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治疗儿童急性淋巴细胞白血病在资源贫困的地理空间
Moisés M Gallardo-Pérez1,2, Robert Peter Gale3, Oscar A Reyes-Cisneros1,4
1Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Puebla, Mexico.
Frontiers in oncology
|July 3, 2023
概括
这项研究适应了白血病治疗方案,用于在低资源环境中的门诊护理,取得了良好的结果,并显著降低了儿科急性淋巴细胞白血病 (ALL) 患者的成本.
科学领域:
- 儿科瘤学 儿科瘤学
- 血液学 血液学 血液学
- 全球健康 全球健康
背景情况:
- 在资源有限的地区治疗儿童急性淋巴细胞白血病 (ALL) 在平衡安全性,疗效,可用性和成本方面存在重大挑战.
- 现有的协议通常需要广泛的医院基础设施,限制低收入地区的可访问性.
研究的目的:
- 适应圣朱德总体XI协议,在资源有限的环境中为患有ALL的儿童提供门诊分娩.
- 评估这种修改的门诊治疗方案的安全性,疗效和成本效益.
主要方法:
- 修改了St. Jude Total XI门诊护理协议,包括每周的化疗,延迟的内治疗,预防性抗生素/抗菌剂,仿制药,没有中枢神经系统辐射.
- 收集了104名年龄小于12岁的门诊治疗儿童的数据.
- 分析了血液学缓解,无事件生存率 (EFS),复发累积发病率 (CIR) 和治疗费用.
主要成果:
- 在104名儿童中,有88名儿童实现了完全缓解.
- 平均EFS总体为87个月,因风险分层而有所不同.
- 5年的CIR为28%,大多数患者的存活时间超过5年.
- 与高收入国家 (约15万美元) 相比,治疗成本要低得多 (28500美元).
结论:
- 圣朱德总体XI协议的门诊修改为儿童ALL在资源有限的环境中提供了良好的结果.
- 这种适应的协议显示了可控住院和不良事件的显著成本节省.
- 该模型适用于其他资源较差的地区,在儿童癌症治疗方面面临着类似的挑战.
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