Pediatric Hematology-Oncology Outreach for Developing Countries

Wilimas, Judith A.; Ribeiro, Raul C.

doi:10.1016/s0889-8588(05)70246-x

Cited by 40 publications

(28 citation statements)

References 9 publications

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“…20,24 Leaders in international pediatric oncology have summarized key elements of successful treatment of cancer in resourcepoor countries: identification of local needs, mobilization of the community, partnership with an established center, development of a multidisciplinary health care team, improvement of supportive care, subsidized travel and housing for patients, and development of treatment protocols adapted to local conditions. 17,[25][26][27] Our findings confirm the importance of each of these elements, which have led to success in El Salvador and other countries with limited resources. 8,17,18,28 Essential for success is a dedicated, local, well-trained, full-time pediatric hematologist/oncologist who can identify correctable defects in the health care system and implement costeffective changes; also crucial is the support of a private foundation that can lobby for change of the health care system, support patients and families economically, and raise money to assist with other needed improvements.…”

Section: Commentsupporting

confidence: 78%

Establishment of a Pediatric Oncology Program and Outcomes of Childhood Acute Lymphoblastic Leukemia in a Resource-Poor Area

Howard

Pedrosa²,

Lins³

et al. 2004

JAMA

274

249

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CUTE LYMPHOBLASTIC LEUKEmia (ALL), the most common childhood cancer, has a cure rate of 80% in resourcerich countries. [1][2][3][4][5][6] However, more than 80% of the world's children live in less-advantaged countries, where the cure rate generally does not exceed 35%. [7][8][9][10][11] The outcome of treatment of childhood ALL, which depends on effective chemotherapy and supportive care, serves as an index of the status of pediatric oncology in countries with limited resources. Because of its high incidence and its curability, ALL is a logical initial target for pediatric cancer programs under development in such countries. The causes of treatment failure in resource-poor countries include relapse, abandonment of therapy, and death from toxicity because of suboptimal supportive care, delayed diagnosis, and comorbid conditions. [8][9][10][11][12][13][14][15][16][17][18][19] Strategies to reduce some of these problems have been studied, 17,18 and establishment of a dedicated pediatric oncology program in El Salvador was associated with an increase in ALL survival from 5% to 48%. 9

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Section: Commentsupporting

confidence: 78%

Establishment of a Pediatric Oncology Program and Outcomes of Childhood Acute Lymphoblastic Leukemia in a Resource-Poor Area

Howard

Pedrosa²,

Lins³

et al. 2004

JAMA

274

249

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“…25 To improve survival in underprivileged countries, a number of factors have been recognized. [36][37][38][39][40] These include difficulties in accessing health care, limitations in the existing health care systems, and the socio-economic status of families can explain this low rate of survival. 40 In Morocco, only 2 major pediatric cancer centers exist for a total population of about 33 million with a high birthrate.…”

Section: Discussionmentioning

confidence: 99%

Immunologic Profile and Outcome of Childhood Acute Lymphoblastic Leukemia (ALL) in Morocco

Dakka¹,

Bellaoui

Khattab³

et al. 2007

Journal of Pediatric Hematology/Oncology

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Immunophenotyping in leukemia offers a precise delineation of the hematopoietic lineage and differentiation stage of the malignant cell. In this study, we used flow cytometry to determine the frequency of the immunologic types of acute lymphoblastic leukemia (ALL) in Moroccan children. We analyzed 100 samples from ALL patients within an age ranging from 6 months to 16 years presented over a 4-year period (1996 to 2000). Immunophenotyping allowed classification into 2 major categories: T-ALL (37%) and B-ALL (63%), with a higher percentage of males (69%). Comparison of the clinical characteristics showed that the frequency of splenomegaly was similar in B-ALL and T-ALL patients (53% and 47%, respectively). Hepatomegaly and mediastinal masses were more often associated with T-ALL (62% and 71%, respectively). Splenomegaly, hepatomegaly, and mediastinal masses were more frequent in immature than mature B-ALL, whereas the reverse was observed for T-ALL. Complete remission was obtained in 88% and 84% of B-ALL and T-ALL, respectively and relapse after 1 year occurred in 30% and 37% of cases, respectively. CD10 expressing B-ALL showed a slightly higher complete remission rate, whereas the reverse was observed for CD10 expressing T-ALL. The overall 5-year survival rate of ALL was 38%, whereas patients with B-ALL showed better survival than children with T-ALL.

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“…Fifteen nurses were trained in 2001 in Morocco. The residential program in El Salvador, which graduated its first class in July 2000, has trained 76 nurses from 12 countries (Chile, Columbia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Panama, Peru, and Venezuela) [3]. In return for permission from their hospitals to participate, trainees must sign a contract agreeing to a 5-year term of employment.…”

Section: Resultsmentioning

confidence: 99%

Training subspecialty nurses in developing countries: Methods, outcome, and cost

Wilimas

Donahue

Chammas

et al. 2003

Med. Pediatr. Oncol.

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Pediatric Hematology-Oncology Outreach for Developing Countries

Cited by 40 publications

References 9 publications

Establishment of a Pediatric Oncology Program and Outcomes of Childhood Acute Lymphoblastic Leukemia in a Resource-Poor Area

Establishment of a Pediatric Oncology Program and Outcomes of Childhood Acute Lymphoblastic Leukemia in a Resource-Poor Area

Immunologic Profile and Outcome of Childhood Acute Lymphoblastic Leukemia (ALL) in Morocco

Training subspecialty nurses in developing countries: Methods, outcome, and cost

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