Leucemia linfóide aguda infantil no peculiar contexto amazônico.
The Acute Lymphoblastic Leukemia (ALL) is the most common cancer in the childhood, but the disease’s kind of evolution and the quality of the assistance which the pediatric patients receive are unknown in a lot of regions in the world – among them, the Amazon region, in Brazil. OBJECTIVE: To id...
| Autor principal: | CAJADO, Luciana Corrêa de Sena |
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| Outros Autores: | SILVA, Natália Herculando da |
| Grau: | Trabalho de Conclusão de Curso - Graduação |
| Publicado em: |
2023
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https://bdm.ufpa.br:8443/jspui/handle/prefix/4909 |
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oai:https:--bdm.ufpa.br:8443:prefix-49092023-01-11T03:05:20Z Leucemia linfóide aguda infantil no peculiar contexto amazônico. CAJADO, Luciana Corrêa de Sena SILVA, Natália Herculando da RIBEIRO, Rita de C. M. CARNEIRO, Rita de Cássia Matos http://lattes.cnpq.br/7352881699165848 Leucemia linfoide aguda Câncer infantil Câncer na Amazônia Acute lymphoblastic leukemia Cancer on the childhood Cancer on the amazon region CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::CANCEROLOGIA The Acute Lymphoblastic Leukemia (ALL) is the most common cancer in the childhood, but the disease’s kind of evolution and the quality of the assistance which the pediatric patients receive are unknown in a lot of regions in the world – among them, the Amazon region, in Brazil. OBJECTIVE: To identify a local profile of pediatric patients diagnosed with ALL and assisted in a reference health service in the Amazon region; to describe the ALL in its clinical and laboratorial presentation and to analyze some clinical-epidemiological factors influences in three of the possible endings in this population: complete clinical remission, relapse and death. METHODS: Clinical-epidemiological study (observational, individual and analytic), with a retrospective design in series of cases, from 2003 to 2011. Patients with ALL were included according the following characteristics: to be from zero to twelve years old; and to be admitted from January/2003 to January/2008, in the Pediatric Sector of the Ofir Loyola Hospital (OLH). RESULTS: There were 152 patients in the study: 62.5% were boys and 37.5% girls. The age’s peak of incidence was with three years old and the average, 5.1 years old. Browns, Whites, Blacks, Indians and Yellows races/colors were found in this population: 71.1%, 11.2%, 3.9%, 0.7%, 0.7% and 12.5%, respectively. The origin was distributed among: Belem metropolitan region (27.6%), other towns in Para State (55.3%) and cities in other Brazilian States (16.4%). The spent time between the symptoms beginning and the admission at the OLH was 65.8 days (average). In the admission, 8.5% had central nervous system infiltration and 1% of the boys had testicle infiltration. Pancytopenia was the most found laboratorial standard, just as the blasts cells count over 85% in myelogram. There was more ALL cells B occurrence (36.2%) than other kinds, just as the subtype B common (30.2%). 98% of the treatments used chemotherapy protocols; only 0.7% of the patients was submitted to the bone marrow transplantation. The found endings were: death during the treatment (52%); complete clinical remission/cure (30.2%); treatment continuous to the first clinical remission (5.3%); treatment of relapse after the first finished treatment (4.6%); treatment of relapse without finishing the first treatment (3.9%); abandonment (3.3%); transference (0.7%). There was significant statistical association between: death and age, brown color, lack of pain in limbs in the admission, presentation of mucositis as co-morbidity on the diagnosis, no change of chemotherapy protocol during the treatment, no realization of intrathecal therapy, sepsis during the treatment, just as relapse and a long time of treatment; between relapse, male sex and late change of protocol; between cure and age, pale skin on the diagnosis and pain in limbs in the admission, realization of intrathecal therapy, no change of protocol, lack of relapse and having a treatment with a longer time. CONCLUSION: With significant statistical association mainly linked to the clinical presentation on the diagnosis and admission and to the conducts and complications during the treatment, it is responsibility of the health service reanalyze proposals of improvements to the assistance with the main objective of obtaining best results in