1
|
Negreiros EADS, da Silveira TMB, Fortier SC, Chiattone CS. Evaluation of C-reactive protein and its prognostic relationship in patients with Hodgkin's Lymphoma. Hematol Transfus Cell Ther 2024:S2531-1379(24)00003-8. [PMID: 38307826 DOI: 10.1016/j.htct.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/17/2023] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVES To assess the prognostic value of C-Reactive Protein (CRP), at diagnosis and during follow-up, of patients with Hodgkin´s Lymphoma treated at the Hematology Service of the Santa Casa de São Paulo Hospital, and to correlate serum CRP levels with disease stage and treatment response. METHODS A retrospective study involving review of 71 medical records of patients diagnosed with Hodgkin´s Lymphoma between February 2012 and January 2016 was performed. Three patients were subsequently excluded, giving a total of 68 patients for analysis. A level of CRP > 1mg/dl was considered elevated. RESULTS Patients were predominantly male (61.8%) and mean age was 34 years. Fifty-three (78%) patients had advanced stage and (76.5%) had B symptoms. Elevated baseline CRP was associated with greater likelihood of B symptoms (p= 0.02) and of advanced stage (p= 0.015). Patients with Low CRP level after 5th and 6th cycles of chemotherapy was associated with complete response (p=0.04 and p=0.03, respectively). Treatment-refractory patients had greater risk of death (p=0.002). CONCLUSION CRP is clinically important for follow-up of patients with Hodgkin´s Lymphoma, where high levels were associated with advanced disease and/or presence of B symptoms. CRP level was considered a predictor of treatment response. Persistence of high CRP values during treatment was associated with refractoriness.
Collapse
Affiliation(s)
| | - Talita Máira Bueno da Silveira
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo/SP, Brazil
| | - Sérgio Costa Fortier
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo/SP, Brazil
| | - Carlos Sérgio Chiattone
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo/SP, Brazil
| |
Collapse
|
2
|
Negreiros E, Bueno da Silveira TM, Fortier SC, Chiattone CS. Evaluation of C-reactive protein and its prognostic relationship in patients with Hodgkin's Lymphoma. Hematol Transfus Cell Ther 2023:S2531-1379(23)02604-4. [PMID: 38233302 DOI: 10.1016/j.htct.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/19/2023] [Accepted: 11/17/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVES To assess the prognostic value of C-Reactive Protein (CRP), at diagnosis and during follow-up, of patients with Hodgkin´s Lymphoma treated at the Hematology Service of the Santa Casa de São Paulo Hospital, and to correlate serum CRP levels with disease stage and treatment response. METHODS A retrospective study involving review of 71 medical records of patients diagnosed with Hodgkin´s Lymphoma between February 2012 and January 2016 was performed. Three patients were subsequently excluded, giving a total of 68 patients for analysis. A level of CRP > 1 mg/dl was considered elevated. RESULTS Patients were predominantly male (61.8 %) and mean age was 34 years. Fifty-three (78 %) patients had advanced stage and (76.5 %) had B symptoms. Elevated baseline CRP was associated with greater likelihood of B symptoms (p = 0.02) and of advanced stage (p = 0.015). Patients with Low CRP level after 5th and 6th cycles of chemotherapy was associated with complete response (p = 0.04 and p = 0.03, respectively). Treatment-refractory patients had greater risk of death (p = 0.002). CONCLUSION CRP is clinically important for follow-up of patients with Hodgkin´s Lymphoma, where high levels were associated with advanced disease and/or presence of B symptoms. CRP level was considered a predictor of treatment response. Persistence of high CRP values during treatment was associated with refractoriness.
Collapse
Affiliation(s)
- Elizete Negreiros
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo SP, Brazil.
| | - Talita Máira Bueno da Silveira
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo SP, Brazil
| | - Sérgio Costa Fortier
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo SP, Brazil
| | - Carlos Sérgio Chiattone
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo SP, Brazil
| |
Collapse
|
3
|
Ferhanoglu B, Kim TM, Karduss A, Brittain D, Tumyan G, Al-Mansour M, Zerga M, Song Y, Rivas-Vera S, Kwong YL, Lim ST, Yeh SP, Abdillah A, Huang Z, Dalal M, Wan H, Hertzberg M. Treatment pathways and clinical outcomes in Hodgkin lymphoma outside Europe and North America: results from the international, multicenter, retrospective, B-HOLISTIC study. Leuk Lymphoma 2022; 63:3317-3330. [PMID: 36200380 DOI: 10.1080/10428194.2022.2126281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Information on Hodgkin lymphoma (HL) is mostly limited to Europe and North America. This real-world, retrospective study assessed treatment pathways and clinical outcomes in adults with stage IIB-IV classical HL receiving frontline treatment (n = 1598) or relapsed/refractory HL (RRHL, n = 426) in regions outside Europe and North America between January 2010 and December 2013. The primary endpoint was progression-free survival (PFS) in the RRHL group. Among patients with RRHL, 89.0% received salvage chemotherapy; most common regimen was etoposide, methylprednisolone, cytarabine, cisplatin (ESHAP; 26.3%). Median PFS in the RRHL group was 13.2 months (95% confidence interval [CI]: 9.9-20.2) and was longer in patients with vs. without stem cell transplantation (SCT; 20.6 vs. 7.5 months; p = 0.0071). This large-scale study identified a lower PFS for RRHL in the rest of the world compared with Europe and North America, highlighting the need for novel targeted therapies and SCT earlier in the treatment continuum.Clinical trial registration: NCT03327571.
