Strategies to Overcome Inequities in the Treatment of Patients with Hematologic Malignancies

To examine inequities affecting the diagnosis, disease-specific treatment, and supportive care of hematologic malignancies in resource-constrained settings, and to critically evaluate resource-adapted strategies intended to address these barriers.

Evidence identifies limited access to hematopathology, flow cytometry, cytogenetic and molecular testing, measurable residual disease assessment, and specialized imaging as major diagnostic barriers. Treatment inequities include delayed or of access to effective therapies, limited delivery of risk- or response adapted protocols and inadequate access to transplantation and cell therapy. Tiered diagnostic networks, resource-adapted protocols, quality-assured generics and biosimilars, shared-care models, and selective use of telemedicine may expand access. However, supporting evidence is largely observational and provides limited information on cost-effectiveness, scalability, and survival benefit. Reducing inequities in hematologic cancer care requires prioritizing interventions that directly improve diagnostic and treatment decisions and can be sustained within local resources. Resource-adapted diagnostic pathways, disease-specific treatment protocols, adequate supportive care, patient navigation, and selective digital follow-up provide pragmatic approaches. These interventions should be evaluated using clinically relevant outcomes, including diagnostic accuracy, treatment delay and abandonment, toxicity, cost, and survival.