2005
DOI: 10.1016/j.ejca.2004.11.004
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Treatment of acute lymphoblastic leukaemia in countries with limited resources; lessons from use of a single protocol in India over a twenty year peroid

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Cited by 141 publications
(120 citation statements)
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“…However, 80-85% of the cases of childhood ALL occur in resource-poor countries where the cure rate is significantly lower than that of resource-rich countries. The prognosis of childhood ALL is poor in these countries due to several clinical, social, and environmental factors [9][10][11]18].…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…However, 80-85% of the cases of childhood ALL occur in resource-poor countries where the cure rate is significantly lower than that of resource-rich countries. The prognosis of childhood ALL is poor in these countries due to several clinical, social, and environmental factors [9][10][11]18].…”
Section: Discussionmentioning
confidence: 99%
“…In low-income countries (LICs), however, therapy results for pediatric ALL are still not encouraging. Cure rates are lower due to relapse, abandonment of therapy, and death from toxicity secondary to suboptimal supportive care, delayed diagnosis, and comorbid conditions [9][10][11]. In Lebanon, only one study presented pediatric ALL experience and survival results [12].…”
Section: Introductionmentioning
confidence: 99%
“…An array of clinical and biological features have been identified as prognostically significant in childhood ALL, including age, presenting leukocyte count, Immunophenotypic, chromosomal abnormalities, the presence of overt central nervous system leukemia and the rapidity with which the patients demonstrate a response to initial induction chemotherapy. [4][5][6] Risk factors are utilized for stratification of therapy. [6][7][8] More intensive therapies are administered to patients considered to have the highest risk of relapse.…”
Section: Introductionmentioning
confidence: 99%
“…Geographic differences in incidence may suggest unique genetic or environmental exposures that affect cancer risk. In this report we review the inci- Health planning Measurement of the geographic distribution and total number of cases of each cancer type allows planning of the location where pediatric cancer units and satellite clinics should be established and determination of services needed at each site Honduras satellite clinics; development of a regional flow cytometry center 45 Quality improvement Measuring outcomes of treatment and cancer-specific mortality identifies services that need to be improved and facilitates assessment of the efficacy of interventions Development of a pediatric cancer center of excellence in Recife, Brazil 34 Clinical research Adaptation of pediatric oncology treatment regimens Conducting clinical trials of therapy in LIC that use less toxic, less expensive, or otherwise modified versions of published treatment regimens can evaluate the feasibility and outcomes in the local setting ALL and lymphoma in Recife, Brazil, 33,34 Indonesia, 35 and India [46][47][48] Clinical research that can only be performed in LIC Evaluation of clinical problems unique to children with cancer in LIC, including abandonment of therapy, the effects of extreme poverty on compliance and toxicity, and the effects of comorbid illnesses (e.g. malnutrition, parasitic infection) on outcomes can lead to specific mitigation strategies Abandonment risk factors for children with ALL 23,34,35 ; telemedicine in Jordan to improve treatment of central nervous system cancer 49 Comparative clinical research Evaluation of specific aspects of care in diverse settings, such as the effects on outcome of culture, language, socioeconomic status, and other variables that differ greatly between countries…”
mentioning
confidence: 99%