global y libre de enfermedad en adultos que reciben TPH en una institución colombiana de alta complejidad Internal medicine Medicine Medical sciences Health sciences Hematopoietic stem cell transplantation HCT-CI index Overall survival Non-relapse mortality Health institutions Comorbidity Epidemiology Public health Medicina Ciencias médicas Medicina interna Instituciones de salud Comorbilidad Epidemiología Salud pública Ciencias de la salud Trasplante de progenitores hematopoyéticos Índice HCT-CI Score de riesgo del EBMT Mortalidad sin recaída Supervivencia global Sobrevida libre de evento |
| title_short |
Asociación de las puntuaciones de riesgo con la sobrevida global y libre de enfermedad en adultos que reciben TPH en una institución colombiana de alta complejidad |
| title_full |
Asociación de las puntuaciones de riesgo con la sobrevida global y libre de enfermedad en adultos que reciben TPH en una institución colombiana de alta complejidad |
| title_fullStr |
Asociación de las puntuaciones de riesgo con la sobrevida global y libre de enfermedad en adultos que reciben TPH en una institución colombiana de alta complejidad |
| title_full_unstemmed |
Asociación de las puntuaciones de riesgo con la sobrevida global y libre de enfermedad en adultos que reciben TPH en una institución colombiana de alta complejidad |
| title_sort |
Asociación de las puntuaciones de riesgo con la sobrevida global y libre de enfermedad en adultos que reciben TPH en una institución colombiana de alta complejidad |
| dc.creator.fl_str_mv |
Rivera Castillo, Karina Esther |
| dc.contributor.advisor.none.fl_str_mv |
Sossa Melo, Claudia Lucía Salazar Montaña, Luis Antonio Ochoa Vera, Miguel Enrique Luna González, María Lucrecia |
| dc.contributor.author.none.fl_str_mv |
Rivera Castillo, Karina Esther |
| dc.contributor.cvlac.spa.fl_str_mv |
Sossa Melo, Claudia Lucia [0001425704] Ochoa Vera, Miguel Enrique [0000898465] Luna González, María Lucrecia [0001347422] Salazar Montaña, Luis Antonio [0000919497] Rivera Castillo, Karina Rivera [0001816978] |
| dc.contributor.googlescholar.spa.fl_str_mv |
Sossa Melo, Claudia Lucia [n1PL8iUAAAAJ] Luna González, María Lucrecia [pLIVNZYAAAAJ] |
| dc.contributor.orcid.spa.fl_str_mv |
Luna Gonzalez, María Lucrecia 0000-0003-2846-6868 Sossa Melo, Claudia Lucía [0000-0001-9876-222X] Luna González, María Lucrecia [0000-0003-2846-6868] |
| dc.contributor.researchgate.spa.fl_str_mv |
Ochoa Vera, Miguel Enrique [Miguel_Ochoa7] |
| dc.contributor.apolounab.spa.fl_str_mv |
Sossa Melo, Claudia Lucía [claudia-lucia-sossa-melo] Ochoa Vera, Miguel Enrique [miguel-enrique-ochoa-vera] Luna González, María Lucrecia [maría-lucrecia-luna-gonzález] |
| dc.subject.keywords.spa.fl_str_mv |
Internal medicine Medicine Medical sciences Health sciences Hematopoietic stem cell transplantation HCT-CI index Overall survival Non-relapse mortality Health institutions Comorbidity Epidemiology Public health |
| topic |
Internal medicine Medicine Medical sciences Health sciences Hematopoietic stem cell transplantation HCT-CI index Overall survival Non-relapse mortality Health institutions Comorbidity Epidemiology Public health Medicina Ciencias médicas Medicina interna Instituciones de salud Comorbilidad Epidemiología Salud pública Ciencias de la salud Trasplante de progenitores hematopoyéticos Índice HCT-CI Score de riesgo del EBMT Mortalidad sin recaída Supervivencia global Sobrevida libre de evento |
| dc.subject.lemb.spa.fl_str_mv |
Medicina Ciencias médicas Medicina interna Instituciones de salud Comorbilidad Epidemiología Salud pública |
