Survival Outcome of Childhood Acute Lymphoblastic Leukemia in India

Abstract

The outcome of childhood acute lymphoblastic leukemia in India has been inferior to more than 80% cure rates in developed nations. This study was done to analyze the outcome of acute lymphoblastic leukemia in India over 4 decades. There has been a gradual improvement in survival rates of up to >70% in some centers along with a decline in relapse and mortality. However, these results cannot be generalized to the entire nation. There is a crying need to address treatment abandonment, take quality improvement, educational and financial initiatives; cooperative research into risk factors and disease biology, and the implementation of risk stratification along with the assessment of response to therapy.

In the realms of future: new frontiers of ‘techno-oncology’ as a platform for global improvement in the outcomes of childhood cancer

“…It must be remembered that the improvement in pediatric cancer outcomes in resource-constrained nations clearly needs a holistic approach [3]. No one solution or strategy could cater to the diverse and complex challenges in pediatric cancer care across all the continents and replace the need of a holistic approach.…”

“…Grassroots level research has the potential of unraveling locally relevant prognostic factors and other parameters of local significance that may be of no relevance in developed nations [3]. Through technology partnership programs, knowledge regarding development of patient databases and study of cancer epidemiology could be shared with developing nations.…”

“…Several factors including higher rates of mortality, relapse, abandonment of therapy and socioeconomic factors have been deemed contributory [3][4][5]. Traditionally, the efforts were directed toward directly transplanting aggressive protocols from developed nations to developing nations in desperate attempts to improve survival [6].…”

“…Such efforts need to be all-inclusive to incorporate infrastructure, personnel, support systems, funding and technology [1][2][3]. Several successful training and education/fellowship programs for physicians, nurses and ancillary personnel are available through partner sites in HICs.…”

“…An important frontier of techno-oncology is developing solutions to locally relevant problems and strengthening local health systems in the developing nations [3]. Such efforts need to be all-inclusive to incorporate infrastructure, personnel, support systems, funding and technology [1][2][3].…”