Revisión sistemática y metanálisis de las antraciclinas como tratamiento de inducción en pacientes con nuevo diagnóstico de leucemia mieloide aguda

Abstract

Background Acute myeloid leukaemia (AML) is a heterogeneous malignant disease resulting from acquired mutations that conduct to malignant transformation of precursor haematopoietic cells. As a result, there is an accumulation of immature forms with a variable reduction in the production of normal cells. For more than three decades anthracyclines have been the cornerstone in AML induction therapy for patients with newly diagnosed disease. Objective To evaluate the efficacy and safety of different anthracyclines and doses included in the initial induction therapy schemes of adult patients of all ages, above 15 years. Search methods We search MEDLINE (access by Ovid, from 1950 to June 2014), EMBASE (access by Ovid, from 1980 to December 2014) and the Cochrane Central Register of Controlled Trials (The Cochrane Library 2014) Data collection and analysis The trials were identified by title and abstract and full reports of potentially relevant trials were retrieved and reviewed for inclusion criteria. We extracted data and assessed the bias risk of the clinical trials according to methodological standards of the Cochrane Collaboration based in generation of allocation sequence and allocation concealment, blinding and incomplete outcome data. We used Rev Man program for statistical analysis and the Risk ratio, with 95% confidence interval, and random or fixed effect model was used to analyse the data. Risk ratio was used to pool adverse event data if the trials were sufficiently similar intheir adverse event definitions. Statistical heterogeneity was assessed by examining the forest plots and using the I² and Chi² statistics. Heterogeneity was considered as substantial if I² was greater than 30% or there was a low-value (less than 0.10) in the Chi² test for heterogeneity.