| dc.subject.proposal.spa.fl_str_mv |
Ciencias de la salud Trasplante de progenitores hematopoyéticos Índice HCT-CI Score de riesgo del EBMT Mortalidad sin recaída Supervivencia global Sobrevida libre de evento |
| description |
Introducción: El trasplante de progenitores hematopoyéticos (TPH) es una estrategia potencialmente curativa para una serie de enfermedades malignas y no malignas que afectan el sistema hematopoyético y algunos tumores sólidos. Sin embargo, se asocia con complicaciones a corto y largo plazo. El Índice HCT-CI y el Score de riesgo del EBMT son herramientas para predecir la sobrevida global y la mortalidad relacionada con TPH. Objetivo: Evaluar la asociación de los puntuajes de riesgo con respecto a la sobrevida global y libre de enfermedad del TPH en una institución de alta complejidad de Colombia. Materiales y Métodos: Análisis secundario de 389 pacientes incluidos en el ¨Registro epidemiológico de pacientes adultos con TPH¨, de la Clínica Foscal entre 2009 y 2021. Se excluyeron registros de segundos trasplantes. Se calcularon riesgos de acuerdo con el Índice HCT-CI y el Score de riesgo del EBMT. Resultados: Predominaron los hombres (51,9%) y una edad media 52 años. La mayoría con ECOG entre 0 y 1 (95,5%), con diabetes y enfermedad pulmonar moderada (11,3%). Las indicaciones de TPH más frecuentes fueron los Linfomas (39,3%) y el mieloma múltiple (30,6%), la mayoría de los TPH se realizaron en etapa temprana de la enfermedad (51,8%), el auto-TPH (71,21%) se realizó con mayor frecuencia, hubo 28,57% recaídas en alo-TPH y 22,74% en auto-TPH, a los 5 años se registraron 49,53% muertes en alo-TPH y 35% en auto-TPH, como causa principal recaída/progresión de la enfermedad, en ambos tipos de TPH. 28 personas tuvieron una causa de muerte relacionada con el TPH, siendo las infecciones y la enfermedad injerto contra huésped eventos que ocurrieron en 16 personas que recibieron alo-TPH. La evaluación del riesgo con el HCT-CI no mostró diferencias significativas en ningún tipo de TPH ni en ningún grupo de riesgo, mientras que para el Score EBMT en alo-TPH predominó el riesgo intermedio (58,03%) con diferencias estadísticamente significativas entre las categorías de riesgo, para los períodos evaluados de 100 días, uno y cinco años. Conclusión: En nuestro estudio, el Score EBMT demostró estar asociado con los resultados de supervivencia, por lo que se confirma que es una herramienta valiosa para la estimación del riesgo en los pacientes en nuestra institución. |
| publishDate |
2024 |
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2024-07-05T14:46:02Z |
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2024-07-05T14:46:02Z |
| dc.date.issued.none.fl_str_mv |
2024-06-27 |
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info:eu-repo/semantics/masterThesis |
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Tesis |
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instname:Universidad Autónoma de Bucaramanga - UNAB |
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reponame:Repositorio Institucional UNAB |
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| dc.relation.references.spa.fl_str_mv |
