Eficacia del tinidazol en la profilaxis terapéutica de la colitis amebiana en pacientes con leucemia aguda de novo que reciben quimioterapia intensiva

espanolIntroduccion: En Mexico la seroprevalencia de la Entamoeba histolytica es del 8.4%. La amebiasis intestinal en pacientes con leucemia aguda de novo posterior al inicio de quimioterapia (QT), en el Servicio de Hematologia del CMN 20 de Noviembre, es del 12%, aun si muestran test coprologico negativo basal. Objetivo: Averiguar si la administracion de tinidazol, en pacientes con leucemia aguda y coprologico negativo, al principio de la QT, disminuye la incidencia de colitis amebiana durante la induccion a la remision. Metodo: Prospectivo y no comparativo. Enfermos con diagnostico de leucemia aguda de novo que inician QT de induccion y coprologico inicial. Se indico tinidazol, 2 g/dia durante 5 dias en la primera semana de comenzada QT. Se vigilaron hasta que la induccion concluyo y se inicio la recuperacion hematopoyetica. Resultados: 38 pacientes, 15 mujeres y 23 hombres con edad media de 44 anos (16-72). Con leucemia aguda linfoblastica 19, con mieloblastica 16 y con promielocitica 3. Casos sin y con amebiasis intestinal, 35 y 3, respectivamente. Los pacientes con amebiasis solo recibieron tinidazol durante 3 dias y se dio despues de 2 dias de empezada la QT. Conclusion: El tinidazol, en pacientes con leucemia aguda de novo que inician QT de induccion, es efectivo en la prevencion de la amebiasis intestinal, durante la etapa de induccion, si se administra a 2 g/dia, durante cinco dias, a partir del dia 1 de la QT. EnglishIntroduction: In Mexico, seroprevalence of Entamoeba histolytica is 8.4%. The intestinal amebiasis in patients with acute leukemia of novo, after the start of chemotherapy (CT) in the Hematology Service of the CMN 20 de Noviembre is 12%, even if patients show a negative baseline coprological test. Objective: To find out if the administration of tinidazole, in patients with acute leukemia and negative coprological test, at the beginning of the CT, decreases the incidence of amoebic colitis during the induction to remission. Method: Prospective and not comparative study. Patients with de novo diagnosis of acute leukemia who initiate induction and initial coprological CT. Tinidazole was indicated, 2 g/day for 5 days in the first week of CT started. They were monitored until the induction was concluded and hematopoietic recovery started. Results: 38 patients, 15 women and 23 men with a mean age of 44 years (16-72), with acute lymphoblastic leukemia 19, myeloblastic 16 and promyelocytic 3. Cases without and with intestinal amebiasis were 35 and 3, respectively. Patients with amebiasis only received tinidazole for 3 days and it was given 2 days after the CT started. Conclusion: Tinidazole, in patients with acute de novo leukemia who initiate induction CT, is effective in the prevention of intestinal amebiasis, during the induction stage, if administered at 2 g/day, for five days, starting on day 1 of the CT.