Long-term results with the adapted LMB 96 protocol in children with B-cell non Hodgkin lymphoma treated in Iraq: comparison in two subsequent cohorts of patients

Moleti, Maria Luisa; Al‐Jadiry, Mazin Faisal; Shateh, Wafa Ablahad; Al‐Darraji, Amir Fadhil; Mohamed, Sara; Uccini, Stefania; Piciocchi, Alfonso; Foà, Robin; Al‐Hadad, Salma Abbas

doi:10.1080/10428194.2018.1519810

Cited by 7 publications

(17 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The oncology unit receives an average of 300 new malignant cases per year. Improvement in childhood cancer services was achieved over the past two decades through better availability of WHO essential chemotherapy drugs, introduction of advanced diagnostic/screening tools and bone marrow transplant services, provision of satellite telemedicine e-learning training program, in collaboration with Sapienza University in Rome, fostering consultation and quality control, using Tele-Pathology, introduction of ATRA, adapted APL protocols, strengthening research in coordination with Japanese institutes and promote training in accredited international centers [47][48][49].…”

Section: Pediatric Oncologymentioning

confidence: 99%

General Oncology Care in Iraq

Alwan

2022

Cancer in the Arab World

View full text Add to dashboard Cite

The estimated population of Iraq (40,222,493 in 2020) continues to grow at a rate of 2.4% per year; only 5% is over 60 years with a life expectancy approaching 72 years. There are 18 governorates in Iraq. Before 1990, Iraq had the most robust healthcare system in the Middle East. The consequences of the successive wars and political instability yielded a significant shortage in the medical resources and funds. Currently, the government spends 6–7% of its Gross Domestic Product (GDP) on the health sector, providing free of charge services to all citizens through a network of primary healthcare centers and public hospitals. The Iraqi Cancer Board of the Ministry of Health is responsible for implementing the National Cancer Control Plan (NCCP). The latest Iraqi Cancer Registry revealed that the top recorded malignancies among the population are the breast, bronchus, and lungs followed by colorectal cancers, whereas the most common causes of malignant related deaths are cancers of the bronchus and lungs, breast, and leukemia. Overall, there are over 40 public cancer care facilities distributed among the governorates. This chapter illustrates the general oncology care in Iraq; highlighting the implemented elements of the NCCP, the offered specialized cancer services, and the international collaborations on cancer control and research.

show abstract

Section: Pediatric Oncologymentioning

confidence: 99%

General Oncology Care in Iraq

Alwan

2022

Cancer in the Arab World

View full text Add to dashboard Cite

show abstract

“…In countries suffering from lack of resources and poor social conditions, despite protocol adaptations, the outcome is heavily influenced by the high rate of toxic deaths, which can be as high as 37%, due in particular to tumour lysis syndrome (TLS; 4-11%) and infections (10-23%) occurring in the first treatment phases. 22,[38][39][40][43][44][45]48 In these contexts, the TRM may overcome deaths for lymphoma unresponsiveness or relapse.…”

Section: Lmb-derived Protocolsmentioning

confidence: 99%

“…In these settings, therapeutic protocols must be adapted to the available local resources in order to avoid prohibitive toxicities. Adapted BFM and LMB protocols, modified according to the local conditions, are employed around the world in LMICs with EFS results that range between 60% and 80% (Table I, BFM-derived protocols 23,[31][32][33][34][35][36][37][38] and Table II, LMB-derived protocols 22,[38][39][40][41][42][43][44][45][46][47][48][49][50] ). Less aggressive therapeutic schemes have been utilized in India and in other LMICs (Table III).…”

Section: Treatmentmentioning

confidence: 99%

“…22 In the Iraqi protocol, the MTX dose was 1 g/m 2 over a 3-h infusion and the doses of cytarabine and cyclophosphamide were also reduced. 44,45 Most patients presented advanced stages of disease. These reports are from countries with very different local situations, in terms of drugs and supportive care availability, economic constraints, social instability and conflicts.…”

Section: Lmb-derived Protocolsmentioning

confidence: 99%

See 1 more Smart Citation

Childhood aggressive B‐cell non‐Hodgkin lymphoma in low–middle‐income countries

2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…In newly diagnosed paediatric BL and DLBCL, a short intensive multiagent chemotherapy, modulated according to the extent of the disease, provides five‐year event‐free survival (EFS) rates around 90% in high‐income countries (Bowman et al , 1996; Reiter et al ., 1999; Cairo et al , 2002, 2007, 2012; Woessmann et al , 2005; Patte et al , 2007; Gerrard et al , 2008; Pillon et al , 2016; Egan et al , 2019). This is a key point; it is in fact estimated that 90% of children diagnosed with NHL live in low/middle income countries, where a rapid diagnostic work‐up with a correct histologic characterization, as well as optimal front‐line treatment and timely follow‐up, and adequate supportive measures are suboptimal (Moleti et al , 2011, 2019). This means that many more relapsed/refractory (r/r) patients are managed in these less favourable real‐life settings.…”

mentioning

confidence: 99%

Treatment of relapsed/refractory paediatric aggressive B‐cell non‐Hodgkin lymphoma

2020

Self Cite

View full text Add to dashboard Cite

Summary Aggressive B‐cell non‐Hodgkin lymphoma (B‐NHL) accounts for ≈60% of NHL in children/adolescents. In newly diagnosed Burkitt lymphoma and diffuse large B‐cell lymphoma, short intensive multiagent chemotherapy is associated with a five‐year event‐free survival of around 90%. Very few children/adolescents with aggressive B‐NHL show a relapsed/refractory (r/r) disease. The outcome is poor, with cure rates <30%, and there is no standard of care. Rituximab‐containing salvage regimens may provide a complete/partial response in 60–70% of cases. However, long‐term survival is <10% for non‐transplanted patients. Autologous or allogeneic haematopoietic stem cell transplant is, nowadays, the best option for responding patients, with survival rates around 50%. The benefit of autologous versus allogeneic HSCT is not clear. Numerous novel therapies for r/r B‐NHL are currently being tested in adults, including next‐generation monoclonal antibodies, novel cellular therapy strategies and therapies directed against new targets. Some are under investigation also in children/adolescents, with promising preliminary results.

show abstract

Long-term results with the adapted LMB 96 protocol in children with B-cell non Hodgkin lymphoma treated in Iraq: comparison in two subsequent cohorts of patients

Cited by 7 publications

References 35 publications

General Oncology Care in Iraq

General Oncology Care in Iraq

Childhood aggressive B‐cell non‐Hodgkin lymphoma in low–middle‐income countries

Treatment of relapsed/refractory paediatric aggressive B‐cell non‐Hodgkin lymphoma

Contact Info

Product

Resources

About