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El Instituto Nacional de Salud respalda la tradición científica y técnica de trasplantes de médula ósea en Colombia. 2014. Simpson E, Dazzi F. Bone Marrow Transplantation 1957-2019. Front Immunol. 2019 Jun 5;10:1246. Duarte M. Trasplante Autólogo de Médula Ósea. Acta Medica Colombiana. 2012 Oct;37(4):1–7. Rifón JJ. Trasplante de Progenitores hemopoyéticos. An Sist Sanit Navar. 2006;29(2):1–16. Gratwohl A, Hermans J, Goldman JM, Arcese W, Carreras E, Devergie A, et al. Risk assessment for patients with chronic myeloid leukaemia before allogeneic blood or marrow transplantation. Lancet. 1998;352(9134). Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: A new tool for risk assessment before allogeneic HCT. Blood. 2005 Jun 30;106(8):2912–9. Gooley TA, Chien JW, Pergam SA, Hingorani S, Sorror ML, Boeckh M, et al. Reduced Mortality after Allogeneic Hematopoietic Cell Transplantation. N Engl J Med. 2010 Nov 25;363(22):1–16 Gratwohl A, Hermans J, Goldman J, Arcese W, Carreras E, Devergie A. Risk assessment for patients with chronic myeloid leukaemia before allogeneic blood or marrow transplantation. Bone Marrow Transplant. 2012 Jun 6;47(6):749–56. Gratwohl A, Stern M, Brand R, Apperley J, Baldomero H, De Witte T, et al. Risk score for outcome after allogeneic hematopoietic stem cell transplantation: A retrospective analysis. Cancer. 2009 Oct 15;115(20):4715–26. Barba P, Piñana JL, Martino R, Valcárcel D, Amorós A, Sureda A, et al. Comparison of Two Pretransplant Predictive Models and a Flexible HCT-CI Using Different Cut off Points to Determine Low-, Intermediate-, and High-Risk Groups: The Flexible HCT-CI Is the Best Predictor of NRM and OS in a Population of Patients Undergoing allo-RIC. Biology of Blood and Marrow Transplantation. 2010 Mar;16(3):413–20. Zhu X, Huang L, Zheng C, Tang B, Liu H, Geng L, et al. European Group for Blood and Marrow Transplantation Risk Score Predicts the Outcome of Patients with Acute Leukemia Receiving Single Umbilical Cord Blood Transplantation. Biology of Blood and Marrow Transplantation. 2017 Aug 12;23(12):2118–26. Rezvani K, Kanfer EJ, Marin D, Gabriel I, Rahemtulla A, Taylor A, et al. EBMT Risk Score Predicts Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in Patients Who Have Failed a Previous Transplantation Procedure. Biology of Blood and Marrow Transplantation. 2012 Jun 30;18(2):235–40. Pitombeira BS, Paz A, Pezzi A, Amorin B, Valim V, Laureano A, et al. Validation of the EBMT Risk Score for South Brazilian Patients Submitted to Allogeneic Hematopoietic Stem Cell Transplantation. Bone Marrow Res. 2013 Dec 12;2013:1–7. Veeraputhiran M, Yang L, Sundaram V, Arai S, Lowsky R, Miklos D, et al. Validation of the Hematopoietic Cell Transplantation–Specific Comorbidity Index in Nonmyeloablative Allogeneic Stem Cell Transplantation. 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Optimized EBMT transplant-specific risk score in myelodysplastic syndromes after allogeneic stem-cell transplantation. Haematologica. 2019 Apr 30;104(5):929–36. Iacobelli S. Suggestions on the use of statistical methodologies in studies of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant. 2013 Mar;48(Suppl 1):S1-37. Organización Nacional de Trasplantes España. Memoria de actividad TPH. ONT. 2022 Solaiman OM, Elhassan T, Fakih RE, Mannan A, Alduhailib Z, Mahdali AA, et al. Outcomes and Long-Term Survival of Adolescent and Young Adult Patients Admitted to the Intensive Care Unit Following Allogeneic Hematopoietic Stem Cell Transplantation: A Single-Center Experience of 152 Patients. Hematol Oncol Stem Cell Ther. 2024 Mar 22;17(2):110–9. Kliman D, Nivison-Smith I, Gottlieb D, Hamad N, Kerridge I, Purtill D, et al. Hematopoietic Stem Cell Transplant Recipients Surviving at Least 2 Years from Transplant Have Survival Rates Approaching Population Levels in the Modern Era of Transplantation. Biology of Blood and Marrow Transplantation. 