the childhood cancer care in this Brazilian region. A Leucemia Linfóide Aguda (LLA) é o câncer mais comum da infância, mas seu padrão evolutivo e assistência a que são submetidos os pacientes pediátricos acometidos com a doença ainda são uma incógnita em muitas regiões do mundo – dentre elas, a Amazônia. OBJETIVO: Identificar um perfil local dos pacientes pediátricos diagnosticados com LLA e assistidos por um serviço de referência inserido na Amazônia; descrevê-la enquanto apresentação clínica e laboratorial e analisar a influência de alguns fatores clínico epidemiológicos em três dos possíveis desfechos nessa população: remissão clínica completa, recaída e óbito. MÉTODO: Estudo clínico-epidemiológico observacional, individual, analítico, com desenho retrospectivo do tipo série de casos consecutivos, entre 2003 e 2011. Incluíram-se, no estudo, pacientes com LLA, entre zero e doze anos, admitidos entre janeiro de 2003 e janeiro de 2008, no Setor de Pediatria Oncológica do Hospital Ofir Loyola (HOL). RESULTADOS: Houve 152 pacientes estudados: 62,5% para o sexo masculino e 37,5%, feminino. O pico de incidência foi aos três anos, com média de 5,1 anos. Pardos, brancos, negros, indígenas, amarelos correspondiam a 71,1%, 11,2%, 3,9%, 0,7%, 0,7% e 12,5%, respectivamente. A procedência distribuiu-se em: região metropolitana de Belém (27,6%), interior do Estado do Pará (55,3%) e municípios de outros Estados (16,4%). O tempo despendido entre o inicio dos sintomas e a admissão no HOL foi de, em média, 65,8 dias. À admissão, 8,5% apresentavam infiltração de sistema nervoso central e 1% dos meninos tinha infiltração testicular. Pancitopenia foi o padrão laboratorial mais encontrado, bem como contagens acima de 85% de blastos ao mielograma. Houve maior ocorrência da LLA tipo células B (36,2%) e do subtipo B comum (30,2%). Tratou-se 98% dos pacientes baseando-se em protocolos quimioterápicos e apenas 0,7% submeteu-se a transplante de medula óssea. Os desfechos obtidos foram: óbito durante o tratamento (52%); remissão clinica completa/cura (30,2%); manutenção do tratamento da primeira remissão clinica (5,3%); tratamento de recaída após conclusão do primeiro tratamento (4,6%); tratamento de recaída sem haver concluído o primeiro tratamento (3,9%); abandono (3,3%); transferência (0,7%). Houve associação estatisticamente significante: entre óbito e faixa etária, cor parda, mucosite ao diagnóstico, ausência de dor em membros/osteoarticular à admissão, ausência de mudança de protocolo durante o tratamento, não realização de terapia intratecal, sepse ao longo do tratamento, ocorrência de recaída e tempo prolongado de tratamento; entre recaída, sexo masculino e mudança tardia de protocolo; e entre cura e faixa etária, palidez ao diagnóstico e dor em membros/osteoarticular à admissão, realização de terapia intratecal, não mudar de protocolo, ausência de recaída e maior duração de tratamento. CONCLUSÃO: Sabendo-se das associações estatisticamente significantes relacionadas à apresentação clínica ao diagnóstico, à admissão e ainda frente às condutas e complicações ao longo do tratamento, cabe ao serviço reavaliar propostas de melhoria a assistência a fim de obter melhores resultados no cuidado do câncer infantil na região. 2023-01-10T15:04:49Z 2023-01-10T15:04:49Z 2011 Trabalho de Conclusão de Curso - Graduação CAJADO, Luciana Corrêa de Sena; SILVA, Natália Herculando da. Leucemia linfóide aguda infantil no peculiar contexto amazônico. Orientadora: Rita de C. M. Ribeiro; Coorientadora: Rita de Cássia Matos Carneiro. 2011. 121 f. Trabalho de Conclusão de Curso (Bacharelado em Medicina)-Faculdade de Medicina, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, 2011. Disponível em: https://bdm.ufpa.br:8443/jspui/handle/prefix/4909. Acesso em:. https://bdm.ufpa.br:8443/jspui/handle/prefix/4909 Acesso Aberto 1 CD ROM |
| institution |
Biblioteca Digital de Monografias - UFPA |
| collection |
MonografiaUFPA |
| topic |
Leucemia linfoide aguda Câncer infantil Câncer na Amazônia Acute lymphoblastic leukemia Cancer on the childhood Cancer on the amazon region CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::CANCEROLOGIA |
| spellingShingle |
Leucemia linfoide aguda Câncer infantil Câncer na Amazônia Acute lymphoblastic leukemia Cancer on the childhood Cancer on the amazon region CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::CANCEROLOGIA CAJADO, Luciana Corrêa de Sena Leucemia linfóide aguda infantil no peculiar contexto amazônico. |
| topic_facet |
