Aspectos hematológicos e clínicos de crianças leucêmicas no período de indução da quimioterapia

Abstract

The leukemia happens in approximately 30% of cases of pediatric malignant diseases involving the hematopoietic system, affects preferentially the white blood cells, characterized by replacement of normal blood cells to young abnormal cells in the bone marrow. Te leukemia is the most common cause of cancer deaths in childhood, and the main types are: acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) or chronic (CML). Chemotherapy is a specific treatment and the most used for healing or prolong life of these patients, often requiring hospitalization, since these patients show significant changes in blood counts, making them immunocompromised. This increases the risk of potentially serious infections and other complications that often prolong hospital stay and increase the rates of morbidity and mortality. In order to broaden the knowledge about the hematology and clinical characteristics of pediatric leukemia patients during chemotherapy induction in an oncology hospital reference in the northern region of Brazil from 2005 to 2010 aged 0-12 years. Therefore was made a retrospective study with secondary data collection from records filed on the division of medical records and statistics of the hospital involved in the study. In the statistical analysis of the results we obtained mean, standard deviation and median of continuous variables and frequency of categorical variables, and statistical significance assessed by means of obtaining confidence intervals at 95% and by an ANOVA test and Wilcoxon considered α = 5%. These analyzes were performed in Epi-Info software 3.5.1. Of the 556 medical records, 141 were complete, and observed higher prevalence in masculine gender, age group between 1-4 years, coming from the state of Pará, with clinical classification for ALL, with Brazilian protocol GBTLI selected in most cases, making use of empirical antibiotic therapy, especially ceftazidime, amikacin and ceftriaxone, and records of use of blood bag during hospitalization, and the outcome of the type of hospital discharge. The study also revealed alteration of the data found in all variables in the blood count to the white and red, both the first and the fifteenth day of hospitalization these periods chosen for data collection hematological, and found use in blood bags virtually all hospitalized patients (92.20%) with predominance of platelet concentrate (CP5), leukocyte-poor red blood cells (CHPL) and red blood cells. Given the above, it is recommended the development of strategic actions and local policies that address not only the tertiary specialist in pediatric oncology, but all levels of health care for the child, to reduce the impact of this disease in the pediatric population the northern region.