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Supportive medical care for children with acute lymphoblastic leukemia in low- and middle-income countries

Francesco Ceppi1, Federico Antillon, Carlos Pacheco

  • 1a 1 Division of Hematology/Oncology, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.

Expert Review of Hematology
|May 28, 2015
PubMed

Insights

Survival rates for childhood acute lymphoblastic leukemia remain lower in low- and middle-income countries (LMIC) due to inadequate supportive care. This article provides practical recommendations for improving supportive care and reducing treatment failure in LMIC.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Global Health

Background:

  • Significant advancements in treating childhood acute lymphoblastic leukemia (ALL) have been made globally.
  • However, survival rates in low- and middle-income countries (LMIC) lag considerably behind high-income nations.

Purpose of the Study:

  • To outline practical supportive care recommendations for healthcare providers in LMIC.
  • To address key challenges contributing to treatment failure in pediatric ALL patients in LMIC.

Main Methods:

  • Summarizes core oncology nursing care principles.
  • Details management strategies for tumor lysis syndrome and mediastinal masses.
  • Includes recommendations for nutritional support and use of blood products.

Main Results:

  • Highlights the critical role of supportive care in improving outcomes for pediatric ALL in LMIC.
  • Provides actionable guidance on managing common toxicities and complications.
  • Emphasizes the need for comprehensive care, including palliative support.

Conclusions:

  • Improving supportive care is essential to reduce excess mortality from toxicity in pediatric ALL in LMIC.
  • Implementing these practical recommendations can enhance treatment success rates.
  • Addresses critical gaps in care for vulnerable pediatric populations.

Keywords:
acute lymphoblastic leukemiachemotherapylow-income countrymiddle-income countryoncology nursingpediatricssupportive care

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