2020 Sep 1;26(9):1711–8. McHenry M, HLB, MRT. Impact Of Health Insurance On Time To Approval And Time To Transplant Among Patients Receiving Hematopoietic Stem Cell Transplantation. 2007. Mark E, Goldsman D, Gurbaxani B, Keskinocak P, Sokol J. Predicting a kidney transplant patient’s pre-transplant functional status based on information from waitlist registration. Sci Rep. 2023 Dec 1;13(1) Kocher F, Mian M, Seeber A, Fiegl M, Stauder R. The prognostic impact of comorbidities in patients with de-novo diffuse large b-cell lymphoma treated with R-CHOP immunochemotherapy in curative intent. J Clin Med. 2020 Apr 1;9(4). Rizzo JD, Curtis RE, Rard Socié G, Sobocinski KA, Gilbert E, Landgren O, et al. Solid cancers after allogeneic hematopoietic cell transplantation. 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Graft-versus-host disease. Vol. 373, The Lancet. Elsevier B.V.; 2009. p. 1550–61. Passweg JR, Baldomero H, Bader P, Bonini C, Cesaro S, Dreger P, et al. Hematopoietic stem cell transplantation in Europe 2014: More than 40 000 transplants annually. Bone Marrow Transplant. 2016 Jun 1;51(6):786–92 Bejanyan N, Weisdorf DJ, Logan BR, Wang HL, Devine SM, de Lima M, et al. Survival of Patients with Acute Myeloid Leukemia Relapsing after Allogeneic Hematopoietic Cell Transplantation: A Center for International Blood and Marrow Transplant Research Study. Biology of Blood and Marrow Transplantation. 2015 Mar 1;21(3):454–9. Thanarajasingam G, Kim HT, Cutler C, Ho VT, Koreth J, Alyea EP, et al. Outcome and Prognostic Factors for Patients Who Relapse after Allogeneic Hematopoietic Stem Cell Transplantation. Biology of Blood and Marrow Transplantation. 2013 Dec;19(12):1713–8. Mohty B, Mohty M. Long-term complications and side effects after allogeneic hematopoietic stem cell transplantation: An update. Vol. 1, Blood Cancer Journal. 2011. Schmid C, Schleuning M, Ledderose G, Tischer J, Kolb HJ. Sequential regimen of chemotherapy, reduced-intensity conditioning for allogeneic stem-cell transplantation, and prophylactic donor lymphocyte transfusion in high-risk acute myeloid leukemia and myelodysplastic syndrome. Journal of Clinical Oncology. 2005;23(24):5675–87. Saad A, Mahindra A, Zhang MJ, Zhong X, Costa LJ, Dispenzieri A, et al. Hematopoietic cell transplant comorbidity index is predictive of survival after autologous hematopoietic cell transplantation in multiple myeloma. Biology of Blood and Marrow Transplantation. 2014;20(3):402-408.e1. Birninger N, Bornhäuser M, Schaich M, Ehninger G, Schetelig J. The hematopoietic cell transplantation-specific comorbidity index fails to predict outcomes in high-risk AML patients undergoing allogeneic transplantation-investigation of potential limitations of the index. Biology of Blood and Marrow Transplantation. 2011 Dec;17(12):1822–32. Weise G, Massoud R, Krause R, Heidenreich S, Janson D, Klyuchnikov E, et al. Development and Validation of a Concise Objectifiable Risk Evaluation Score for Non-Relapse Mortality after Allogeneic Hematopoietic Stem Cell Transplantation. Cancers (Basel). 2024 Feb 1;16(3). Itonaga H, Miyazaki Y, Fujioka M, Aoki J, Doki N, Nishida T, et al. Prognostic impact of the conditioning intensity on outcomes after allogeneic transplantation for MDS with low blasts: a nationwide retrospective study by the adult MDS working group of the Japan Society for Transplantation and Cellular Therapy. Bone Marrow Transplant [Internet]. 2024 May 7; Available from: https://www.nature.com/articles/s41409-024-02297-0 Gu Z, Li F, Li M, Wang L, Lu N, Jin X, et al. Upfront allogeneic hematopoietic stem cell transplantation for adult T-cell acute lymphoblastic leukemia/lymphoma in first complete remission: a single-center study. Ann Hematol. 2024 Birninger N, Bornhäuser M, Schaich M, Ehninger G, Schetelig J. The hematopoietic cell transplantation-specific comorbidity index fails to predict outcomes in high-risk AML patients undergoing allogeneic transplantation-investigation of potential limitations of the index. Biology of Blood and Marrow Transplantation. 2011 Dec;17(12):1822–32. |