Leucemia linfoide aguda Câncer infantil Câncer na Amazônia Acute lymphoblastic leukemia Cancer on the childhood Cancer on the amazon region CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::CANCEROLOGIA |
| description |
The Acute Lymphoblastic Leukemia (ALL) is the most common cancer in the childhood, but
the disease’s kind of evolution and the quality of the assistance which the pediatric patients
receive are unknown in a lot of regions in the world – among them, the Amazon region, in
Brazil. OBJECTIVE: To identify a local profile of pediatric patients diagnosed with ALL and
assisted in a reference health service in the Amazon region; to describe the ALL in its clinical
and laboratorial presentation and to analyze some clinical-epidemiological factors influences
in three of the possible endings in this population: complete clinical remission, relapse and
death. METHODS: Clinical-epidemiological study (observational, individual and analytic),
with a retrospective design in series of cases, from 2003 to 2011. Patients with ALL were
included according the following characteristics: to be from zero to twelve years old; and to
be admitted from January/2003 to January/2008, in the Pediatric Sector of the Ofir Loyola
Hospital (OLH). RESULTS: There were 152 patients in the study: 62.5% were boys and
37.5% girls. The age’s peak of incidence was with three years old and the average, 5.1 years
old. Browns, Whites, Blacks, Indians and Yellows races/colors were found in this population:
71.1%, 11.2%, 3.9%, 0.7%, 0.7% and 12.5%, respectively. The origin was distributed among:
Belem metropolitan region (27.6%), other towns in Para State (55.3%) and cities in other
Brazilian States (16.4%). The spent time between the symptoms beginning and the admission
at the OLH was 65.8 days (average). In the admission, 8.5% had central nervous system
infiltration and 1% of the boys had testicle infiltration. Pancytopenia was the most found
laboratorial standard, just as the blasts cells count over 85% in myelogram. There was more
ALL cells B occurrence (36.2%) than other kinds, just as the subtype B common (30.2%).
98% of the treatments used chemotherapy protocols; only 0.7% of the patients was submitted
to the bone marrow transplantation. The found endings were: death during the treatment
(52%); complete clinical remission/cure (30.2%); treatment continuous to the first clinical
remission (5.3%); treatment of relapse after the first finished treatment (4.6%); treatment of
relapse without finishing the first treatment (3.9%); abandonment (3.3%); transference
(0.7%). There was significant statistical association between: death and age, brown color, lack
of pain in limbs in the admission, presentation of mucositis as co-morbidity on the diagnosis,
no change of chemotherapy protocol during the treatment, no realization of intrathecal
therapy, sepsis during the treatment, just as relapse and a long time of treatment; between
relapse, male sex and late change of protocol; between cure and age, pale skin on the
diagnosis and pain in limbs in the admission, realization of intrathecal therapy, no change of
protocol, lack of relapse and having a treatment with a longer time. CONCLUSION: With
significant statistical association mainly linked to the clinical presentation on the diagnosis
and admission and to the conducts and complications during the treatment, it is responsibility
of the health service reanalyze proposals of improvements to the assistance with the main
objective of obtaining best results in the childhood cancer care in this Brazilian region. |
| author_additional |
RIBEIRO, Rita de C. M. |
| author_additionalStr |
RIBEIRO, Rita de C. M. |
| format |
Trabalho de Conclusão de Curso - Graduação |
| author |
CAJADO, Luciana Corrêa de Sena |
| author2 |
SILVA, Natália Herculando da |
| author2Str |
SILVA, Natália Herculando da |
| title |
Leucemia linfóide aguda infantil no peculiar contexto amazônico. |
| title_short |
Leucemia linfóide aguda infantil no peculiar contexto amazônico. |
| title_full |
Leucemia linfóide aguda infantil no peculiar contexto amazônico. |
| title_fullStr |
Leucemia linfóide aguda infantil no peculiar contexto amazônico. |
| title_full_unstemmed |
Leucemia linfóide aguda infantil no peculiar contexto amazônico. |
| title_sort |
leucemia linfóide aguda infantil no peculiar contexto amazônico. |
| publishDate |
2023 |
| url |
https://bdm.ufpa.br:8443/jspui/handle/prefix/4909 |
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1787155384686870528 |
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11.653393 |