4.2 Article

Acute myeloid leukemia: challenges for diagnosis and treatment in Latin America

Journal

HEMATOLOGY
Volume 28, Issue 1, Pages -

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/16078454.2022.2158015

Keywords

Acute myeloid luekemia; acute promyelocytic leukemia; Latinamerica; hematopoietic stem cell transplantation; venetoclax; ATRA; arsenic trioxide; cytarabine

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The objective of this study is to review the current diagnostic and therapeutic landscape of AML in Latin America, reflecting the situation in other low- and middle-income countries and regions. Although most technologies and treatment options are available in the region, a significant proportion of patients have limited access to them. Mortality in the first weeks from diagnosis is higher in Latin America compared to developed countries.
Objective to review the current diagnostic and therapeutic landscape of AML in Latin America as a reflection of other low- and middle-income countries and regions of the world. Encompassing both acute promyelocytic and non-promyelocytic disease types. Methods We reviewed the literature and study registries concerning epidemiological features of patients with AML/APL treated in Latin America, as well as evaluated diagnostic and genetic stratification and patient fitness assessment challenges, the importance of early mortality and supportive care capacity, intensive and non-intensive chemotherapy alternatives, consolidation, and maintenance strategies including novel agents and hematopoietic stem cell transplantation. Results Although most of the current technologies and treatment options are available in the region, a significant fraction of patients have only limited access to them. In addition, mortality in the first weeks from diagnosis is higher in the region compared to developed countries. Conclusions Disparities in access to technologies, supportive care capacity, and availability of novel agents and HSCT hinder results in our region, reflecting barriers common to other LMICs. Recent developments in the diagnosis and treatment of this disease must be implemented through education, collaborative clinical research, and advocacy to improve outcomes.

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