Hospitalization rate and costs in acute lymphoblastic leukemia of childhood in a low‐income group: Financial impact in Northeast Mexico

Jaime‐Pérez, José Carlos; Fernández, Lucía T; Jiménez-Castillo, Raúl Alberto; Colunga‐Pedraza, Julia E.; Padilla-Medina, José Ramón; Mancı́as-Guerra, Consuelo; Gómez‐Almaguer, David

doi:10.1002/pbc.26673

Cited by 10 publications

(11 citation statements)

References 16 publications

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“…Two recent studies using a threshold analysis and global costing procedure suggest treating childhood cancers in LMICs is very cost-effective as per WHO criteria. 134,135 Very few formal micro-costing studies of ALL specifically have been completed with published reports showing a wide variation in ALL treatment costs, ranging from $3,000 in Bangladesh 136 to $10,000 to 20,000 in Brazil 134 , Mexico 137 , and China 138,139 to $100,000 in North America and Europe 140 . A significant proportion of the costs (up to 50% in many cases) are associated with diagnostics, supportive care, and hospitalization.…”

Section: Global Impact Of Childhood Allmentioning

confidence: 99%

Global efforts toward the cure of childhood acute lymphoblastic leukaemia

Pui

Yang

Bhakta

et al. 2018

The Lancet Child & Adolescent Health

103

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Improvements in risk-directed treatment and supportive care, together with increased reliance on both national and international collaborative studies, have made childhood acute lymphoblastic leukaemia (ALL) one of the most curable human cancers. Next-generation sequencing studies of leukaemia cells and the host germline provide new opportunities for precision medicine and thus potential improvements in the cure rate and quality of life of patients. Efforts are underway to assess the global impact of childhood ALL and develop initiatives that can meet the long-term challenge of providing quality care to children with this disease worldwide and improving cure rates globally. This ambitious task will rely on increased collaborative research and international networking so that the therapeutic gains in high-income countries can be translated to patients in low-income and middle-income countries. Ultimately, the greatest obstacle to overcome will be to fully understand leukaemogenesis, enabling measures to decrease the risk of leukaemia development and thus close the last major gap in offering a cure to any child who might have the disease.

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Section: Global Impact Of Childhood Allmentioning

confidence: 99%

Global efforts toward the cure of childhood acute lymphoblastic leukaemia

Pui

Yang

Bhakta

et al. 2018

The Lancet Child & Adolescent Health

103

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“…The improvements in the study period were financed by a federal government program, the “Seguro Popular” (People’s Insurance), that allocates funds for childhood leukemia treatment, as we have previously reported, for the hospitalization of children with ALL. 30 …”

Section: Discussionmentioning

confidence: 93%

Childhood T-cell acute lymphoblastic leukemia in a single Latin American center: impact of improved treatment scheme and support therapy on survival

Jaime‐Pérez

Santos

Gómez‐Almaguer

2020

Hematology, Transfusion and Cell Therapy

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Background and objective T-cell acute lymphoblastic leukemia (T-ALL) in children represents a high-risk disease. There is a lack of studies assessing the outcome of T-ALL in Hispanic populations, in which it is a rare malignancy. We report the characteristics and results of treatment for childhood T-cell ALL in children over 14 years at a Latin American reference center. Material and methods From January 2005 to December 2018, there occurred the analysis of twenty patients ≤ 16 years of age from a low-income open population diagnosed at a university hospital in Northeast Mexico. Clinical and laboratory characteristics, treatment regimens and outcomes were assessed by scrutinizing clinical records and electronic databases. Diagnosis was confirmed by flow cytometry, including positivity for CD-2, 5, 7 and surface/cytoplasmic CD3. Survival rates were assessed by the Kaplan-Meier method. Results There was a male preponderance (70 %), with a 2.3 male-to-female ratio ( p =  .074), the median age being 9.5 years. Leucocytes at diagnosis were ≥ 50 × 10 9 /L in 13 (65 %) children, with CNS infiltration in 6 (30 %) and organomegaly in 10 (50 %). The five-year overall survival (OS) was 44.3 % (95 % CI 41.96–46.62), significantly lower in girls, at 20.8 % (95 % CI 17.32–24.51) vs. 53.1 % (95 % CI 50.30–55.82), ( p = .035) in boys; there was no sex difference in the event-free survival (EFS) ( p = .215). The survival was significantly higher after 2010 ( p = .034). Conclusion The T-cell ALL was more frequent in boys, had a higher mortality in girls and the survival has increased over the last decade with improved chemotherapy and supportive care.

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“…In this regard, we have previously analyzed the treatment characteristics and clinical outcomes of patients with hematologic malignancies in Mexico, including those with ALL, AML, NHL, HL MM, and chronic myeloid leukemia. 31 -37 In most cases, results show suboptimal survival rates in comparison to high-income countries and the need to improve treatment strategies, which are considerably limited due to the financial restrictions in the low-income group being cared for at our public hospital, particularly with regard to incorporation of new highly effective pharmacologic and biological agents, which are beyond reach for this population; budget limitations also restrict state-of-the-art PC interventions.…”

Section: Discussionmentioning

confidence: 99%

Palliative Care for Patients With Hematologic Malignancies in a Low-Middle Income Country: Prevalence of Symptoms and the Need for Improving Quality of Attention at the End of Life

Jaime‐Pérez

Turrubiates-Hernández

Nava-Obregón

et al. 2019

Am J Hosp Palliat Care

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Background: Palliative care (PC) for patients with malignant hematological diseases is scarcely documented, particularly in low- and middle-income countries. This study aimed to document PC provided to patients with hematologic malignancies. Methods: Bidirectional study conducted from July 2016 to June 2019 at the hematology and palliative care departments at a reference center in Northeast Mexico for low-income open population uninsured patients. Clinical records and electronic files of patients with malignant hematological diseases of both sexes and all ages attending an academic hematology center were reviewed. Statistical analysis was performed with the SPSS version 22 program. Acute and chronic leukemias, multiple myeloma, Hodgkin lymphoma, non-Hodgkin lymphoma, and others were included. Results: Five-hundred ten patients were studied, of which 148 (29%) died. Eighty-one (15.88%) patients including 31 (20.9%) who died received PC. Median age at palliative diagnosis was 42 (2-91) years. The most common symptom was pain (69.7%). The most frequent reason for palliative referral was treatment-refractory disease (39%). During the last week of life, 19 (95%) of 20 patients had blood sampling; 17 (85%) received antibiotics; 16 (80%) had a urinalysis performed; 16 (80%) received analgesia, including paracetamol (11, 35.5%) and buprenorphine (7, 22.6%); 10 (50%) received blood products; 9 (45%) were intubated; and central venous catheters were inserted in 5 (25%) patients. Conclusions: Palliative care was provided to a minority of patients with hematologic malignancies and considerable improvement is required in its timely use and extension.

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Hospitalization rate and costs in acute lymphoblastic leukemia of childhood in a low‐income group: Financial impact in Northeast Mexico

Abstract: Hospitalizations for children with ALL were less expensive than in high-income countries but had a significant cost to low-income families and to the healthcare system.

Cited by 10 publications

References 16 publications

Global efforts toward the cure of childhood acute lymphoblastic leukaemia

Global efforts toward the cure of childhood acute lymphoblastic leukaemia

Childhood T-cell acute lymphoblastic leukemia in a single Latin American center: impact of improved treatment scheme and support therapy on survival

Palliative Care for Patients With Hematologic Malignancies in a Low-Middle Income Country: Prevalence of Symptoms and the Need for Improving Quality of Attention at the End of Life

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