Acute Lymphoblastic Leukemia, Acute Lymphoblastic Leukemia (ALL), Adolescent Cancer, Childhood Cancers, Lymphoblastic Lymphoma, Lymphoblastic Lymphoma (LBL), Young Adult Cancer
Conditions
Keywords
Cancer outcomes, Low- and Middle-Income Countries (LMICs), Childhood cancer, Adolescent and young adult cancer (CAYA), Treatment failure, Therapy-related toxicities, Retrospective cohort, Leukemia outcomes, Oncology disparities, High-Income Countries (HICs)
Brief summary
Despite advances in cancer treatment, significant disparities in outcomes persist between high-income countries (HICs) and low-and middle-income countries (LMICs). Around 80% of children with cancer live in LMICs, where they face challenges such as delayed diagnosis, misdiagnosis, comorbidities, distance to treatment, financial barriers, and limited access to risk-adapted therapies. Acute lymphoblastic leukemia(ALL)/lymphoblastic lymphoma(LBL), for example, is one of the greatest success stories in pediatric oncology, however, such improvements are not evenly distributed worldwide, and the outcomes for leukemia patients are poorer in LMICs compared to HICs, primarily due to reduced access to quality healthcare. This study aims to assess cancer treatment outcomes in LMICs, focusing on acute lymphoblastic leukemia/lymphoblastic lymphoma. The findings will inform future studies to implement evidence-based interventions that improve care quality and reduce treatment failures through targeted strategies.
Interventions
This study involves retrospective review of medical records of pediatric, adolescent, and young adult cancer patients (ages 0-21 years) treated at participating oncology centers in Guatemala, Honduras, El Salvador, Armenia, and Tanzania. No experimental drug, device, or behavioral intervention is being administered. Data abstraction will be performed to assess treatment failure, therapy-related toxicities, and clinical outcomes.
Sponsors
Study design
Eligibility
Inclusion criteria
Subjects must meet all the following criteria to be included in this registry: 1. Participants must be willing and able to provide informed consent prior to enrollment in the registry. 1. For minors or individuals unable to provide informed consent, assent must be obtained along with consent from a legal guardian. 2. Note: Exemption applies to this criterion when waiver of informed consent/assent is granted by Institutional Review Board(IRB)/Independent Ethics Committee(IEC)/Competent Authorities(CAs). 2. A confirmed diagnosis of any type of cancer within the 15 years prior to the site's activation date. 3. Age 0 to 21 years at the time of diagnosis. 4. Received substantial anti-cancer treatment at the participating center, including but not limited to: 1. Chemotherapy 2. Surgery 3. Radiation therapy 4. Immunotherapy 5. Medical records are available and accessible for review
Exclusion criteria
* Subjects meeting any of the following criteria will be excluded from this registry: 1. Patients who only visited the participating center for: 1. Consultation without subsequent primary anti-cancer treatment at the participating center 2. Pathology, radiology, or other diagnostic evaluations without treatment
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To estimate the incidence of treatment failure, in patients with any type of cancer diagnosis. | 3 years from date of cancer diagnosis (retrospective follow-up via medical records; patients without an event will be censored at last contact within 3 years) |
| To estimate the incidence of therapy related toxicities in patients diagnosed with acute lymphoblastic leukemia or lymphoblastic lymphoma. | 3 years from date of cancer diagnosis (retrospective follow-up via medical records; patients without an event will be censored at last contact within 3 years) |
Secondary
| Measure | Time frame |
|---|---|
| To estimate the incidence of treatment failure by cancer type, treatment regimen, age groups, and sociodemographic variables of patients diagnosed with any cancer. | 3 years from date of cancer diagnosis (retrospective follow-up via medical records; patients without an event will be censored at last contact within 3 years) |
| To estimate the incidence and severity of individual therapy- related toxicities in patients diagnosed with acute lymphoblastic leukemia or lymphoblastic lymphoma. | 3 years from date of cancer diagnosis (retrospective follow-up via medical records; patients without an event will be censored at last contact within 3 years) |
| To estimate the event-free survival (EFS) and overall survival (OS) for patients diagnosed with acute lymphoblastic leukemia or lymphoblastic lymphoma. | 3 years from date of cancer diagnosis (retrospective follow-up via medical records; patients without an event will be censored at last contact within 3 years) |
| To describe patterns of relapse in patients with acute lymphoblastic leukemia or lymphoblastic lymphoma. | 3 years from date of cancer diagnosis (retrospective follow-up via medical records; patients without an event will be censored at last contact within 3 years) |
Countries
Armenia, El Salvador, Guatemala, Honduras