Acute myeloid leukemia: challenges for diagnosis and treatment in Latin America
Andrés Gómez-De León1, Roberta Demichelis-Gómez2, Abel da Costa-Neto3
1Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Universiadad Autónoma de Nuevo León, Monterrey, Mexico.
Insights
Access to advanced treatments for acute myeloid leukemia (AML) and acute promyelocytic leukemia (APL) is limited in Latin America, leading to higher early mortality rates compared to developed nations.
Area of Science:
- Hematology
- Oncology
- Global Health
Background:
- Acute myeloid leukemia (AML) and acute promyelocytic leukemia (APL) present unique challenges in Latin America.
- Reviewing the diagnostic and therapeutic landscape is crucial for understanding treatment disparities in low- and middle-income countries (LMICs).
Approach:
- Literature and study registry review focusing on Latin American AML/APL patient epidemiology.
- Evaluation of diagnostic, genetic stratification, and fitness assessment challenges.
- Assessment of early mortality, supportive care, chemotherapy, consolidation, maintenance, novel agents, and hematopoietic stem cell transplantation (HSCT).
Key Points:
- While advanced technologies are present in Latin America, patient access remains a significant barrier.
- Higher early mortality rates are observed in the region compared to developed countries.
- Disparities in access to supportive care, novel agents, and HSCT impact patient outcomes.
Conclusions:
- Limited access to diagnostics, supportive care, and novel therapies hinders treatment efficacy for AML/APL in Latin America.
- Addressing these disparities requires enhanced education, collaborative research, and advocacy.
- Implementing recent advancements in AML/APL diagnosis and treatment is essential for improving patient outcomes in LMICs.
Objective:
to review the current diagnostic and therapeutic landscape of AML in Latin America as a reflection of other low- and middle-income countries and regions of the world. Encompassing both acute promyelocytic and non-promyelocytic disease types.
Methods:
We reviewed the literature and study registries concerning epidemiological features of patients with AML/APL treated in Latin America, as well as evaluated diagnostic and genetic stratification and patient fitness assessment challenges, the importance of early mortality and supportive care capacity, intensive and non-intensive chemotherapy alternatives, consolidation, and maintenance strategies including novel agents and hematopoietic stem cell transplantation.
Results:
Although most of the current technologies and treatment options are available in the region, a significant fraction of patients have only limited access to them. In addition, mortality in the first weeks from diagnosis is higher in the region compared to developed countries.
Conclusions:
Disparities in access to technologies, supportive care capacity, and availability of novel agents and HSCT hinder results in our region, reflecting barriers common to other LMICs. Recent developments in the diagnosis and treatment of this disease must be implemented through education, collaborative clinical research, and advocacy to improve outcomes.
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