Collapse
Affiliation(s)
- Burhan Ferhanoglu
- Division of Hematology, Department of Internal Medicine, Koç University School of Medicine, Istanbul, Turkey
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University Cancer Research Institute, Seoul, South Korea
| | - Amado Karduss
- Bone Marrow Transplant Program, Instituto de Cancerologia, Clínica las Américas, Medellín, Colombia
| | - David Brittain
- Albert Alberts Stem Cell Transplant Center, Pretoria East Hospital, Pretoria, South Africa
| | - Gayane Tumyan
- Department of Chemotherapy of Hemoblastosis, Blokhin Russian Cancer Research Center, Moscow, Russia
| | - Mubarak Al-Mansour
- Adult Medical Oncology, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs-Western Region, Jeddah, The Kingdom of Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, The Kingdom of Saudi Arabia
| | - Marta Zerga
- Department of Hematology, Angel Roffo Institute, Buenos Aires, Argentina
| | - Yuqin Song
- Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital, Beijing, China
| | - Silvia Rivas-Vera
- Department of Hematology, Instituto Nacional de Cancerologia Mexico, Mexico City, Mexico
| | - Yok Lam Kwong
- Bone Marrow Transplant Unit, Queen Mary Hospital, Hong Kong, China.,Hematology Division, Medical Oncology and Bone Marrow Transplantation, Department of Medicine, University of Hong Kong, Hong Kong, China
| | - Soon Thye Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Su-Peng Yeh
- Division of Hematology and Oncology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Arif Abdillah
- Takeda Pharmaceuticals International AG-Singapore Branch, Singapore, Singapore
| | - Zhongwen Huang
- Takeda R&D Data Sciences Institute, Takeda Development Center Americas, Inc. (TDCA), Lexington, MA, USA
| | - Mehul Dalal
- Takeda R&D Data Sciences Institute, Takeda Development Center Americas, Inc. (TDCA), Lexington, MA, USA
| | - Hui Wan
- Takeda Pharmaceuticals International AG-Singapore Branch, Singapore, Singapore
| | - Mark Hertzberg
- Department of Clinical Haematology, Prince of Wales Hospital, Sydney, Australia.,University of New South Wales, Sydney, Australia
| |
Collapse
|
4
|
Bhurani D, Nair R, Rajappa S, Rao SA, Sridharan N, Boya RR, Raman GS, Menon H, Seshachalam A, Nimmagadda R. Real-World Outcomes of Hodgkin Lymphoma: A Multi-Centric Registry From India. Front Oncol 2022; 11:799948. [PMID: 35223455 PMCID: PMC8881143 DOI: 10.3389/fonc.2021.799948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundHodgkin’s lymphoma (HL) is one of the most curable malignancies with a 5-year survival of over 80%. Most published literature from low-middle income countries comes from single institute experience.MethodologyThe OncoCollect Lymphoma group registry was set up in 2017 and has 9 major participating sites across India. Data of newly diagnosed classical HL (CHL) patients, treated between 2011 and 2017, were collected using OncoCollect software. The clinical features, subtypes, prognostic stratification, treatment patterns, response to first-line treatment, and 5-year outcomes were analyzed. All statistical analysis was done using Microsoft R Open statistical software linked to OncoCollect software.ResultsThere were 939 newly diagnosed CHL patients with a median age of 38 (range, 18–99) years at presentation. The male-to-female ratio was 2.07:1. Histological subtypes included mixed cellularity, CHL (MC, CHL), nodular sclerosis, CHL (NS, CHL), lymphocyte-rich, CHL (LR, CHL), and lymphocyte-depleted, CHL (LD, CHL), in 60.60%, 26.94%, 9.80%, and 2.66%, respectively. At presentation, 50.43% had B symptoms and 53.35% had advanced disease. 29.71% of advanced-stage patients had high Hodgkin IPI score. 79% and 21% of patients received 1st-line treatment with chemotherapy alone or combined modality treatment with chemotherapy and radiotherapy. The most common first-line chemotherapy was ABVD-based regimen (94.68%). The overall response rate was 93.48%. Complete response rates among early-stage favorable and unfavorable risk groups were 92.73% and 86.79%, and those among advanced-stage low- and high-risk groups were 76.64% and 69.78%, respectively. The median relapse-free follow-up duration was 51 months (IQR 22–69). A significant difference was found in 5-year EFS between the early- and advanced-stage disease 83.53% and 73.55% (p = 0.00087), respectively. Similarly, significant difference was found in EFS among early-stage patients treated with a combination of 4-cycle chemotherapy and radiotherapy vs. chemotherapy alone 88.57% and 66.33% (p = 0.0042), respectively.ConclusionsIn this large cohort from India, survival of patients with HL was comparable to the developed world. With a median follow-up of 51 months, the 5-year EFS and OS of all patients were 78.24% and 83.63%, respectively.
