Acute lymphoblastic leukemia in low and middle-income countries

Abboud, Miguel R.; Ghanem, Khaled M.; Muwakkit, Samar

doi:10.1097/cco.0000000000000125

Cited by 37 publications

(34 citation statements)

References 46 publications

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“…Similar to observations from studies in other low–middle income countries (LMIC) and prior studies from India, our results confirm there are broadly three reasons for poor outcome of children with acute leukemias; treatment abandonment, relapses, and toxic deaths. [ 6 22 23 ]…”

Section: Discussionmentioning

confidence: 99%

Acute leukemia in children: A review of the current Indian data

Arora

2016

South Asian J Cancer

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Acute leukemias are the most common diagnostic group of childhood cancer. This review summarizes the published literature on reported current outcomes of childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) from India. Overall survival in ALL ranged from 45% to 81% (commonly >60%) and event-free survival ranged from 41% to 70% (commonly >50%). Outcome data for AML was patchy with varying duration of follow-up, but it can be inferred that 50–80% of treated patients had experienced an event (toxic death, refractory disease or relapse). It is imperative that going forward focus should be on collaborative efforts, which promote treatment of patients on risk-stratified adapted protocols based on local infrastructure, improvement in supportive care and encourage prospective multi-center clinical trials.

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Section: Discussionmentioning

confidence: 99%

Acute leukemia in children: A review of the current Indian data

Arora

2016

South Asian J Cancer

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“…In the United States, the overall survival (OS) with risk-directed treatment is 90% [1]. Cure rates are inferior in low-income countries, where the majority of children with ALL live [4].…”

Section: Introductionmentioning

confidence: 99%

Relapse of childhood acute lymphoblastic leukemia and outcomes at a reference center in Latin America: organomegaly at diagnosis is a significant clinical predictor

et al. 2017

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“…These resource limitations may be addressed with a focus on capacity building through collaborative efforts . For example, twinning programs, which are based on partnering and interaction between hospitals in developing countries and cancer centers in developed countries, have improved survival and outcomes for pediatric cancer patients in developing countries . Despite the success of twinning programs, this approach has not been specifically applied in the context of high‐risk neuroblastoma.…”

Section: Discussionmentioning

confidence: 99%

Survival of high‐risk pediatric neuroblastoma patients in a developing country

Easton

Gómez

Asdahl

et al. 2016

Pediatric Transplantation

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Little information is available about survival of high-risk pediatric neuroblastoma patients in developing countries. We aimed to assess survival among high-risk pediatric neuroblastoma patients in La Plata, Argentina. Individuals eligible for our cohort were aged <20 years when diagnosed with high-risk neuroblastoma and received cancer-directed therapy including stem cell transplantation at Hospital de Niños Sor Maria Ludovica between February 1999 and February 2015. We estimated overall survival probabilities using an extended Kaplan-Meier approach. Our study population comprised 39 high-risk neuroblastoma patients, of whom 39% were aged >4 years at diagnosis, 54% were male, and 62% had adrenal neuroblastoma. We observed 18 deaths, and the median survival time of our study population was 1.7 years. The 5-year overall survival probability was 24% (95% confidence limits [CL]: 10%, 41%). In contrast, 5-year survival of high-risk neuroblastoma patients ranges between 23% and 76% in developed countries. Survival among high-risk neuroblastoma patients is generally poor regardless of geographic location, but our results illustrate dramatically worse survival for patients in a developing country. We speculate that the observed survival differences could be attenuated or eliminated with improvements in treatment and supportive care, but addressing these issues will require creative solutions because of resource limitations.

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Acute lymphoblastic leukemia in low and middle-income countries

Abstract: The experience in low-income countries shows that a structured approach to the treatment of acute lymphoblastic leukemia results in improved survival.

Cited by 37 publications

References 46 publications

Acute leukemia in children: A review of the current Indian data

Acute leukemia in children: A review of the current Indian data

Relapse of childhood acute lymphoblastic leukemia and outcomes at a reference center in Latin America: organomegaly at diagnosis is a significant clinical predictor

Survival of high‐risk pediatric neuroblastoma patients in a developing country

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