在资源贫困国家的儿童急性淋巴细胞白血病的结果
Monika L Metzger1, Scott C Howard, Ligia C Fu
1Department of Hematology-Oncology and International Outreach Program, St Jude Children's Research Hospital, Memphis, TN 38105-2794, USA. monika.metzger@stjude.org
Lancet (London, England)
|September 6, 2003
概括
放弃治疗,通常是由于长时间的旅行和年轻的年龄,是洪都拉斯儿童急性淋巴细胞白血病治疗失败的主要原因. 解决这些障碍的干预措施可以改善结果.
科学领域:
- 儿科瘤学 儿科瘤学
- 全球健康 全球健康
- 血液学 血液学 血液学
背景情况:
- 儿童急性淋巴细胞白血病 (ALL) 治疗失败的原因因国家经济状况而异.
- 了解这些差异对于改善全球儿童癌症护理至关重要.
研究的目的:
- 调查儿童ALL治疗失败的主要原因在洪都拉斯,一个资源贫困的环境.
- 确定与儿童ALL患者放弃治疗和死亡相关的因素.
主要方法:
- 对于168名在洪都拉斯接受治疗的儿科ALL患者的医疗记录进行了回顾性分析.
- 统计分析,包括危险比率,以确定与治疗失败和放弃相关的因素.
主要成果:
- 放弃治疗是导致失败的主要原因 (n=38).
- 漫长的旅行时间 (>2小时) 和年轻的年龄 (<4.5岁) 显著增加了遗弃的风险.
- 35名患者死于与治疗相关的并发症,突出了需要支持性护理的需要.
结论:
- 放弃治疗是成功童年的关键障碍. 在像洪都拉斯这样的资源贫困环境中,ALL治疗.
- 交通支持,卫星诊所和支持小组等干预措施对于减少放弃至关重要.
- 迅速管理感染和支持性护理对于提高生存率至关重要.
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