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Supervivencia del trasplante hematopoyético con donante idéntico y donante haploidéntico / Survival after hematopoietic stem cell transplantation with identical and haploidentical donors
Resumen
Resumen
Introducción: el trasplante de células progenitoras hematopoyéticas (TCPH) es una terapia que ofrece potencial curación de neoplasias hematológicas. Una limitante es que solo 25% de los pacientes tendrán un donante idéntico. El uso de donantes haploidénticos permite que el 95% de los pacientes tengan donador. La experiencia en México con TCPH haploidéntico es limitada. En 2018 se inició el Programa de Trasplantes Haploidénticos en el Hospital de Especialidades del Centro Médico Nacional Siglo XXI.
Objetivo: comparar la supervivencia global de los pacientes sometidos a TCPH con donante idéntico y haploidéntico en el Hospital de Especialidades.
Material y métodos: se hizo un estudio tipo observacional, retrospectivo, en pacientes sometidos a TCPH en el Hospital de Especialidades, de enero de 2018 a diciembre de 2022. Se incluyeron todos los pacientes trasplantados. Se realizó un análisis de supervivencia global por curvas de Kaplan-Meier. Se consideró un nivel de significación de p < 0.05.
Resultados: se analizaron 109 pacientes sometidos a TCPH alogénico, 34% de ellos tuvieron un donante haploidéntico. No hubo diferencias en la supervivencia. El grupo haploidéntico presentó mayor reactivación de citomegalovirus y menor enfermedad del injerto en contra del hospedero (EICH) crónica.
Conclusiones: no se encontraron diferencias en la supervivencia en ambos grupos, por lo que el trasplante haploidéntico es una opción de tratamiento en los pacientes que no cuentan con donante idéntico en nuestra institución.
Abstract
Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is a therapy that offers the potential to cure hematological malignancies. One limitation is that only 25% of patients will have an identical donor. The use of haploidentical donors allows 95% of patients to have a donor. Experience in Mexico with haploidentical HSCT is limited. In 2018, the Haploidentical Transplantation Program began at the Hospital de Especialidades (Specialties Hospital) from the Centro Médico Nacional Siglo XXI (21st Century National Medical Center).
Objective: To compare the overall survival of patients undergoing HSCT with an identical or haploidentical donor at the Hospital de Especialidades.
Material and methods: A retrospective, observational study was carried out in patients undergoing HSCT at the Hospital de Especialidades, from January 2018 to December 2022. All patients who received HSCT were included. Overall survival analysis was performed using Kaplan-Meier curves. A significance level of p < 0.05 was considered.
Results: 109 patients who underwent to allogeneic HSCT were analyzed, 34% of them had a haploidentical donor. There were no differences in overall survival. The haploidentical group presented greater cytomegalovirus reactivation and less chronic graft-versus-host disease (GVHD).
Conclusions: No differences in survival were found in both groups, which is why haploidentical transplantation could be a good treatment option in patients who do not have an identical donor at our institution.
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DOI: https://doi.org/10.24875/10.5281/zenodo.10814305
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