Improving the prognosis of pediatric hodgkin lymphoma in developing countries: A moroccan society of pediatric hematology and oncology study

Abstract

Good outcomes for pediatric HL patients can be achieved in LMIC using a multidisciplinary team approach, uniform protocol-based therapy, twinning partnership among oncology units in-country and abroad, and a data collection system to monitor compliance and identify gaps in care.

Treatment outcome in children and adolescents with relapsed Hodgkin lymphoma - results of the UK HD3 relapse treatment strategy

“…Children and adolescents with Hodgkin lymphoma [HL] achieve long‐term overall survival rates of over 90% with conventional chemotherapy alone or with a combination of chemotherapy and radiotherapy (Landman‐Parker et al , ; Nachman et al , ; Mauz‐Körholz et al , ; Shankar et al , ; Dörffel et al , ; Hessissen et al , ). Nevertheless, up to 10–15% of low stage and 20–25% of children with advanced stage HL will relapse or have primary refractory disease [defined as progression or relapse within 3 months of completion of primary treatment].…”

Addressing regional disparities in pediatric oncology: Results of a collaborative initiative across the Mexican–North American border

“…These accomplishments are also spreading to other centers in the region, such as the emerging pediatric oncology program in the neighboring state of Baja California Sur. The challenge going forward includes the continuation of local capacity development so that all children with cancer in Baja California can be diagnosed and referred to the GHT promptly, a challenge common in LMIC …”

“…Despite the usual risk factors for treatment abandonment in LMIC previously reported, such as poverty, lack of transportation, and increased mean home‐to‐hospital travel time, we encountered factors particular to the diverse population in the state of Baja California. These include a floating immigrant population, single‐parent household status, relying on informal activities for income, parent substance abuse, and family violence.…”

“…The RCHSD-SJCRH-GHT twinning program is a unique model of collaboration, involving institutions located directly across an international border in a region with profound economic and cultural dispar- 14,25,26,29 Future directions include continuing the education program for the staff and patients' families, building up a pediatric neurosurgery program, enhancing the palliative care efforts, maintaining the psychosocial support for families, and continuing to consolidate the newly established collaborative program in Baja California Sur, through the development of a "training hub" in Tijuana. If our efforts in these areas continue for 5 more years, we expect the 5-year survival rate for acute lymphoblastic leukemia to reach 70%, similar to that in many HIC, and other programs in LMIC such as in Guatemala and Brazil.…”

“…Of note, the mortality rate during induction therapy for acute lymphoblastic leukemia at our center was higher when compared to institutions in HIC, but lower (5.3%) when compared to other LMICs (28%). 25,27 Despite the usual risk factors for treatment abandonment in LMIC previously reported, [28][29][30][31] such as poverty, lack of transportation, and increased mean home-to-hospital travel time, we encountered factors particular to the diverse population in the state of Baja California.…”