Enfermedad de injerto contra huésped cutáneo en pacientes con trasplante de precursores hematopoyéticos alogénico en la FOSCAL

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dc.contributor.advisorSossa Melo, Claudia Lucía
dc.contributor.advisorVergara Rueda, Jessica Inés
dc.contributor.apolounabSossa Melo, Claudia Lucía [claudia-lucia-sossa-melo]spa
dc.contributor.apolounabVergara Rueda, Jessica Inés [jessica-inés-vergara-rueda]spa
dc.contributor.authorAnaya Reyes, Katty Camila
dc.contributor.cvlacSossa Melo, Claudia Lucía [0001425704]spa
dc.contributor.cvlacVergara Rueda, Jessica Inés [0001497364]spa
dc.contributor.googlescholarSossa Melo, Claudia Lucía [es&oi=ao]spa
dc.contributor.orcidAnaya Reyes, Katty Camila [0000-0003-0428-4744]spa
dc.contributor.orcidSossa Melo, Claudia Lucía [0000-0001-9876-222X]spa
dc.contributor.orcidVergara Rueda, Jessica Inés [0000-0002-4763-3935]spa
dc.contributor.scopusSossa Melo, Claudia Lucía [57189519230]spa
dc.coverage.campusUNAB Campus Bucaramangaspa
dc.coverage.spatialFloridablanca (Santander, Colombia)spa
dc.date.accessioned2023-06-30T15:01:07Z
dc.date.available2023-06-30T15:01:07Z
dc.date.issued2023-06-29
dc.degree.nameEspecialista en Dermatologíaspa
dc.description.abstractLa Enfermedad de Injerto Contra Huésped (EICH) es una de las complicaciones más frecuentes (40-60%) del trasplante de progenitores hematopoyéticos alogénico (TPH-alo), y la piel es el órgano más afectado y su expresión clínica es temprana (75%). En esta cohorte retrospectiva de 13 años de reclutamiento, se evaluaron los factores asociados a la incidencia de EICH cutáneo (EICH-c) en mayores de 18 años. De un total de 110 pacientes con TPH-alo, con edad promedio 36,35 años, se presentó una incidencia de EICH-c del 53,64%, sin mostrar asociación por edad o sexo (p=0,83 Vs p=0,11), la leucemia aguda fue la causa más frecuente del TPH-alo (80%) y EICH-c (83,05%, p=0,74). En la EICH-c aguda (76,27%), fue más prevalente la presentación aguda clásica (62,22%), con severidad grado 2 (43,18%) clínica e histológicamente (54,55%, p=0,16). En la EICH-c crónica (45,76%), el 81,48% debutó con la forma clásica y una severidad grado 2 (44,44%), un estadio histológico 1 (45%, p=0,01). Las lesiones similares a liquen plano fueron las más frecuentes tanto en piel como en mucosas (74,07% Vs 50%), otras menos frecuentes fueron esclerosis (14,81) y poquilodermia (11,11%). En cuero cabelludo predominó la descamación (11,11%), en el aparato ungueal las estrías longitudinales (22,22%), y en genitales externos las lesiones similares a liquen escleroso y erosiones por igual (7,41%). Las lesiones en piel similares a liquen plano fueron las más frecuentes en concomitancia con EICH extracutáneo, principalmente hepático 55%%, ocular 50% y gastrointestinal 45%. Otras variables relacionadas con el trasplante y donante no mostraron asociación con EICH-c. Los subtipos de clasificación del EICH-c agudo y crónico no se correlacionaron con la severidad de la enfermedad clínica o histológica. Es posible que estos resultados y la escasa asociación encontrada se deba al tamaño de muestra al tratarse de un estudio censal institucional; sin embargo demuestra el gran impacto de esta enfermedad y la morbilidad asociada a los pacientes con TPH-alo.spa
dc.description.abstractenglishGraft-versus-host disease (GVHD) is one of the most frequent complications (40-60%) of allogeneic hematopoietic stem cell transplantation (allo-HSCT), and the skin is the most affected organ and its clinical expression is early (75 %). In this retrospective cohort of 13 years of recruitment, the factors associated with the incidence of cutaneous GVHD (c-GVHD) in people over 18 years of age were evaluated. Of a total of 110 patients with HPCT-allo, with an average age of 36.35 years, there was a 53.64% incidence of c-GVHD, without showing any association by age or sex (p=0.83 Vs p=0 ,11), acute leukemia was the most frequent cause of HPCT-allo (80%) and GVHD-c (83.05%, p=0.74). In acute c-GVHD (76.27%), the classic acute presentation was more prevalent (62.22%), with grade 2 severity (43.18%) clinically and histologically (54.55%, p=0, 16). In chronic c-GVHD (45.76%), 81.48% debuted with the classic form and a grade 2 severity (44.44%), a histological stage 1 (45%, p=0.01). Lesions similar to lichen planus were the most frequent both on skin and mucous membranes (74.07% Vs 50%), others less frequent were sclerosis (14.81) and pochiloderma (11.11%). Scaling prevailed on the scalp (11.11%), longitudinal striations on the nail apparatus (22.22%), and lesions similar to lichen sclerosus and erosions equally on the external genitalia (7.41%). Skin lesions similar to lichen planus were the most frequent concomitant with extracutaneous GVHD, mainly hepatic 55%, ocular 50% and gastrointestinal 45%. Other variables related to the transplant and donor did not show an association with c-GVHD. Acute and chronic c-GVHD classification subtypes did not correlate with the severity of clinical or histological disease. It is possible that these results and the low association found are due to the sample size as it is an institutional census study; however, it demonstrates the great impact of this disease and the morbidity associated with patients with HPCT-allo.spa
dc.description.degreelevelEspecializaciónspa
dc.description.learningmodalityModalidad Presencialspa
