Fatores de risco associados a comorbidades, recaídas e óbitos de pacientes com Leucemia Linfoblástica Aguda: implicações para os cuidados de enfermagem

Abstract

Introduction: Acute Lymphoblastic Leukemia (ALL) is characterized by a rapid increase in immature cells, which can be detected through clinical examinations. To describe the clinical-epidemiological profile of patients diagnosed with ALL in the Amazon region, this study evaluated the spatial distribution of the disease, municipalities with the highest number of cases, epidemiological and clinical patterns and risk factors for ALL. Material and Methods: This study was carried out with a longitudinal and retrospective approach, using data from patients diagnosed with ALL at the Fundação de Hematologia e Hemoterapia do Amazonas (HEMOAM), obtained by spontaneous demand from January 2016 to December 2021. Pretreatment characteristics of patients were summarized using descriptive statistics. Univariate and multivariate Cox proportional hazards regression analyzes were performed to identify risk factors for death and infectious and non-infectious comorbidities. Results: Between 2016 and 2021, 393 new cases of ALL were identified in the state of Amazonas. The profile identified was a predominance of the disease in male patients, mixed race and aged <10 years. We identified that 183 (48.54%) patients died during the course of treatment. There was a significant presence of patients from different municipalities in the state of Amazonas, emphasizing the regional relevance of this study, with a higher incidence in the city of Manaus, followed by Manacapuru. The age group of 41 to 50 years has a 7 times higher risk of death and patients with positive Measurable Residual Disease (MRD) have a 5 times higher risk of dying from ALL. Discussion: A higher incidence of ALL in males was reported, as in other studies and the age range of 0 to 10 years was significantly identified, corroborating other studies that describe it as the most common epidemiological pattern. Scientific research must continue to explore these complex interactions of genetic, immunological, and environmental factors to better understand this association. Final considerations: This study represents an update of the epidemiological panorama through active data research, providing a more comprehensive view of information about patients with acute leukemia in the Amazonas region.