Expert Recommendations for the Diagnosis, Treatment, and Management of Adult B-Cell Acute Lymphoblastic Leukemia in Latin America

Abstract

PURPOSE Despite strong induction chemotherapy response rates, only 30%-40% of patients with adult B-cell acute lymphoblastic leukemia (ALL) attain long-term remission. This study analyzes ALL in Latin America (LA) and recommends diagnosis, treatment, and management protocols. METHODS The Americas Health Foundation organized a panel of hematologists from Argentina, Brazil, Chile, Colombia, and Mexico to examine ALL diagnosis and therapy and produce recommendations. RESULTS Lack of regional data, unequal access to diagnosis and therapy, inadequate treatment response, and uneven health care distribution complicate adult ALL management. The panel recommended diagnosis, first-line and refractory treatment, and post-transplantation maintenance. Targeted treatments, including rituximab, blinatumomab, and inotuzumab ozogamicin, are becoming available in LA and must be equitably accessed. CONCLUSION This review adapts global information on treating ALL to LA. Governments, the medical community, society, academia, industry, and patient advocates must work together to improve policies.

Estado nutricional y supervivencia de los pacientes con leucemia linfoblástica aguda atendidos en el Instituto Nacional de Enfermedades Neoplásicas, 2017-2019

“…Existen escasos datos epidemiológicos sobre LLA en América Latina, a pesar de que se ha reportado que los latinoamericanos tienen una mayor incidencia, así como un peor pronóstico en comparación a otras etnias [11][12][13] . Por lo tanto, se ha identificado la necesidad reforzar el sistema de reporte de esta enfermedad e identificar los factores asociados para comprender mejor su mecanismo y así mejorar la supervivencia 14,15 .…”