Collapse
Affiliation(s)
- Dinesh Bhurani
- Department of Haematology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
- *Correspondence: Dinesh Bhurani,
| | - Reena Nair
- Department of Haematology, Tata Medical Centre, Kolkata, India
| | - Senthil Rajappa
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Suparna Ajit Rao
- Department of Medical Oncology, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, India
| | | | - Rakesh Reddy Boya
- Department of Medical Oncology, Mahatama Gandhi Cancer Hospital and Research Center, Visakhapatnam, India
| | - Ganapathi S. Raman
- Department of Medical Oncology, Kumaran Hospital Private Ltd., Chennai, India
| | - Hari Menon
- Department of Medical Oncology, CyteCare Cancer Hospitals, Bengaluru, India
| | | | - Ramesh Nimmagadda
- Department of Medical Oncology, Apollo Cancer Institute, Chennai, India
| |
Collapse
|
5
|
Arakelyan J, Movsisyan A, Sargsyan L, Chopikyan A, Andreasyan D, Torosyan A, Papyan R, Vardevanyan H, Bardakhchyan S, Tadevosyan A, Tamamyan G, Tananyan A, Danielyan S, Kazandjian D. Incidence patterns and review of Hodgkin lymphoma in the Republic of Armenia. Ecancermedicalscience 2022; 15:1319. [PMID: 35047070 PMCID: PMC8723743 DOI: 10.3332/ecancer.2021.1319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Indexed: 12/24/2022] Open
Abstract
Hodgkin lymphoma (HL) accounts for roughly 10% of all lymphomas and 0.6% of all malignant tumours analysed worldwide yearly. Data regarding HL in developing world are exceptionally constrained. The main objective of this research is to investigate the incidence patterns of HL within the Republic of Armenia and to portray disease distribution according to age and sex. There is a very strict evidence on the frequency of HL in Armenia. The results of our research find out that the frequency of HL in Armenia has not changed altogether over the past 15 years and is comparable to that detailed from the USA and Europe.
Collapse
Affiliation(s)
- Jemma Arakelyan
- Department of Oncology, Yerevan State Medical University, 2 Koryun St, 0025 Yerevan, Armenia.,Department of Adult Oncology and Hematology, Hematology Center after Prof. R.H.Yeolyan, 7 Nersisyan St, 0014 Yerevan, Armenia.,Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R.H. Yeolyan, 7 Nersisyan St., 0014 Yerevan, Armenia.,Drug Discovery Lab, Department of Chemistry, City University of Hong Kong, 83 Tat Chee Avenue, Hong Kong 999077, China
| | - Alisa Movsisyan
- Department of Adult Oncology and Hematology, Hematology Center after Prof. R.H.Yeolyan, 7 Nersisyan St, 0014 Yerevan, Armenia
| | - Lilit Sargsyan
- Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R.H. Yeolyan, 7 Nersisyan St., 0014 Yerevan, Armenia.,Department of Pediatric Oncology and Hematology, Yerevan State Medical University, 2 Koryun St, 0025 Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, 7 Nersisyan St., 0014 Yerevan, Armenia
| | - Armine Chopikyan
- Department of Public Health, Yerevan State Medical University, 2 Koryun St, 0025 Yerevan, Armenia
| | - Diana Andreasyan
- National Health Information Analytic Center, National Institute of Health, Ministry of Health of the Republic of Armenia, 49/4, Komitas ave, Yerevan, 375051, Armenia
| | - Arevik Torosyan
- National Health Information Analytic Center, National Institute of Health, Ministry of Health of the Republic of Armenia, 49/4, Komitas ave, Yerevan, 375051, Armenia
| | - Ruzanna Papyan
- Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R.H. Yeolyan, 7 Nersisyan St., 0014 Yerevan, Armenia.,Department of Pediatric Oncology and Hematology, Yerevan State Medical University, 2 Koryun St, 0025 Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, 7 Nersisyan St., 0014 Yerevan, Armenia
| | - Hovhannes Vardevanyan
- Armenian Pediatric Hematology and Oncology Group, 7 Nersisyan St., 0014 Yerevan, Armenia.,Department of Radiology, Armenian-American Wellness Center, 5 Heratsu Street, Yerevan 0025, Armenia
| | - Samvel Bardakhchyan
- Department of Oncology, Yerevan State Medical University, 2 Koryun St, 0025 Yerevan, Armenia.,Department of Adult Oncology and Hematology, Hematology Center after Prof. R.H.Yeolyan, 7 Nersisyan St, 0014 Yerevan, Armenia
| | - Artashes Tadevosyan
- Department of Public Health, Yerevan State Medical University, 2 Koryun St, 0025 Yerevan, Armenia
| | - Gevorg Tamamyan
- Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R.H. Yeolyan, 7 Nersisyan St., 0014 Yerevan, Armenia.,Department of Pediatric Oncology and Hematology, Yerevan State Medical University, 2 Koryun St, 0025 Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, 7 Nersisyan St., 0014 Yerevan, Armenia
| | - Armen Tananyan
- Department of Oncology, Yerevan State Medical University, 2 Koryun St, 0025 Yerevan, Armenia
