Abstract
Children with acute lymphoblastic leukemia (ALL) in low-income countries have disproportionately lower cure rates than those in high-income countries. At Butaro Cancer Center of Excellence (BCCOE), physicians treated patients with ALL with the first arm of the Hunger Protocol, a graduated-intensity method tailored for resource-limited settings. This article provides the first published outcomes, to our knowledge, of patients with ALL treated with this protocol. This is a retrospective descriptive study of patients with ALL enrolled at BCCOE from July 1, 2012 to June 30, 2014; data were collected through December 31, 2015. Descriptive statistics were used to calculate patient demographics, disease characteristics, and outcomes; event-free survival was assessed at 2 years using the Kaplan-Meier method. Forty-two consecutive patients with ALL were included. At the end of the study period, 19% (eight) were alive without evidence of relapse: three completed treatment and five were continuing treatment. Among the remaining patients, 71% (30) had died and 10% (four) were lost to follow-up. A total of 83% (25) of the deaths were disease related, 3% (one) treatment-related, and 13% (four) unclear. Event-free survival was 22% (95% CI, 11...Continue Reading
References
Nov 5, 1997·Annals of the New York Academy of Sciences·H P Wagner, V Antic
Jul 9, 1999·Medical and Pediatric Oncology·M CampbellP Advis
Dec 29, 2000·Journal of Pediatric Hematology/oncology·M BonillaF G Antillon
Dec 29, 2000·Journal of Pediatric Hematology/oncology·F PedrosaJ A Wilimas
Feb 24, 2001·Lancet·R C Ribeiro, M Bonilla
Sep 6, 2003·Lancet·Monika L MetzgerRaul C Ribeiro
Jul 20, 2005·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·I MagrathV Raina
Aug 3, 2006·Pediatric Blood & Cancer·Scott C HowardUNKNOWN MISPHO Consortium Writing Committee
Nov 1, 2006·Pediatrics·Saskia MostertAnjo J P Veerman
Nov 25, 2006·Hematology·Ching-Hon Pui
Sep 19, 2008·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Stewart J Kellie, Scott C Howard
Jan 8, 2009·Pediatric Blood & Cancer·Stephen P HungerScott C Howard
Dec 25, 2009·Leukemia·M TsuchidaUNKNOWN Tokyo Children's Cancer Study Group
Feb 16, 2010·Blood·Valentino ConterMartin Schrappe
Mar 30, 2011·Cancer·Sumit GuptaLillian Sung
Aug 30, 2011·Transfusion Medicine Reviews·Evan M BlochEdward Murphy
Mar 14, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Stephen P HungerWilliam L Carroll
Dec 28, 2012·The New England Journal of Medicine·Monika L MetzgerMichael P Link
Sep 17, 2013·Pediatric Blood & Cancer·Elizabeth KerstenKatherine K Matthay
Oct 31, 2014·Nature Reviews. Cancer·Lawrence N ShulmanAgnes Binagwaho
Mar 20, 2016·BMC Cancer·Neo M TapelaLawrence N Shulman