Caracterizaci&oacute;n clinicoepidemiol&oacute;gica y supervivencia de pacientes menores de 19 a&ntilde;os con leucemia  <span class="so-article-trans-title"> Translated title: Clinical epidemiological characterization and survival in patients under 19 years with leukemia </span>

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Abstract

RESUMEN Introducción: La leucemia es el cáncer más frecuente en la infancia y representan 41 % de todas las neoplasias malignas en niños menores de 15 años. Objetivo: Describir las características clinicoepidemiológicas y supervivencia de niños y adolescentes con leucemia. Método: Se realizó un estudio descriptivo, longitudinal y retrospectivo de 82 pacientes menores de 19 años de edad, con diagnóstico de leucemia, atendidos en el Servicio Regional de Hematología del Hospital Infantil Sur Docente Dr. Antonio María Béguez César de Santiago de Cuba, desde enero de 2014 hasta diciembre de 2018. Resultados: En la casuística predominaron el grupo de 1-4 años de edad (42,7 %), el sexo masculino (59,7 %), los mestizos (48,8 %), la leucemia linfoide aguda como variante morfológica (73,2 %), así como el síndrome anémico y febril (97,7 y 86,6 %, respectivamente). En 89,0 % de los pacientes se logró la remisión completa al finalizar la primera fase del tratamiento y 17,1 % presentó algún tipo de recaída en su evolución, donde la médula ósea resultó ser el sitio más afectado. Se logró una supervivencia global de 67,1 %. Conclusiones: Los resultados del estudio no difieren del contexto clínico y epidemiológico mundial y resultan alentadores, teniendo en cuenta la no disponibilidad en la provincia de medios de diagnóstico, con tecnología de avanzada, para una mejor estratificación de los pacientes.

Translated abstract

ABSTRACT Introduction: Leukemia is the most frequent cancer in childhood and represents 41 % of all the malignancies in children under 15 years. Objective: To describe the clinical epidemiological characteristics and survival in children and adolescents with leukemia. Method: A descriptive, longitudinal and retrospective study of 82 patients under 19 years, with diagnosis of leukemia was carried out. They were assisted in the Regional Service of Hematology at Dr. Antonio María Béguez César Teaching Southern Children Hospital in Santiago de Cuba, from January, 2014 to December, 2018. Results: In the case material there was a prevalence of the 1-4 age group (42.7 %), male sex (59.7 %), mixed race children (48.8 %), acute lymphoid leukemia as morphological variant (73.2 %), as well as the anemic and fever syndrome (97.7 and 86.6 %, respectively). Complete remission was achieved in 89.0 % of the patients after concluding the first phase of the treatment and 17.1 % presented some type of relapse during their clinical course, where the most affected site was the bone marrow. A global survival of 67.1 % was achieved. Conclusions: The results of the study are encouraging and do not differ from the world clinical and epidemiological context, taking into account the non availability of diagnosis means in the province, with advanced technology, for a better stratification of patients.

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Worldwide comparison of survival from childhood leukaemia for 1995–2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries

Audrey Bonaventure, Rhea Harewood, Charles Stiller … (2017)

Summary Background Global inequalities in access to health care are reflected in differences in cancer survival. The CONCORD programme was designed to assess worldwide differences and trends in population-based cancer survival. In this population-based study, we aimed to estimate survival inequalities globally for several subtypes of childhood leukaemia. Methods Cancer registries participating in CONCORD were asked to submit tumour registrations for all children aged 0–14 years who were diagnosed with leukaemia between Jan 1, 1995, and Dec 31, 2009, and followed up until Dec 31, 2009. Haematological malignancies were defined by morphology codes in the International Classification of Diseases for Oncology, third revision. We excluded data from registries from which the data were judged to be less reliable, or included only lymphomas, and data from countries in which data for fewer than ten children were available for analysis. We also excluded records because of a missing date of birth, diagnosis, or last known vital status. We estimated 5-year net survival (ie, the probability of surviving at least 5 years after diagnosis, after controlling for deaths from other causes [background mortality]) for children by calendar period of diagnosis (1995–99, 2000–04, and 2005–09), sex, and age at diagnosis (<1, 1–4, 5–9, and 10–14 years, inclusive) using appropriate life tables. We estimated age-standardised net survival for international comparison of survival trends for precursor-cell acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML). Findings We analysed data from 89 828 children from 198 registries in 53 countries. During 1995–99, 5-year age-standardised net survival for all lymphoid leukaemias combined ranged from 10·6% (95% CI 3·1–18·2) in the Chinese registries to 86·8% (81·6–92·0) in Austria. International differences in 5-year survival for childhood leukaemia were still large as recently as 2005–09, when age-standardised survival for lymphoid leukaemias ranged from 52·4% (95% CI 42·8–61·9) in Cali, Colombia, to 91·6% (89·5–93·6) in the German registries, and for AML ranged from 33·3% (18·9–47·7) in Bulgaria to 78·2% (72·0–84·3) in German registries. Survival from precursor-cell ALL was very close to that of all lymphoid leukaemias combined, with similar variation. In most countries, survival from AML improved more than survival from ALL between 2000–04 and 2005–09. Survival for each type of leukaemia varied markedly with age: survival was highest for children aged 1–4 and 5–9 years, and lowest for infants (younger than 1 year). There was no systematic difference in survival between boys and girls. Interpretation Global inequalities in survival from childhood leukaemia have narrowed with time but remain very wide for both ALL and AML. These results provide useful information for health policy makers on the effectiveness of health-care systems and for cancer policy makers to reduce inequalities in childhood cancer survival. Funding Canadian Partnership Against Cancer, Cancer Focus Northern Ireland, Cancer Institute New South Wales, Cancer Research UK, US Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, and the University of Kentucky.