| | - Samvel Danielyan
- Department of Adult Oncology and Hematology, Hematology Center after Prof. R.H.Yeolyan, 7 Nersisyan St, 0014 Yerevan, Armenia.,Armenian Pediatric Hematology and Oncology Group, 7 Nersisyan St., 0014 Yerevan, Armenia
| | - Dickran Kazandjian
- Department of Oncology, Yerevan State Medical University, 2 Koryun St, 0025 Yerevan, Armenia.,Multiple Myeloma Program, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA
| |
Collapse
|
6
|
Sánchez-Valledor LF, Habermann TM, Murrieta-Alvarez I, Córdova-Ramírez AC, Rivera-Álvarez M, León-Peña A, Cantero-Fortiz Y, Olivares-Gazca JC, Ruiz-Delgado GJ, Ruiz-Argüelles GJ. Long-term results of the treatment of Hodgkin's lymphoma in a resource-constrained setting: Real-world data from a single center. World J Clin Oncol 2021; 12:800-807. [PMID: 34631443 PMCID: PMC8479346 DOI: 10.5306/wjco.v12.i9.800] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 05/17/2021] [Accepted: 08/09/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The outcomes of Hodgkin´s lymphoma (HL) in México have not been widely reported. Simplified and affordable treatments have been adopted in middle-income countries. AIM The aim was to evaluate long-used therapies for HL in México in a long-term basis. METHODS In a 34-year time period, 88 patients with HL were treated at a single institution in México. Patients were treated with adriamycin bleomycin vinblastine and dacarbazine (ABVD) or mechlorethamine, vincristine, procarbazine, and prednisone (MOPP). Relapsed or refractory patients were given ifosfamide, carboplatin, and etoposide (ICE) followed by autologous or allogeneic stem cell transplants. RESULTS Thirty-seven women and 51 men were included; the median age was 29 years. Patients were followed for a mean of 128 mo. The 310-mo overall survival (OS) was 83% for patients treated with MOPP and 88% for those treated with ABVD. The OS of patients who received autologous stem cell transplantation was 76% (330 mo) vs 93% (402 mo) in those who did not. CONCLUSION HL may be less aggressive in Mexican population than in Caucasians. Combined chemotherapy renders acceptable results, regardless of clinical stage.
Collapse
Affiliation(s)
| | - Thomas M Habermann
- Department of Medicine, Division of Hematology, Mayo Clinical and Mayo Foundation, Rochester, MN 55905, United States
| | | | | | | | - Andrés León-Peña
- Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla 72530, Mexico
| | | | | | | | | |
Collapse
|
7
|
Hewamana S, Kandabadage L, Skandarajah T, Peiris N, Abeyaratne S, Arseculeratne G, Perera E, Harischandra M, Wijewickrama A, Somasundaram G, Srinivasan V, Somiah S, Jayawardena P, Wadanamby R, Galagoda G, Jayasinghe C, De Silva C, Munasinghe S, Wijesiriwardena B, Balawardena J. Applicability of protocols from high-income countries in a resource limited setting; real world data of histopathology, clinical features and long-term outcome of Hodgkin Lymphoma in Sri Lanka. EClinicalMedicine 2021; 38:100998. [PMID: 34278283 PMCID: PMC8267551 DOI: 10.1016/j.eclinm.2021.100998] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 12/21/2022] Open
Abstract
Background:: There is a significant disparity in global cancer care and out-come between countries. We aimed to provide data on characteristics, average cost of treatment and survival estimates in patients with Hodgkin Lymphoma in Sri Lanka. Methods: All patients diagnosed with Hodgkin Lymphoma between 01.05.2013 and 01.10.2020 were included in the analysis. Findings: Classical Hodgkin Lymphoma(cHL) diagnosed in 85%; 68% presented with B symptoms and 61% had advanced stage of disease. Treatment was discontinued by 23% either before or just after starting treatment of whom 72% percent were females. The complete response (CR) rate of patients who continued treatment was 86% while the estimated five-year survival rate is 92%. Seventeen percent of these patients died but only two percent due to Hodgkin Lymphoma or associated treatment in the group which continued treatment compared to 45% in the group who defaulted treatment (p-value 0.0002). Five-year survival rate of patients who defaulted treatment was 50% while patients who continued treatment have an estimated five-year survival rate of 90%. Average cost of first line treatment was between US$ 2280 and US$ 7642. First treatment failure may incur substantially higher health care costs. Interpretation: This is the only well characterized study on long-term survival of patients with Hodgkin Lymphoma in Sri Lanka. We have shown that it is possible to successfully apply western treatment and supportive care protocols to the local population. This published data will help to bench mark and improve the treatment and develop blood cancer care in the local setting.
