Anaplastic Large Cell Lymphoma in Central America: A Report From the Central American Association of Pediatric Hematology Oncology (AHOPCA)

Abstract

Treatment of ALCL in countries with limited resources is feasible with similar outcomes as in HIC, though the causes of treatment failure differ. Less intensive regimens may be preferable in order to decrease TRM and improve outcomes. Prospective clinical trials determining the ideal treatment for LMIC children with ALCL are necessary.

Optimizing outcomes for children with non‐Hodgkin lymphoma in low‐ and middle‐income countries by early correct diagnosis, reducing toxic death and preventing abandonment

“…In a retrospective cohort analysis in Shanghai, China, abandonment affected 11·5% of 108 patients with lymphoblastic lymphoma, which, the authors noted, was less than the abandonment rates of 13·5–51·3% in patients with acute lymphoblastic leukaemia over the same time period in Shanghai (Gao et al , ). Of patients with ALCL treated across 6 AHOPCA countries between 2000 and 2013 ( n = 31), 6·5% abandoned therapy, somewhat lower than the abandonment rate typically experienced with other tumours in the same settings (Ceppi et al , ). It is possible that abandonment rates in aggressive lymphomas may be lower given the shorter treatment duration (than for leukaemia, for instance) and children are too acutely unwell to be discharged during therapy and thus have less opportunity to abandon treatment.…”

“…The relationship with EBV infection is comparable to that in HIC, but specific molecular features have been reported in some MIC (Liao et al , ; Uccini et al , ). There is far less information about the epidemiology and results in other lymphoma subtypes, such as lymphoblastic lymphomas or large cell lymphomas, including anaplastic large cell lymphomas (ALCL), in LMIC (Ceppi et al , ). In addition, there is relatively little known about certain lymphoma subtypes that are rare in Western countries, such as natural killer (NK) cell cancers, which are much more common in specific regions of LMIC, including East Asia and some Latin American countries (Pillai et al , ).…”

Science and health for all children with cancer

“…To address treatment abandonment, various strategies have been deployed successfully. In Central America, only 6.5% of patients with anaplastic large-cell lymphoma abandoned therapy, somewhat lower than the abandonment rate typically experienced with other tumors in the same settings, perhaps because of relatively short treatment duration (compared to acute lymphoblastic leukaemia) and government coverage of all chemotherapy costs(67)(68)(69).…”

Outcome of pediatric non‐Hodgkin lymphoma in Central America: A report of the Association of Pediatric Hematology Oncology of Central America (AHOPCA)

“…Previous experience with unmodified treatment regimens in our region showed unacceptable toxicity . For the past 20 years, pediatric oncologists from Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica, Panama, the Dominican Republic, and Haiti (as members of AHOPCA, the Asociación de Hemato‐Oncología Pediátrica de Centro América) have been working collaboratively to standardize treatment regimens across multiple institutions to improve therapy for children with cancer . Here we report the results of a retrospective review of multisite experience with a common treatment strategy adapted from the Berlin–Frankfurt–Münster (BFM) protocol for children with a clinicopathologic diagnosis of B‐NHL, as used by institutions in six Central American countries.…”