BACKGROUND: In order to understand the disparity in childhood leukemia survival in low-income countries (LICs) compared to high-income countries (HICs), we evaluated the resources available at Tanzania's national pediatric oncology ward, and clinical characteristics, disease course and outcomes of children diagnosed with acute leukemia from 2008 through 2010. PROCEDURES: A chart review and assessment of services was performed to assess childhood leukemia diagnoses, treatment, and outcomes in Tanzania at the Ocean Road Cancer Institute (ORCI) from January 1, 2008 to December 31, 2010. Results were compared to those from a 2005 evaluation that showed only one of 20 children with leukemia surviving at 1 year. RESULTS: During the study period, 106 patients presented with leukemia, including 81 patients with acute lymphoblastic leukemia (ALL) and 25 with acute myeloid leukemia (AML). Forty-nine of 58 (84%) patients with ALL, and six of 17 (35%) with AML who received therapy and had complete data, achieved complete remission. Estimated 2-year event-free survival for all patients with ALL was 33%; for AML it was 0%. Ten patients died prior to initiation of therapy, 19 died of toxicity, and eight abandoned therapy. CONCLUSIONS: Though leukemia survival in Tanzania remains far below that in HICs, survival rates for ALL have significantly improved in recent years due to standardization of treatment regimens and better staff, though AML outcome remains dismal. Ongoing improvements in pediatric leukemia outcomes will require strategies to improve awareness and early access to treatment coupled with improvements in diagnostic capabilities, supportive care, and training.
BACKGROUND: In order to understand the disparity in childhood leukemia survival in low-income countries (LICs) compared to high-income countries (HICs), we evaluated the resources available at Tanzania's national pediatric oncology ward, and clinical characteristics, disease course and outcomes of children diagnosed with acute leukemia from 2008 through 2010. PROCEDURES: A chart review and assessment of services was performed to assess childhood leukemia diagnoses, treatment, and outcomes in Tanzania at the Ocean Road Cancer Institute (ORCI) from January 1, 2008 to December 31, 2010. Results were compared to those from a 2005 evaluation that showed only one of 20 children with leukemia surviving at 1 year. RESULTS: During the study period, 106 patients presented with leukemia, including 81 patients with acute lymphoblastic leukemia (ALL) and 25 with acute myeloid leukemia (AML). Forty-nine of 58 (84%) patients with ALL, and six of 17 (35%) with AML who received therapy and had complete data, achieved complete remission. Estimated 2-year event-free survival for all patients with ALL was 33%; for AML it was 0%. Ten patients died prior to initiation of therapy, 19 died of toxicity, and eight abandoned therapy. CONCLUSIONS: Though leukemia survival in Tanzania remains far below that in HICs, survival rates for ALL have significantly improved in recent years due to standardization of treatment regimens and better staff, though AML outcome remains dismal. Ongoing improvements in pediatric leukemia outcomes will require strategies to improve awareness and early access to treatment coupled with improvements in diagnostic capabilities, supportive care, and training.
Authors: Grace K Ellis; Agness Manda; Hillary Topazian; Christopher C Stanley; Ryan Seguin; Caroline E Minnick; Blessings Tewete; Asekanadziwa Mtangwanika; Mena Chawinga; Sara Chiyoyola; Maria Chikasema; Ande Salima; Stephen Kimani; Edwards Kasonkanji; Victor Mithi; Bongani Kaimila; Matthew S Painschab; Satish Gopal; Katherine D Westmoreland Journal: Int Health Date: 2021-04-27 Impact factor: 2.473
Authors: Rupali Sood; Nestory Masalu; Roisin M Connolly; Christina A Chao; Lucas Faustine; Cosmas Mbulwa; Benjamin O Anderson; Anne F Rositch Journal: BMC Cancer Date: 2021-05-10 Impact factor: 4.430
Authors: Romy E van Weelderen; Festus Njuguna; Kim Klein; Saskia Mostert; Sandra Langat; Terry A Vik; Gilbert Olbara; Martha Kipng'etich; Gertjan J L Kaspers Journal: Cancer Rep (Hoboken) Date: 2021-11-22
Authors: Kristin Schroeder; Anthony Saxton; Jessica McDade; Christina Chao; Nestory Masalu; Colin Chao; Daniel S Wechsler; Beda Likonda; Nelson Chao Journal: J Glob Oncol Date: 2017-06-09