SidaSubSaharaV1, Main, Exploration, bibRecord, 000D23

Treatment of Chronic Myeloid Leukemia in Rural Rwanda: Promising Early Outcomes

Identifieur interne : 000D23 ( Main/Exploration ); précédent : 000D22; suivant : 000D24

Treatment of Chronic Myeloid Leukemia in Rural Rwanda: Promising Early Outcomes

Auteurs : Neo Tapela ; Ignace Nzayisenga ; Roshan Sethi ; Jean Bosco Bigirimana ; Hamissy Habineza ; Vedaste Hategekimana ; Nicholas Mantini ; Tharcisse Mpunga ; Lawrence N. Shulman ; Leslie Lehmann

Source :

Journal of Global Oncology [ 2378-9506 ] ; 2016.

RBID : PMC:5495451

Abstract

Purpose

The burden of cancer is rising in low- and middle-income countries, yet cancer treatment requires resources that are often not available in these settings. Although management of chronic myeloid leukemia (CML) has been described in low- and middle-income countries, few programs involve patients treated in rural settings. We describe characteristics and early outcomes of patients treated for CML at rural district hospitals in Rwanda.

Methods

We conducted a retrospective review of patients with confirmed BCR-ABL–positive CML who were enrolled between July 1, 2009 and June 30, 2014. Types of data included patient demographics, diagnostic work up, treatment, clinical examination, laboratory testing, and death.

Results

Forty-three patients were included, with a maximum follow-up of 58 months. Of 31 patients who were imatinib-naïve at enrollment, 54.8% were men and the median age at diagnosis was 36.9 years (interquartile range: 29-42 years). Approximately two-thirds of patients (67.7%) were on the national public insurance scheme. The imatinib dose was reduced for 16 patients and discontinued for five. Thirty-two of the 43 patients continued to have normal blood counts at last follow-up. Four patients have died and four are lost to follow-up.

Conclusion

Our experience indicates that CML can be effectively managed in a resource-constrained rural setting, despite limited availability of on-site diagnostic resources or specialty oncology personnel. The importance of model public-private partnerships as a strategy to bring high-cost, life-saving treatment to people who do not have the ability to pay is also highlighted.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5495451

DOI: 10.1200/JGO.2015.001727
PubMed: 28717692
PubMed Central: 5495451

Affiliations:

Le document en format XML

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<p>The burden of cancer is rising in low- and middle-income countries, yet cancer treatment requires resources that are often not available in these settings. Although management of chronic myeloid leukemia (CML) has been described in low- and middle-income countries, few programs involve patients treated in rural settings. We describe characteristics and early outcomes of patients treated for CML at rural district hospitals in Rwanda.</p>
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<p>We conducted a retrospective review of patients with confirmed BCR-ABL–positive CML who were enrolled between July 1, 2009 and June 30, 2014. Types of data included patient demographics, diagnostic work up, treatment, clinical examination, laboratory testing, and death.</p>
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<p>Forty-three patients were included, with a maximum follow-up of 58 months. Of 31 patients who were imatinib-naïve at enrollment, 54.8% were men and the median age at diagnosis was 36.9 years (interquartile range: 29-42 years). Approximately two-thirds of patients (67.7%) were on the national public insurance scheme. The imatinib dose was reduced for 16 patients and discontinued for five. Thirty-two of the 43 patients continued to have normal blood counts at last follow-up. Four patients have died and four are lost to follow-up.</p>
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<p>Our experience indicates that CML can be effectively managed in a resource-constrained rural setting, despite limited availability of on-site diagnostic resources or specialty oncology personnel. The importance of model public-private partnerships as a strategy to bring high-cost, life-saving treatment to people who do not have the ability to pay is also highlighted.</p>
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Le SIDA en Afrique subsaharienne (serveur d'exploration)

Treatment of Chronic Myeloid Leukemia in Rural Rwanda: Promising Early Outcomes

Treatment of Chronic Myeloid Leukemia in Rural Rwanda: Promising Early Outcomes

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