Collapse
Affiliation(s)
- Saman Hewamana
- Clinical Haematology Unit, Lanka Hospital, Colombo, Sri Lanka
- Correspondence: Dr. Saman Hewamana, Clinical Haematology Unit, Lanka Hospitals, 578, Elwitigala Mawatha, Colombo 05, Sri Lanka.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Chandu De Silva
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | | | | |
Collapse
|
8
|
Gaur S, Philipovskiy A, Onyedika U, Eiring AM, Dwivedi AK, Orazi A. Discordant PET Findings and a High Relapse Rate Characterize Hispanics With Hodgkin's Lymphoma Treated With ABVD. CANCER DIAGNOSIS & PROGNOSIS 2021; 1:127-133. [PMID: 35399309 PMCID: PMC8962786 DOI: 10.21873/cdp.10017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 07/25/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Population-based studies on Hodgkin's lymphoma (HL) have shown reduced survival in Hispanics and non-Hispanic Blacks compared with non-Hispanic Whites. To better understand the factors contributing to this outcome discrepancy, we retrospectively reviewed the charts of patients with HL diagnosed and treated at a single institution located along the Texas-Mexico border. PATIENTS AND METHODS We performed a retrospective chart review of all patients with HL treated at our institution over an 8-year period (2011-2018). The International Prognostic Score was calculated for all patients and results of positron-emission tomography (PET) scans (interim and end of treatment) were also recorded. Variables analyzed included tumor-related findings (stage, subtype of HL), treatment history (chemotherapy regimen including number of cycles, dose intensity and radiation treatments) and neutrophil to lymphocyte ratio. Quantitative variables were described using median, interquartile range, minimum and maximum observations. Categorical variables were described using frequency and proportions. Kaplan-Meier curves were used to show relapse-free survival. RESULTS A total of 24 patients were treated in the time frame, of whom 23 were Hispanic. All were treated with doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) or an ABVD-like regimen. Dose intensity for chemotherapy exceeded 90%. After a median follow-up of 43 months, the relapse rate was 45.8%. Positive and negative predictive values for interim PET (0% and 50%) and end of therapy PET (80% and 58%) were suboptimal to allow for a PET-adapted therapeutic approach. CONCLUSION Hispanics have a high relapse rate following ABVD which is not fully explained by universally accepted prognostic factors. Performance of PET scan in predicting outcomes of HL needs to be further studied and optimized before adopting a PET-adapted treatment paradigm for underserved Hispanic populations.
Collapse
Affiliation(s)
- Sumit Gaur
- Department of Internal Medicine, Texas Tech University Health ScienceCenter- El Paso, Paul L. Foster School of Medicine, El Paso, TX, U.S.A
| | - Alexander Philipovskiy
- Department of Internal Medicine, Texas Tech University Health ScienceCenter- El Paso, Paul L. Foster School of Medicine, El Paso, TX, U.S.A
| | - Umeanaeto Onyedika
- Department of Internal Medicine, Texas Tech University Health ScienceCenter- El Paso, Paul L. Foster School of Medicine, El Paso, TX, U.S.A
| | - Anna M Eiring
- Center of Emphasis in Cancer, Department of Molecular and Translational Medicine,Texas Tech University Health Science Center, El Paso, TX, U.S.A
| | - Alok K Dwivedi
- Division of Biostatistics and Epidemiology, Department of Molecular andTranslational Medicine, Texas Tech University Health Science Center, El Paso, TX, U.S.A
| | - Attilio Orazi
- Department of Pathology, Texas Tech University Health Science Center, El Paso, TX, U.S.A
| |
Collapse
|
9
|
Jaime-Pérez JC, Hernández-Coronado M, Ancer-Rodríguez J, Gómez-Almaguer D. Increased blood transfusion after outpatient autologous transplantation with reduced intensity conditioning for hematological malignancies predicts worse outcomes. Clin Transplant 2021; 35:e14247. [PMID: 33559181 DOI: 10.1111/ctr.14247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/12/2021] [Accepted: 02/01/2021] [Indexed: 11/28/2022]
Abstract
Transfusion has a recognized immunomodulatory effect, and its role on the outcomes after an ambulatory autologous hematopoietic stem cell transplantation (auto-HSCT) following reduced intensity conditioning (RIC) has not been documented. A study to assess factors associated with the number of packed red blood cells (PRBCs) and platelet units transfused and their impact on survival rates of auto-HSCT recipients after RIC was conducted between 2013 and 2019. Transfusions were recorded from days 0 to 100. Of the 130 patients studied, seventy (53.9%) required transfusion support. The median number of PRBC transfused was 2 (range 1-20), and for platelets, it was also 2 units (range 1-19). Infused CD34 + cells/kg, pre-transplant CMV status, and relapse/progression were significantly associated with the number of PRBC units transfused and sex, infused CD34 + cells/kg, and pre-transplant CMV status with the number of platelet units transfused. In multivariate analysis, a high/very high Disease Risk Index (P = .001) (P = .001) and transfusion of ≥ 5 total blood products (P = .001) (P = .010) were associated with decreased disease-free and overall survival. Two-year cumulative incidence of relapse was 50% for transfused patients vs. 34% for those not transfused (P = .009). These data suggest that the transfusion burden and its interplay with other patient and transplant-related factors could be associated with inferior auto-HSCT outcomes.