dc.description.tableofcontentsDescripción del Proyecto .................................................................................................... 7 Planteamiento de la Pregunta y Justificación................................................................. 7 Marco Teórico ..................................................................................................................... 9 Introducción y epidemiología....................................................................................... 9 Trasplante de progenitores hematopoyéticos........................................................... 12 Fisiopatología............................................................................................................. 14 Factores de riesgo ..................................................................................................... 16 Diagnostico histopatológico....................................................................................... 30 Profilaxis de la EICH.................................................................................................. 33 Tratamiento................................................................................................................ 34 Estado del Arte.................................................................................................................. 38 Objetivos ........................................................................................................................... 40 Objetivo general ............................................................................................................ 40 Objetivos específicos .................................................................................................... 40 Metodología ...................................................................................................................... 41 Tipo de estudio.............................................................................................................. 41 Población....................................................................................................................... 41 Criterios de inclusión ................................................................................................. 41 Criterios de exclusión ................................................................................................ 41 Cálculo del tamaño de muestra................................................................................. 41 Muestreo .................................................................................................................... 42 Variables........................................................................................................................ 42 Plan de análisis ............................................................................................................. 44 Resultados ........................................................................................................................ 46 Discusión........................................................................................................................... 63 Conclusión......................................................................................................................... 68 Referencias Bibliográficas ................................................................................................ 69spa
dc.format.mimetypeapplication/pdfspa
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNABspa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.identifier.urihttp://hdl.handle.net/20.500.12749/20388
dc.language.isospaspa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.publisher.programEspecialización en Dermatologíaspa
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dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.rights.localAbierto (Texto Completo)spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.subject.keywordsMedical sciencesspa
dc.subject.keywordsHealth sciencesspa
dc.subject.keywordsGraft vs Host Diseasespa
dc.subject.keywordsHematopoietic Stem Cell Transplantationspa
dc.subject.keywordsPathology clinicalspa
dc.subject.keywordsSkin diseasesspa
dc.subject.keywordsDemographic characteristicsspa
dc.subject.keywordsHematopoiesisspa
dc.subject.keywordsCell transplantationspa
dc.subject.lembDermatologíaspa
dc.subject.lembCiencias médicasspa
dc.subject.lembMedicinaspa
dc.subject.lembCaracterísticas demográficasspa
dc.subject.lembHematopoyésisspa
dc.subject.lembTrasplante celularesspa
dc.subject.proposalCiencias de la saludspa
dc.subject.proposalEnfermedades cutaneasspa
dc.subject.proposalEnfermedad injerto contra huéspedspa
dc.subject.proposalPatología clínicaspa
dc.subject.proposalDermatitisspa
dc.subject.proposalTrasplante de células madrespa
dc.titleEnfermedad de injerto contra huésped cutáneo en pacientes con trasplante de precursores hematopoyéticos alogénico en la FOSCALspa
dc.title.translatedCutaneous graft-versus-host disease in patients with allogeneic hematopoietic stem cell transplantation at FOSCALspa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aaspa
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.type.localTesisspa
dc.type.redcolhttp://purl.org/redcol/resource_type/TM

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