Systematic Review of the Burden and Treatment Patterns of Adult and Adolescent Acute Lymphoblastic Leukemia in India: Comprehending the Challenges in an Emerging Economy

Precursor B‐cell acute lymphoblastic leukaemia—a global view

“…A reduction in relapse and ALL‐related mortality has been observed at an incremental cost of treatment‐related toxicity. It would be worthwhile to mention here that an early protocol used in India, MCP‐841, continues to be used in some centres in India, especially in institutions where cost constraints and logistic challenges of delivering intensive therapies are of significant clinical and administrative concern 27,39 …”

“…In the AYA group, treatment regimens have varied between paediatric‐inspired protocols (BFM‐based), increased‐dosage cyclophosphamide, vincristine (VCR) and daunorubicin (DNR) (hyper‐CVAD), or adult protocols (e.g., GMALL). A systematic review of AYA ALL reported the five‐year OS rates from different Indian retrospective series to be in the range of 38–58% 27 . Multicentre collaborative efforts are attempting to address several real‐world clinical questions encountered by haematologists/oncologists treating ALL of the young in India, and early results are promising 28,29 .…”

“…Most referral institutions in the country are now transitioning towards paediatric‐inspired protocols for the treatment of ALL in the adolescent and young adult group of patients. A recent systematic review and large retrospective studies indicate this transition in treatments 27,37 . This has also been facilitated by an increasing crosstalk and collaboration occurring between adult and paediatric haemato‐oncology physicians within and outside their respective institutions.…”

“…A systematic review of AYA ALL reported the five‐year OS rates from different Indian retrospective series to be in the range of 38–58%. 27 Multicentre collaborative efforts are attempting to address several real‐world clinical questions encountered by haematologists/oncologists treating ALL of the young in India, and early results are promising. 28 , 29 Many of these treatments are possible in India due to the availability of generics, and biosimilar preparations of drugs like L‐asparaginase (L‐ASAP) and rituximab.…”

“…A recent systematic review and large retrospective studies indicate this transition in treatments. 27 , 37 This has also been facilitated by an increasing crosstalk and collaboration occurring between adult and paediatric haemato‐oncology physicians within and outside their respective institutions.…”