Browsing by Autor "Luara L. Arana-Luna"

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Consenso de leucemia mieloide aguda en México
(Academia Nacional de Medicina de México, 2022) Luara L. Arana-Luna; Martha Alvarado‐Ibarra; Luis G. Silva-Michel; Adrián Morales-Maravilla; María del C. González-Rubio; Lénica A. Chávez-Aguilar; Ma. Fernanda Tena-Iturralde; Liliana Mojica-Balceras; Nidia Zapata-Canto; Patricia Galindo-Delgado
Acute myeloid leukemia (AML) comprises a heterogeneous group of hematopoietic cell neoplasms of myeloid lineage that arise from the clonal expansion of their precursors in the bone marrow, interfering with cell differentiation, leading to a syndrome of bone marrow failure. AML is a consequence of genetic and epigenetic changes (point mutations, gene rearrangements, deletions, amplifications, and arrangements in epigenetic changes that influence gene expression) in hematopoietic precursor cells, which create a clone of abnormal cells that are capable of proliferating but cannot differentiate into mature hematopoietic cells or undergo programmed cell death. The diagnosis requires more than 20% myeloid blasts in the bone marrow and certain cytogenic abnormalities. Treatment will depend on age, comorbidities, and cytogenetic risk among the most frequent.
Essential thrombocythaemia
(Academia Nacional de Medicina de México, 2023) Raúl Martínez-Castro; Gilberto Barranco-Lampón; Luara L. Arana-Luna; José L. Álvarez-Vera; Flavio Rojas-Castillejos; Rosalinda Peñaloza-Ramírez; Adrián A. Carballo‐Zarate; Irma Olarte-Carrillo; Jaime Israel-García Minamy; Javier López‐Salazar
Essential thrombocythemia (ET) is a chronic Philadelphia-negative myeloproliferative neoplasm that has its main involvement in the megakaryopoietic lineage, generating sustained thrombocytosis in peripheral blood and an increase in the number of mature megakaryocytes in the bone marrow. In addition to marked thrombocytosis, it is characterized by increased thrombotic or hemorrhagic risk and the presence of constitutional symptoms. Patients with ET have a low but known risk of disease progression to myelofibrosis and/or acute leukemia. The diagnosis is made based on the 2016 WHO criteria. At present, available treatments for patients with ET are mainly aimed at minimizing the risk of thrombosis and/or bleeding.
First inter-institutional consensus on chronic myeloproliferative neoplasms
(Academia Nacional de Medicina de México, 2023) Raúl Martínez-Castro; Gilberto Barranco-Lampón; Luara L. Arana-Luna; José L. Álvarez-Vera; Flavio Rojas-Castillejos; Rosalinda Peñaloza-Ramírez; Adrián A. Carballo‐Zarate; Irma Olarte-Carrillo; Jaime Israel-García Minamy; Javier López‐Salazar
The objective of the consensus is to make available to the professionals of the different public health institutions in our country, who are in charge of these diseases, the most relevant and up-to-date information about their diagnosis and treatment in clinical practice. With this inter-institutional consensus we hope to contribute to improving the quality of care for patients with chronic myeloproliferative neoplasms throughout the Mexican Republic, to unify criteria in both diagnosis and treatment of the different myeloproliferative diseases.
Myelofibrosis: diagnosis and treatment
(Academia Nacional de Medicina de México, 2023) Raúl Martínez-Castro; Gilberto Barranco-Lampón; Luara L. Arana-Luna; José L. Álvarez-Vera; Flavio Rojas-Castillejos; Rosalinda Peñaloza-Ramírez; Adrián A. Carballo‐Zarate; Irma Olarte-Carrillo; Jaime Israel-García Minamy; Javier López‐Salazar
Myelofibrosis (MF) is a BCR-ABL1-negative myeloproliferative neoplasm characterized by clonal myeloproliferation, dysregulated kinase signaling, and release of abnormal cytokines. In recent years, important progress has been made in the knowledge of the molecular biology and the prognostic assessment of MF. Conventional treatment has limited impact on the patients' survival; it includes a wait-and-see approach for asymptomatic patients, erythropoiesis-stimulating agents, androgens, or immunomodulatory agents for anemia, cytoreductive drugs such as hydroxyurea for the splenomegaly and constitutional symptoms, and splenectomy or radiotherapy in selected patients. The discovery of the Janus kinase (JAK) 2 mutation triggered the development of molecular targeted therapy of MF. The JAK inhibitors are effective in both JAK2-positive and JAK2-negative MF; one of them, ruxolitinib, is the current best available therapy for MF splenomegaly and constitutional symptoms. Although ruxolitinib has changed the therapeutic scenario of MF, there is no clear indication of a disease-modifying effect. Allogeneic stem cell transplantation remains the only curative therapy of MF, but due to its associated morbidity and mortality, it is usually restricted to eligible high- and intermediate-2-risk MF patients. To improve current therapeutic results, the combination of JAK inhibitors with other agents is currently being tested, and newer drugs are being investigated.
Risks in invasive procedures
(Academia Nacional de Medicina de México, 2023) Raúl Martínez-Castro; Gilberto Barranco-Lampón; Luara L. Arana-Luna; José L. Álvarez-Vera; Flavio Rojas-Castillejos; Rosalinda Peñaloza-Ramírez; Adrián A. Carballo‐Zarate; Irma Olarte-Carrillo; Jaime Israel-García Minamy; Javier López‐Salazar
Patients with myeloproliferative neoplasms have an increased risk of thrombosis and bleeding. This risk must be identified, as well as individualizing the therapeutic strategy before invasive procedures; adequate cytoreduction reduces the risk of complications.