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Noviembre de 2009 a Diciembre 2022 |
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Universidad Autónoma de Bucaramanga UNAB |
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Sossa Melo, Claudia Lucía090f67d5-2a77-4cbb-8a32-0c23a2487d41Salazar Montaña, Luis Antonio05562fd4-5abb-40c4-b7a9-bc425a04bc30Ochoa Vera, Miguel Enriquebf83ca83-93c9-401e-91d3-b424889e868fLuna González, María Lucrecia7f524da3-dbfd-4a5c-9e72-4ea55989230aRivera Castillo, Karina Esther28126869-fcb9-45d2-8654-c71cf761ef8dSossa Melo, Claudia Lucia [0001425704]Ochoa Vera, Miguel Enrique [0000898465]Luna González, María Lucrecia [0001347422]Salazar Montaña, Luis Antonio [0000919497]Rivera Castillo, Karina Rivera [0001816978]Sossa Melo, Claudia Lucia [n1PL8iUAAAAJ]Luna González, María Lucrecia [pLIVNZYAAAAJ]Luna Gonzalez, María Lucrecia 0000-0003-2846-6868Sossa Melo, Claudia Lucía [0000-0001-9876-222X]Luna González, María Lucrecia [0000-0003-2846-6868]Ochoa Vera, Miguel Enrique [Miguel_Ochoa7]Sossa Melo, Claudia Lucía [claudia-lucia-sossa-melo]Ochoa Vera, Miguel Enrique [miguel-enrique-ochoa-vera]Luna González, María Lucrecia [maría-lucrecia-luna-gonzález]Floridablanca (Santander, Colombia)Noviembre de 2009 a Diciembre 2022UNAB Campus Bucaramanga2024-07-05T14:46:02Z2024-07-05T14:46:02Z2024-06-27http://hdl.handle.net/20.500.12749/25329instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.coIntroducción: El trasplante de progenitores hematopoyéticos (TPH) es una estrategia potencialmente curativa para una serie de enfermedades malignas y no malignas que afectan el sistema hematopoyético y algunos tumores sólidos. Sin embargo, se asocia con complicaciones a corto y largo plazo. El Índice HCT-CI y el Score de riesgo del EBMT son herramientas para predecir la sobrevida global y la mortalidad relacionada con TPH. Objetivo: Evaluar la asociación de los puntuajes de riesgo con respecto a la sobrevida global y libre de enfermedad del TPH en una institución de alta complejidad de Colombia. Materiales y Métodos: Análisis secundario de 389 pacientes incluidos en el ¨Registro epidemiológico de pacientes adultos con TPH¨, de la Clínica Foscal entre 2009 y 2021. Se excluyeron registros de segundos trasplantes. Se calcularon riesgos de acuerdo con el Índice HCT-CI y el Score de riesgo del EBMT. Resultados: Predominaron los hombres (51,9%) y una edad media 52 años. La mayoría con ECOG entre 0 y 1 (95,5%), con diabetes y enfermedad pulmonar moderada (11,3%). Las indicaciones de TPH más frecuentes fueron los Linfomas (39,3%) y el mieloma múltiple (30,6%), la mayoría de los TPH se realizaron en etapa temprana de la enfermedad (51,8%), el auto-TPH (71,21%) se realizó con mayor frecuencia, hubo 28,57% recaídas en alo-TPH y 22,74% en auto-TPH, a los 5 años se registraron 49,53% muertes en alo-TPH y 35% en auto-TPH, como causa principal recaída/progresión de la enfermedad, en ambos tipos de TPH. 28 personas tuvieron una causa de muerte relacionada con el TPH, siendo las infecciones y la enfermedad injerto contra huésped eventos que ocurrieron en 16 personas que recibieron alo-TPH. La evaluación del