El presente artículo resume recomendaciones clínicas basadas en evidencia para la evaluación y el manejo de pacientes con Leucemia Linfoblástica Aguda (LLA) en EsSalud. Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 8 preguntas clínicas a ser respondidas por la presente GPC. Se realizó búsquedas sistemáticas de revisiones sistemáticas y –cuando fue considerado pertinente– estudios primarios en PubMed y CENTRAL durante el 2019. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prá...

Introduction: This article summarizes the clinical practice guidelines (CPG) for the management of patients with ALL in the Social Security of Peru (EsSalud). Objective: To provide clinical evidence-based recommendations for the evaluation and management of patients with ALL in EsSalud. Methods: A CPG for the diagnosis and management of patients with ALL in EsSalud was developed. To this end, a guideline development group (local GDG) was established, including medical specialists and methodologists. The local GDG formulated 8 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when it was considered pertinent- primary studies were conducted in PubMed and CENTRAL during 2019. The evidence to answer each of the posed clinical questions was selected. The quality of the evidence was assessed using the Grading of Recommendations Assessment, Developmen...

Introduction: This article summarizes the clinical practice guidelines (CPG) for the management of patients with ALL in the Social Security of Peru (EsSalud). Objective: To provide clinical evidence-based recommendations for the evaluation and management of patients with ALL in EsSalud. Methods: A CPG for the diagnosis and management of patients with ALL in EsSalud was developed. To this end, a guideline development group (local GDG) was established, including medical specialists and methodologists. The local GDG formulated 8 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when it was considered pertinent- primary studies were conducted in PubMed and CENTRAL during 2019. The evidence to answer each of the posed clinical questions was selected. The quality of the evidence was assessed using the Grading of Recommendations Assessment, Developmen...

Objetive: Report the case of a girl who presented septic shock, hypercalcemia and hemophagocytic syndrome due to paracoccidioidomycosis. Case report: 3-year-old female patient with 2-month illness characterized by fever, lymphadenopathy, weight loss, abdominal distention, and severe anemia. She arrived in poor general condition, developed septic shock and a hemophagocytic syndrome. The hypercalcemia and dermal lesions were striking. A cervical ganglion biopsy and bone marrow aspirate were performed. In the latter, images compatible with Paracoccidioides were found, which were then confirmed with Grocott's stain. She was treated with amphotericin B and trimethoprim-sulfamethoxazole. The evolution was favorable and serum calcium came back to normal ranges. Conclusion: Complications caused by paracoccidioidomycosis are rare; however, the epidemiological history and bone marrow aspirate shou...

En este documento se plasma la evaluación de la eficacia y seguridad del uso del producto farmacéutico clofarabina en combinación de ciclofosfamida + etoposido en pacientes pediátricos con leucemia linfocítica aguda recurrente y/o refractaria a dos líneas de tratamiento; cuyos resultados sustentaron la aprobación del uso de esta tecnología sanitaria en EsSalud.

En Latinoamérica, existen pocos estudios y resultados heterogéneos sobre pacientes pediátricos oncohematológicos con COVID-19. Objetivo: Describir las características clínicas y la supervivencia de pacientes pediátricos oncohematológicos con COVID-19 en un hospital de Lima-Perú, 2020-2021. Métodos: Estudio longitudinal retrospectivo de pacientes menores de 14 años hospitalizados. Los datos se recolectaron de las historias clínicas. Resultados: Incluimos 30 pacientes, mayoría hombres y escolares, predominando la fiebre, síntomas respiratorios y gastrointestinales, la neoplasia hematológica, y la enfermedad oncológica avanzada. La mayoría desarrolló enfermedad leve-moderada, pero también presentaron evolución severa con requerimiento de soporte crítico, con mortalidad alta en hospitalización (13,3%) y baja supervivencia durante el seguimiento (a los 526 días, 59,26%,...

Introduction: In Latin America, there are few studies and heterogeneous results on pediatric oncohematology patients with COVID-19. Objective: To describe the clinical characteristics and survival of pediatric oncohematology patients with COVID-19 in a hospital in Lima-Peru, 2020-2021. Methods: Retrospective longitudinal study of hospitalized patients under 14 years of age. The data was collected from the medical records. Results: We included 30 patients, mostly men and schoolchildren, predominantly fever, respiratory and gastrointestinal symptoms, hematological neoplasia, and advanced oncological disease. The majority developed mild-moderate disease, but they also presented severe evolution requiring critical areas, with high mortality in hospitalization (13.3%) and low survival during follow-up (at 526 days, 59.26%, 95% CI 36 .53 to 76.20%). Survival increased with the start of chemoth...

En este documento se plasma la evaluación de la eficacia y seguridad del uso del producto farmacéutico L-asparaginasa E. coli pegilada en el tratamiento de pacientes con leucemia linfoblástica aguda que presentan hipersensibilidad a L-asparaginasa E. coli nativa; cuyos resultados sustentaron la no aprobación del uso de esta tecnología sanitaria en EsSalud.

En este documento se plasma la evaluación de la eficacia y seguridad del uso del producto farmacéutico L-asparaginasa E. coli pegilada en el tratamiento de pacientes con leucemia linfoblástica aguda que presentan hipersensibilidad a L-asparaginasa E. coli nativa, en el contexto de no disponibilidad de L-asparaginasa Erwinia; cuyos resultados sustentaron la aprobación del uso de esta tecnología sanitaria en EsSalud.