Identificação de alterações genéticas e sua influência prognóstica na Leucemia Linfóide Aguda Pediátrica no Brasil: uma revisão sistemática / Identification of genetic alterations and their prognostic influence in Pediatric Acute Lymphoblastic Leukemia in Brazil: a systematic review
DOI:
https://doi.org/10.34117/bjdv7n3-360Keywords:
Leucemia Linfoide Aguda, Pediatria, Genética, Fatores de Risco.Abstract
A Leucemia Linfoide Aguda (LLA) concentra cerca de 80% de todos os casos em crianças, tornando-se o caso mais comum na faixa etária pediátrica. Alterações genéticas têm implicações terapêuticas e são importantes nos esquemas de tratamento. O objetivo deste trabalho é reunir informações das alterações genéticas encontradas na população brasileira e seus efeitos fenotípicos nos pacientes diagnosticados com LLA. Trata-se de uma revisa?o sistema?tica, com base no modelo PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) , incluindo artigos nos bancos de dados SciELO, Pubmed e Google Scholar com os descritores “Leucemia Linfóide Aguda”, “Pediatria”, “Genética” e “Brasil” entre os anos 2009 a 2019. Os resultados indicam que a presença da alteração na expressão dos genes HDAC3, HDAC7, HADC9 e TIMP1 estão associados a taxa de sobrevida > 5 anos. Um alelo variante do gene IKZF1 conferiu maior risco de desenvolvimento de LLA-B. A baixa expressão do gene ABCG2 foi associado ao pior prognóstico e está relacionada a resposta a quimioterapia. Crianças com hiperdiploidia tem maior frequência de mutações no gene MAPK. A presença da hiperexpressão dos genes BLVRB e IGFBP7 foram relacionados a leucocitose < 50.000 mm³ no diagnóstico. Níveis elevados de MAN1A1 estão associados a LLA entre 1 e 9 anos. Os genes KRAS e NRAS quando mutados e relacionados a translocação MLL-AFF1 conferiram pior taxa de sobrevivência global. As alterações genéticas descritas nos estudos analisados nesta revisão, mostram a importância e relevância de algumas dessas alterações no prognóstico destes pacientes, reforçando a importância da investigação destas alterações como forma de possibilitar condutas clínicas e terapias-alvo dirigidas mais adequadas ao manejo clínico destes pacientes.
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