Collapse
Affiliation(s)
- José Carlos Jaime-Pérez
- Department of Hematology, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Marcela Hernández-Coronado
- Department of Hematology, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Jesús Ancer-Rodríguez
- Department of Pathology, Facultad de Medicina, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - David Gómez-Almaguer
- Department of Hematology, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| |
Collapse
|
10
|
Jaime-Pérez JC, Hernández-Coronado M, Picón-Galindo E, Salazar-Cavazos L, Gutiérrez-Aguirre CH, Gómez-Almaguer D. Results of a completely outpatient autologous stem cell transplant program for lymphoma patients receiving reduced-intensity conditioning. Leuk Lymphoma 2021; 62:1619-1628. [PMID: 33491518 DOI: 10.1080/10428194.2021.1876870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Autologous stem cell transplantation (ASCT) is commonly an in-patient procedure. However, outpatient ASCT grows as a cost-effective and feasible option for patients with lymphoma and reports assessing it after reduced-intensity conditioning (RIC) are sparse. We report the outcome of 102 patients with lymphoma who underwent ASCT on a full outpatient basis in a single-center transplant program between 2010 and 2020. Forty-two percent of the cohort required transfusion support, 36.3% experienced a neutropenic fever episode, 25.5% mucositis, and 9.8% developed severe infection. At a median time of 5 days (range 1-28), only 22.5% of the cohort required admission within the first 100 days after the autograft, median length of hospital stay was 0 days (range 0-14) and neutropenic fever was the most common reason for hospitalization. Non-relapse mortality at 1 year was 5%. ASCT in a completely outpatient setting is feasible, safe, and highly effective to treat lymphoma patients.
Collapse
Affiliation(s)
- José C Jaime-Pérez
- Department of Hematology, Internal Medicine Division, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Marcela Hernández-Coronado
- Department of Hematology, Internal Medicine Division, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Ernesto Picón-Galindo
- Department of Hematology, Internal Medicine Division, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Lorena Salazar-Cavazos
- Department of Hematology, Internal Medicine Division, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | - César Homero Gutiérrez-Aguirre
- Department of Hematology, Internal Medicine Division, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | - David Gómez-Almaguer
- Department of Hematology, Internal Medicine Division, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| |
Collapse
|
11
|
Doubova SV, Terreros-Muñoz E, Delgado-Lòpez N, Montaño-Figueroa EH, Infante-Castañeda C, Pérez-Cuevas R. Experiences with health care and health-related quality of life of patients with hematologic malignancies in Mexico. BMC Health Serv Res 2020; 20:644. [PMID: 32650770 PMCID: PMC7353677 DOI: 10.1186/s12913-020-05498-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/01/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND In Mexico, patients with hematologic malignancies (HMs) are characterized by being at high risk and advanced stages at diagnosis and by having a low cure rate; yet information on their experiences with health care and health-related quality of life (HRQL) is scarce. We aimed to evaluate experiences with health care and HRQL of patients with HMs and the association between these patient-reported measures. METHODS We conducted a cross-sectional survey in two public oncology hospitals in Mexico City. The study included outpatient cancer patients aged ≥18 years with a diagnosis of leukemia, lymphoma, or multiple myeloma. We used a patient-centered quality of cancer care questionnaire to assess patient experiences with receiving 1) timely care; 2) clear information; 3) information for treatment decision-making; 4) care to address biopsychosocial needs; and 5) respectful and coordinated care. We applied the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) to measure HRQL. We performed a multiple linear regression to evaluate the association between patient-reported experiences (independent variables) and the QLQ-C30 summary score (dependent variable). RESULTS Of the 515 participating HM patients, 46.6% had lymphoma, 34% leukemia, and 19.4% multiple myeloma; 70.9% were at advanced stages or at high risk. Additionally, 15.1% had anxiety and 12.8% had depression. Over one third (35.9%) reported receiving clear information, 28.5% timely care, 20.6% information for treatment decision-making, 23.7% care that addressed their biopsychosocial needs, and 31% respectful and coordinated care. The mean QLQ-C30 summary score was 71.9 points. Timely care, clear information, and care that addresses biopsychosocial needs were associated with higher HRQL. CONCLUSIONS Health care services for HM patients at public oncology hospitals in Mexico need improvement. Notably, providing timely care, clear information, and care that addresses patients' biopsychosocial needs can increase the likelihood of better HRQL. Health care providers should measure and improve the experiences of HM patients with health care.
Collapse
Affiliation(s)
- Svetlana V Doubova
- Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Av. Cuauhtemoc 330, Col. Doctores, Del. Cuauhtemoc, CP 06720, Mexico City, Mexico.
| | - Eduardo Terreros-Muñoz
- Servicio de Hematología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Nancy Delgado-Lòpez
- Servicio de Hematología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Efreen Horacio Montaño-Figueroa
- Departamento de Hematología, Hospital General de México "Dr. Eduardo Liceaga". Secretaría de Salud, Ciudad de México, Mexico
| | - Claudia Infante-Castañeda
- Instituto de Investigaciones Sociales, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Ricardo Pérez-Cuevas
- Division of Social Protection and Health, Jamaica Country Office, Interamerican Development Bank, Kingston, Jamaica
| |
Collapse
|
12
|
Relecom A, Federico M, Connors JM, Coiffier B, Biasoli I, Moccia A, Salles G, McKee T, Miralbell R, Borchmann P, Kuruvilla J, Johnson P, Cavalli F, Delavy M, Dietrich PY, Flahault A. Resources-Stratified Guidelines for Classical Hodgkin Lymphoma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051783. [PMID: 32182952 PMCID: PMC7084688 DOI: 10.3390/ijerph17051783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/19/2020] [Accepted: 02/28/2020] [Indexed: 01/23/2023]
Abstract
Hodgkin lymphoma is a haematological malignancy predominantly affecting young adults. Hodgkin lymphoma is a highly curable disease by current treatment standards. Latest treatment guidelines for Hodgkin lymphoma however imply access to diagnostic and treatment modalities that may not be available in settings with restricted healthcare resources. Considerable discrepancies in Hodgkin lymphoma patient survival exist, with poorer outcomes reported in resources-constrained settings. Resources-stratified guidelines for diagnosis, staging and treatment of Hodgkin lymphoma were derived in an effort to optimize patient outcome provided a given setting of available resources. These guidelines were derived based on the framework of the Breast Health Global Initiative stratifying resource levels in basic, core, advanced and maximal categories.