riesgo con el HCT-CI no mostró diferencias significativas en ningún tipo de TPH ni en ningún grupo de riesgo, mientras que para el Score EBMT en alo-TPH predominó el riesgo intermedio (58,03%) con diferencias estadísticamente significativas entre las categorías de riesgo, para los períodos evaluados de 100 días, uno y cinco años. Conclusión: En nuestro estudio, el Score EBMT demostró estar asociado con los resultados de supervivencia, por lo que se confirma que es una herramienta valiosa para la estimación del riesgo en los pacientes en nuestra institución.Planteamiento del Problema y Justificación 9 Marco Teórico 11 Trasplante de Precursores Hematopoyéticos 11 Indicaciones de Trasplante de Progenitores Hematopoyéticos 13 Determinación del Riesgo Pretrasplante 14 Modelos Pronósticos 14 Score de Riesgo Del EBMT 15 Índice HCT-CI 16 Estado del Arte 17 Pregunta de Investigación 20 Hipótesis 21 Objetivos 21 Objetivo General 21 Objetivos Específicos 21 Metodología 22 Tipo de Estudio 22 Población 22 Criterios de Inclusión y Exclusión 22 Cálculo de Tamaño Muestral 22 Recolección de Información 23 Variables 23 Métodos estadísticos en el TPH y terapia celular 24 Plan de Procesamiento y Análisis de Datos 25 Consideraciones Éticas 25 Resultados 26 Características Sociodemográficas 27 Mortalidad de TPH en Foscal 32 Sobrevida Global por Índice HCT-CI en TPH en Foscal 34 Sobrevida global por muerte no relacionada por recaída/ progresión según índice HCT-CI en TPH Foscal a 100 días, 1 y 5 años de seguimiento 36 Sobrevida libre de enfermedad (SLE) en auto-TPH y alo-TPH por índice HCT-CI a 100 días, 1 y 5 años 38 Sobrevida global por Score EBMT en alo-TPH en Foscal, a los 100 días, 1 y 5 años 40 Sobrevida libre de enfermedad por Score EBMT en TPH alogénico en Foscal, a los 100 días, 1 y 5 años 42 Discusión 46 Conclusiones 58 Referencias 59EspecializaciónIntroduction: Hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for a variety of malignant and non-malignant hematologic disorders, as well as select solid tumors. However, it is associated with a significant risk of both short-term and long-term complications, such as graft-versus-host disease (GVHD), infection, and organ dysfunction. The HCT-CI Index and the EBMT Risk Score are two prognostic tools that can be used to predict overall survival and HSCT-related mortality. Objective: This study aimed to assess the correlation between risk scores and overall as well as disease-free survival following HSCT in a high-complexity institution in Colombia. Materials and Methods: A retrospective analysis was conducted on 389 adult patients included in the "Epidemiological Registry of Adult Patients with HSCT" at the Clinica Foscal from 2009 to 2021. Patients who underwent a second HSCT were excluded. Both the HCT-CI index and the EBMT risk score were calculated for each patient. Results: The study population included a majority of male patients (51.9%) with an average age of 52 years. Most patients had good performance status (ECOG scores between 0 and 1; 95.5%) and a minority had comorbidities such as diabetes and moderate lung disease (11.3%). The most common indications for HSCT were lymphomas (39.3%) and multiple myeloma (30.6%). The majority of procedures were performed at an early disease stage (51.8%). Autologous HSCT (auto-HSCT) was more frequently performed (71.21%) compared to allogeneic HSCT (allo-HSCT). Relapse rates were lower in auto-HSCT (22.74%) compared to allo-HSCT (28.57%). The five-year mortality rate was higher for allo-HSCT (49.53%) compared to auto-HSCT (35%). Disease relapse/progression