Análisis de la Supervivencia de Pacientes Sometidos a Trasplante Alogénico de Células Progenitoras Hematopoyéticas antes y durante la Pandemia de COVID-19 en un Hospital de Río de Janeiro
DOI:
https://doi.org/10.32635/2176-9745.RBC.2024v70n3.4733Palabras clave:
COVID-19, Trasplante de Médula Ósea, Criopreservación, SupervivenciaResumen
Introducción: La pandemia de COVID-19 cambió la dinámica de conservación del injerto y la realización de trasplantes alogénicos de células progenitoras hematopoyéticas (TCPH), lo que puede haber afectado la supervivencia de los pacientes. Objetivo: Analizar la supervivencia de los pacientes inmediatamente después del TCPH (100 días después del TCMH) según la exposición a diferentes tipos de trasplantes y fuentes de injerto, antes de la pandemia y durante la pandemia de COVID-19. Método: Estudio de cohorte retrospectivo hospitalario con 246 pacientes sometidos a TCPH en un hospital de referencia de la ciudad de Río de Janeiro entre enero/2016 y diciembre/2021. Se utilizaron los métodos log-rank y Kaplan-Meier para estimar las funciones de supervivencia inmediatas post-TCPH. Resultados: La tasa de mortalidad fue ligeramente mayor durante la pandemia en comparación con la prepandemia (10,1% vs. 8,8%). El injerto más utilizado durante todo el periodo estudiado fue el de médula ósea (MO, 85%). Sin embargo, durante la pandemia, el 50,5% de las recolecciones alogénicas se realizaron utilizando la sangre periférica movilizada (SPM). El ocho por ciento de los injertos criopreservados no fueron infundidos. No se observaron diferencias en la sobrevida entre los pacientes que utilizaron SPM como fuente de injerto en relación con la MO. Conclusión: Los tipos de injerto y fuentes de trasplantes no influyeron en la supervivencia de los pacientes en ambos períodos. La criopreservación se presentó como una herramienta importante para superar los desafíos logísticos relacionados con la pandemia de COVID-19, sin embargo, un porcentaje relevante de injertos criopreservados no fue utilizado. Por lo tanto, es necesario que los centros de trasplantes vuelvan a realizar TCPH con productos frescos, reduciendo el porcentaje de injertos que quedan inutilizables.
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