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Published on: May 10, 2017
Childhood aggressive B-cell non-Hodgkin lymphoma in low-middle-income countries
Maria Luisa Moleti1, Anna Maria Testi1, Robin Foà1
1Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy.
Insights
Paediatric aggressive B-cell lymphomas have significantly lower cure rates in low- and middle-income countries (LMICs) compared to high-income countries (HICs). International cooperation aims to bridge this gap by improving healthcare facilities and knowledge sharing for better outcomes in pediatric non-Hodgkin lymphoma (NHL).
Area of Science:
- Pediatric Oncology
- Hematology
- Global Health
Background:
- Paediatric aggressive B-cell lymphomas are highly curable in high-income countries (HICs), with cure rates around 90%.
- In low- and middle-income countries (LMICs), where 90% of paediatric non-Hodgkin lymphomas (NHL) occur, cure rates range from less than 30% to 70%.
- Socio-economic factors, limited diagnostics, and inadequate supportive care negatively impact treatment outcomes in LMICs.
Purpose of the Study:
- To review the current management and outcomes of paediatric aggressive B-cell NHL in LMICs.
- To highlight the disparities in treatment success between HICs and LMICs.
- To summarize progress and challenges in international cooperation efforts.
Main Methods:
- Review of published data on paediatric aggressive B-cell NHL in LMICs.
- Analysis of factors affecting treatment compliance, delivery, and toxicity.
- Summary of outcomes from national and international cooperation projects.
Main Results:
- Significant disparities exist in cure rates for paediatric aggressive B-cell lymphomas between HICs and LMICs.
- Limited resources and infrastructure in LMICs contribute to poorer outcomes.
- International collaborations show promising initial results in improving care.
Conclusions:
- Addressing the gap in paediatric aggressive B-cell lymphoma treatment requires sustained international cooperation.
- Improving diagnostic capabilities and supportive care in LMICs is crucial.
- Further research and data sharing are needed to optimize management strategies for pediatric NHL in resource-limited settings.
Abstract:
In high-income countries (HICs) paediatric aggressive B-cell lymphomas are curable in about 90% of cases. Much worse results, with cure rates ranging from less than 30% to about 70%, are achieved in low- and middle-income countries (LMICs), where 90% of paediatric non-Hodgkin lymphomas occur. Low socio-economic and cultural conditions, the lack of optimal diagnostic procedures, laboratory facilities and adequate supportive care exert a strong negative impact on compliance, treatment delivery, toxicity and, consequently, on the clinical outcome. Published data are scarce, generally originating from single institutions, and are difficult to compare. National and international cooperation projects have been undertaken to reduce the unacceptable gap between HICs and LMICs in the management of children with cancer, by promoting the sharing of knowledge and by implementing adequate local healthcare facilities, with initial promising results. In the present review, we will summarize the results so far obtained in the management of paediatric aggressive B-cell NHL in LMICs.
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