[Treatment of migrant children with acute lymphoblastic leukemia in Argentina]

The probability of survival for children diagnosed with acute lymphoblastic leukemia (ALL) is below 60%, in Paraguay, Peru, and Bolivia, while in Argentina achieves 80%. Patients from neighboring countries migrate to Argentina looking for better curative options. The objective was to analyze the clinical characteristics, event-free survival (EFS), overall survival (OS), and treatment response in migrant patients with ALL, with or without previous treatment, and to compare them with Argentine patients.

A retrospective, cross-sectional, observational, and descriptive study was conducted from January 2011 to January 2024. Patients were divided into three groups: previously treated (GROUP-1), untreated (GROUP-2), and Argentine patients with ALL (GROUP-3, used for comparison with GROUP-1).

Of 827 patients with ALL, 106 (12%) were migrants; 55% belonged to GROUP-1 and 45% to GROUP-2. Incomplete diagnosis was observed in 35% of GROUP-1. Relapsed ALL accounted for 45% of this group. Comparing GROUP-1 and GROUP-2, EFS was 38% vs. 61% (p=0.0016), and OS was 53% vs. 72% (p=0.0038). When comparing GROUP-1 with GROUP-3, EFS was 38% vs. 75% (p=0.0001), and OS was 53% vs. 79% (p=0.0001). Among 32 migrant patients with an indication for hematopoietic stem cell transplantation (HSCT), only 5 received it.

Incomplete diagnostic workup negatively impacts curative outcomes, and local regulations prevent HSCT from being offered to eligible migrant patients.