Collapse
Affiliation(s)
- Allan Relecom
- Department of Oncology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland; (A.R.); (P.-Y.D.)
| | - Massimo Federico
- Medical Oncology, CHIMOMO Department, University of Modena and Reggio Emilia, Via Università 4, 41121 Modena, Italy;
| | - Joseph M. Connors
- BC Cancer Agency, Vancouver Centre, 600 West 10th Avenue, Vancouver, BC V5Z 1G1, Canada;
| | - Bertrand Coiffier
- Department of Hematology, Hospices Civils de Lyon, 3 Quai des Celestins, 69002 Lyon, France;
| | - Irene Biasoli
- Internal Medicine Department, Federal Univsersity of Rio de Janeiro, Av. Pedro Calmon, 550-Cidade Universitária-Rio de Janeiro, RJ 21941-901, Brazil;
| | - Alden Moccia
- Oncology Institute of Southern Switzerland (IOSI) Ospedale Regionale di Locarno “La Carità”, Via Ospedale 1 CH-6600 Locarno;
| | - Gilles Salles
- Groupe d’étude des lymphomes de l’adulte, CHU de Lyon HCL-GH Sud, 165 Chemin du Grand Revoyet, 69495 Pierre-Benite Cedex, France;
| | - Thomas McKee
- Clinical Pathology Unit, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva Switzerland
- Faculté de Médecine, Geneva University, Rue Michel-Servet 1, 1206 Genève, Switzerland
| | - Raymond Miralbell
- Department of Oncology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland; (A.R.); (P.-Y.D.)
| | - Peter Borchmann
- Department of Internal Medicine, University Hospital of Cologne, Karpener Str 62, 50924 Cologne, Germany;
| | - John Kuruvilla
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Center, Toronto, ON M5G 2C1, Canada;
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Peter Johnson
- Faculty of Medicine, University of Southampton, Southampton S017 1BJ, UK;
| | - Franco Cavalli
- Institute of Oncology Research (IOR), Via Vela 6, 6500 Bellinzona, Switzerland;
| | - Martine Delavy
- Institute of Global Health, Faculty of Medicine, University of Geneva, Campus Biotech, Chemin des Mines 9, 1202 Geneva, Switzerland;
| | - Pierre-Yves Dietrich
- Department of Oncology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland; (A.R.); (P.-Y.D.)
- Faculté de Médecine, Geneva University, Rue Michel-Servet 1, 1206 Genève, Switzerland
| | - Antoine Flahault
- Institute of Global Health, Faculty of Medicine, University of Geneva, Campus Biotech, Chemin des Mines 9, 1202 Geneva, Switzerland;
- Correspondence:
| |
Collapse
|
13
|
Jaime-Pérez JC, Turrubiates-Hernández GA, Nava-Obregón T, Coronado-Hernández B, Gutiérrez-Aguirre H, Cantú-Rodríguez OG, Herrera-Garza JL, Gómez-Almaguer D. Palliative Care for Patients With Hematologic Malignancies in a Low-Middle Income Country: Prevalence of Symptoms and the Need for Improving Quality of Attention at the End of Life. Am J Hosp Palliat Care 2019; 37:600-605. [PMID: 31714147 DOI: 10.1177/1049909119887951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Palliative care (PC) for patients with malignant hematological diseases is scarcely documented, particularly in low- and middle-income countries. This study aimed to document PC provided to patients with hematologic malignancies. METHODS Bidirectional study conducted from July 2016 to June 2019 at the hematology and palliative care departments at a reference center in Northeast Mexico for low-income open population uninsured patients. Clinical records and electronic files of patients with malignant hematological diseases of both sexes and all ages attending an academic hematology center were reviewed. Statistical analysis was performed with the SPSS version 22 program. Acute and chronic leukemias, multiple myeloma, Hodgkin lymphoma, non-Hodgkin lymphoma, and others were included. RESULTS Five-hundred ten patients were studied, of which 148 (29%) died. Eighty-one (15.88%) patients including 31 (20.9%) who died received PC. Median age at palliative diagnosis was 42 (2-91) years. The most common symptom was pain (69.7%). The most frequent reason for palliative referral was treatment-refractory disease (39%). During the last week of life, 19 (95%) of 20 patients had blood sampling; 17 (85%) received antibiotics; 16 (80%) had a urinalysis performed; 16 (80%) received analgesia, including paracetamol (11, 35.5%) and buprenorphine (7, 22.6%); 10 (50%) received blood products; 9 (45%) were intubated; and central venous catheters were inserted in 5 (25%) patients. CONCLUSIONS Palliative care was provided to a minority of patients with hematologic malignancies and considerable improvement is required in its timely use and extension.
