Optimizing outcomes for children with non-Hodgkin lymphoma in low- and middle-income countries by early correct diagnosis, reducing toxic death and preventing abandonment

Guillermo Chantada, Catherine G. Lam, Scott Howard

Research output: Contribution to journalReview article

Abstract

In high-income countries, more than 90% of children with mature B-cell lymphomas are cured with frontline therapy. However, cure requires prompt and correct diagnosis, careful risk stratification, very intense chemotherapy and meticulous supportive care, together with logistical support for patients who live far from the cancer centre or face financial barriers to receiving care. In low- and middle-income countries (LMIC), cure rates range from 20% to 70% because of lack of diagnosis, misdiagnosis, abandonment of treatment, toxic death and excess relapse with reduced-intensity regimens. Fortunately, a wide range of successful interventions in LMIC have reduced these causes of avoidable treatment failure. Public awareness campaigns have led to societal awareness of childhood cancer; telepathology has improved diagnosis, even in remote areas; subsidized chemotherapy, transportation, housing and food have reduced abandonment; and hand hygiene, nurse training programmes and health system improvements have reduced toxic death. These interventions can be deployed everywhere and at low cost, so are highly scalable. Children and adolescents with Burkitt lymphoma can be cured in all countries by making a timely correct diagnosis, applying protocols adapted to the local context, preventing abandonment of therapy and avoiding toxic death. Reducing these causes of treatment failure is feasible and highly cost-effective everywhere.

Original languageEnglish (US)
Pages (from-to)1125-1135
Number of pages11
JournalBritish Journal of Haematology
Volume185
Issue number6
DOIs
StatePublished - Jun 1 2019

Fingerprint

Poisons
Non-Hodgkin's Lymphoma
Early Diagnosis
Treatment Failure
Telepathology
Hand Hygiene
Costs and Cost Analysis
Drug Therapy
Burkitt Lymphoma
B-Cell Lymphoma
Diagnostic Errors
Neoplasms
Therapeutics
Nurses
Education
Recurrence
Food
Health

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

Optimizing outcomes for children with non-Hodgkin lymphoma in low- and middle-income countries by early correct diagnosis, reducing toxic death and preventing abandonment. / Chantada, Guillermo; Lam, Catherine G.; Howard, Scott.

In: British Journal of Haematology, Vol. 185, No. 6, 01.06.2019, p. 1125-1135.

Research output: Contribution to journalReview article

@article{457e27437bdc46428c273e06c73da68f,
title = "Optimizing outcomes for children with non-Hodgkin lymphoma in low- and middle-income countries by early correct diagnosis, reducing toxic death and preventing abandonment",
abstract = "In high-income countries, more than 90{\%} of children with mature B-cell lymphomas are cured with frontline therapy. However, cure requires prompt and correct diagnosis, careful risk stratification, very intense chemotherapy and meticulous supportive care, together with logistical support for patients who live far from the cancer centre or face financial barriers to receiving care. In low- and middle-income countries (LMIC), cure rates range from 20{\%} to 70{\%} because of lack of diagnosis, misdiagnosis, abandonment of treatment, toxic death and excess relapse with reduced-intensity regimens. Fortunately, a wide range of successful interventions in LMIC have reduced these causes of avoidable treatment failure. Public awareness campaigns have led to societal awareness of childhood cancer; telepathology has improved diagnosis, even in remote areas; subsidized chemotherapy, transportation, housing and food have reduced abandonment; and hand hygiene, nurse training programmes and health system improvements have reduced toxic death. These interventions can be deployed everywhere and at low cost, so are highly scalable. Children and adolescents with Burkitt lymphoma can be cured in all countries by making a timely correct diagnosis, applying protocols adapted to the local context, preventing abandonment of therapy and avoiding toxic death. Reducing these causes of treatment failure is feasible and highly cost-effective everywhere.",
author = "Guillermo Chantada and Lam, {Catherine G.} and Scott Howard",
year = "2019",
month = "6",
day = "1",
doi = "10.1111/bjh.15785",
language = "English (US)",
volume = "185",
pages = "1125--1135",
journal = "British Journal of Haematology",
issn = "0007-1048",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Optimizing outcomes for children with non-Hodgkin lymphoma in low- and middle-income countries by early correct diagnosis, reducing toxic death and preventing abandonment

AU - Chantada, Guillermo

AU - Lam, Catherine G.

AU - Howard, Scott

PY - 2019/6/1

Y1 - 2019/6/1

N2 - In high-income countries, more than 90% of children with mature B-cell lymphomas are cured with frontline therapy. However, cure requires prompt and correct diagnosis, careful risk stratification, very intense chemotherapy and meticulous supportive care, together with logistical support for patients who live far from the cancer centre or face financial barriers to receiving care. In low- and middle-income countries (LMIC), cure rates range from 20% to 70% because of lack of diagnosis, misdiagnosis, abandonment of treatment, toxic death and excess relapse with reduced-intensity regimens. Fortunately, a wide range of successful interventions in LMIC have reduced these causes of avoidable treatment failure. Public awareness campaigns have led to societal awareness of childhood cancer; telepathology has improved diagnosis, even in remote areas; subsidized chemotherapy, transportation, housing and food have reduced abandonment; and hand hygiene, nurse training programmes and health system improvements have reduced toxic death. These interventions can be deployed everywhere and at low cost, so are highly scalable. Children and adolescents with Burkitt lymphoma can be cured in all countries by making a timely correct diagnosis, applying protocols adapted to the local context, preventing abandonment of therapy and avoiding toxic death. Reducing these causes of treatment failure is feasible and highly cost-effective everywhere.

AB - In high-income countries, more than 90% of children with mature B-cell lymphomas are cured with frontline therapy. However, cure requires prompt and correct diagnosis, careful risk stratification, very intense chemotherapy and meticulous supportive care, together with logistical support for patients who live far from the cancer centre or face financial barriers to receiving care. In low- and middle-income countries (LMIC), cure rates range from 20% to 70% because of lack of diagnosis, misdiagnosis, abandonment of treatment, toxic death and excess relapse with reduced-intensity regimens. Fortunately, a wide range of successful interventions in LMIC have reduced these causes of avoidable treatment failure. Public awareness campaigns have led to societal awareness of childhood cancer; telepathology has improved diagnosis, even in remote areas; subsidized chemotherapy, transportation, housing and food have reduced abandonment; and hand hygiene, nurse training programmes and health system improvements have reduced toxic death. These interventions can be deployed everywhere and at low cost, so are highly scalable. Children and adolescents with Burkitt lymphoma can be cured in all countries by making a timely correct diagnosis, applying protocols adapted to the local context, preventing abandonment of therapy and avoiding toxic death. Reducing these causes of treatment failure is feasible and highly cost-effective everywhere.

UR - http://www.scopus.com/inward/record.url?scp=85061443833&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061443833&partnerID=8YFLogxK

U2 - 10.1111/bjh.15785

DO - 10.1111/bjh.15785

M3 - Review article

VL - 185

SP - 1125

EP - 1135

JO - British Journal of Haematology

JF - British Journal of Haematology

SN - 0007-1048

IS - 6

ER -