was the main cause of death in both groups. HSCT-related mortality occurred in 28 patients, with infections and graft-versus-host disease (GVHD) being the most common complications in allo-HSCT recipients (16 patients). The HCT-CI score did not show any significant differences between HSCT types or risk groups. The risk assessment using HCT-CI did not show significant differences in any type of HSCT nor in any risk group, whereas for the EBMT Score in allo-HSCT, intermediate risk predominated (58.03%) with statistically significant differences between risk categories, for the evaluated periods of 100 days, one, and five years. Conclusion: This study suggests that the EBMT score is a valuable prognostic tool for predicting survival outcomes following HSCT in our institution. Patients with intermediate-risk EBMT scores had poorer survival compared to other studies, which may be due to differences in patient populations, treatment protocols, or other factors. Further research is needed to investigate these factors.Modalidad Presencialapplication/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)Atribución-NoComercial-SinDerivadas 2.5 Colombiahttp://purl.org/coar/access_right/c_abf2Asociación de las puntuaciones de riesgo con la sobrevida global y libre de enfermedad en adultos que reciben TPH en una institución colombiana de alta complejidadAsociación de las puntuaciones de riesgo con la sobrevida global y libre de enfermedad en adultos que reciben TPH en una institución colombiana de alta complejidadEspecialista en Medicina InternaUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludEspecialización en Medicina Internainfo:eu-repo/semantics/masterThesisTesisinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/redcol/resource_type/TMInternal medicineMedicineMedical sciencesHealth sciencesHematopoietic stem cell transplantationHCT-CI indexOverall survivalNon-relapse mortalityHealth institutionsComorbidityEpidemiologyPublic healthMedicinaCiencias médicasMedicina internaInstituciones de saludComorbilidadEpidemiologíaSalud públicaCiencias de la saludTrasplante de progenitores hematopoyéticosÍndice HCT-CIScore de riesgo del EBMTMortalidad sin recaídaSupervivencia globalSobrevida libre de eventoInstituto Nacional de Salud. 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Biology of Blood and Marrow Transplantation. 2011 Dec;17(12):1822–32.https://apolo.unab.edu.co/en/persons/claudia-lucia-sossa-meloORIGINALTesis.pdfTesis.pdfTesisapplication/pdf2345911https://repository.unab.edu.co/bitstream/20.500.12749/25329/1/Tesis.pdf982c1eb2b65a1b04518818c196ec24b3MD51open accessLicencia.pdfLicencia.pdfLicenciaapplication/pdf336586https://repository.unab.edu.co/bitstream/20.500.12749/25329/5/Licencia.pdf52b3f284ed0fbba9c923be8ef0240093MD55metadata only accessLICENSElicense.txtlicense.txttext/plain; charset=utf-8829https://repository.unab.edu.co/bitstream/20.500.12749/25329/4/license.txt3755c0cfdb77e29f2b9125d7a45dd316MD54open accessTHUMBNAILTesis.pdf.jpgTesis.pdf.jpgIM Thumbnailimage/jpeg5048https://repository.unab.edu.co/bitstream/20.500.12749/25329/6/Tesis.pdf.jpgbad7c72ef1a479ad6893ec3851093c56MD56open accessLicencia.pdf.jpgLicencia.pdf.jpgIM Thumbnailimage/jpeg12676https://repository.unab.edu.co/bitstream/20.500.12749/25329/7/Licencia.pdf.jpg589c768476ef9cc7eda0aeeabe5b9e5fMD57metadata only access20.500.12749/25329oai:repository.unab.edu.co:20.500.12749/253292024-07-05 22:00:25.974open accessRepositorio Institucional | Universidad Autónoma de Bucaramanga - UNABrepositorio@unab.edu.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 |