Collapse
Affiliation(s)
- José Carlos Jaime-Pérez
- Department of Hematology, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Grecia Abigayl Turrubiates-Hernández
- Department of Hematology, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Teresa Nava-Obregón
- Department of Pain and Palliative Care Clinic, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Blanca Coronado-Hernández
- Department of Pain and Palliative Care Clinic, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Homero Gutiérrez-Aguirre
- Department of Hematology, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Olga Graciela Cantú-Rodríguez
- Department of Hematology, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - José Luis Herrera-Garza
- Department of Hematology, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - David Gómez-Almaguer
- Department of Hematology, Dr. José Eleuterio González University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| |
Collapse
|
14
|
Jaime-Pérez JC, Treviño-Reyna G, Aguilar-Calderón P, Cantú-Rodríguez OG, Marfil-Rivera L, Gómez-Almaguer D. Contributions of a regional approach to document hematologic disease in Mexico: a 10-year experience in an open population. Hematology 2018; 23:803-809. [DOI: 10.1080/10245332.2018.1498166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- José Carlos Jaime-Pérez
- Department of Hematology, Internal Medicine Division, Dr. José E. González University Hospital, School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Goel Treviño-Reyna
- Department of Hematology, Internal Medicine Division, Dr. José E. González University Hospital, School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Patrizia Aguilar-Calderón
- Department of Hematology, Internal Medicine Division, Dr. José E. González University Hospital, School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Olga G. Cantú-Rodríguez
- Department of Hematology, Internal Medicine Division, Dr. José E. González University Hospital, School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Luis Javier Marfil-Rivera
- Department of Hematology, Internal Medicine Division, Dr. José E. González University Hospital, School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - David Gómez-Almaguer
- Department of Hematology, Internal Medicine Division, Dr. José E. González University Hospital, School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| |
Collapse
|
15
|
Vasquez L, Diaz R, Chavez S, Tarrillo F, Maza I, Hernandez E, Oscanoa M, García J, Geronimo J, Rossell N. Factors associated with abandonment of therapy by children diagnosed with solid tumors in Peru. Pediatr Blood Cancer 2018; 65:e27007. [PMID: 29431252 DOI: 10.1002/pbc.27007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/16/2018] [Accepted: 01/19/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Abandonment of treatment is a major cause of treatment failure and poor survival in children with cancer in low- and middle-income countries. The incidence of treatment abandonment in Peru has not been reported. The aim of this study was to examine the prevalence of and factors associated with treatment abandonment by pediatric patients with solid tumors in Peru. METHODS We retrospectively reviewed the sociodemographic and clinical data of children referred between January 2012 and December 2014 to the two main tertiary centers for childhood cancer in Peru. The definition of treatment abandonment followed the International Society of Paediatric Oncology, Paediatric Oncology in Developing Countries, Abandonment of Treatment recommendation. RESULTS Data from 1135 children diagnosed with malignant solid tumors were analyzed, of which 209 (18.4%) abandoned treatment. Bivariate logistic regression analysis showed significantly higher abandonment rates in children living outside the capital city, Lima (forest; odds ratio [OR] 3.25; P < 0.001), those living in a rural setting (OR 3.44; P < 0.001), and those whose parent(s) lacked formal employment (OR 4.39; P = 0.001). According to cancer diagnosis, children with retinoblastoma were more likely to abandon treatment compared to children with other solid tumors (OR 1.79; P = 0.02). In multivariate regression analyses, rural origin (OR 2.02; P = 0.001) and lack of formal parental employment (OR 2.88; P = 0.001) were independently predictive of abandonment. CONCLUSION Treatment abandonment prevalence of solid tumors in Peru is high and closely related to sociodemographical factors. Treatment outcomes could be substantially improved by strategies that help prevent abandonment of therapy based on these results.
Collapse
Affiliation(s)
- Liliana Vasquez
- Pediatric Oncology Unit, Edgardo Rebagliati Martins Hospital, Lima, Peru
| | - Rosdali Diaz
- Pediatric Oncology, National Institute of Neoplastic Diseases, Lima, Peru
| | - Sharon Chavez
- Pediatric Oncology, National Institute of Neoplastic Diseases, Lima, Peru
| | - Fanny Tarrillo
- Pediatric Oncology Unit, Edgardo Rebagliati Martins Hospital, Lima, Peru
| | - Ivan Maza
- Pediatric Oncology Unit, Edgardo Rebagliati Martins Hospital, Lima, Peru
| | - Eddy Hernandez
- Pediatric Oncology, National Institute of Neoplastic Diseases, Lima, Peru
| | - Monica Oscanoa
- Pediatric Oncology Unit, Edgardo Rebagliati Martins Hospital, Lima, Peru
| | - Juan García
- Pediatric Oncology, National Institute of Neoplastic Diseases, Lima, Peru
| | - Jenny Geronimo
- Pediatric Oncology Unit, Edgardo Rebagliati Martins Hospital, Lima, Peru
| | - Nuria Rossell
- Amsterdam Institute for Social Sciences Research, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
16
|
Gaiolla RD. Hodgkin's lymphoma in developing countries: can we go further? Rev Bras Hematol Hemoter 2017; 39:299-300. [PMID: 29150100 PMCID: PMC5693266 DOI: 10.1016/j.bjhh.2017.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 08/30/2017] [Indexed: 11/27/2022] Open
|