Acute myeloid leukemia in children and adolescents in Brazilian institutions: reality and challenges

de Melo Rodrigues, Ana Luiza, Lenzi, Luana, Lee-Jones, Lisa ORCID: https://orcid.org/0000-0003-1255-3545, Vieira Wanderley, Alayde, Marinho Da Silva, Ana Maria, De Carvalho, Cinthya Rocha, Teixeira Costa, Juliana, De Castro Junior, Cláudio Galvão, De Martino Lee, Maria Lucia, Mendes Lins, Mecneide, Rezende Godinho, Patrick and Correa Ribeiro, Raul (2020) Acute myeloid leukemia in children and adolescents in Brazilian institutions: reality and challenges. Journal of Bone Marrow Transplantation and Cellular Therapy, 2 (1). pp. 77-86. ISSN 2675-374X

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Abstract

Objective: To describe the outcome of acute myeloid leukemia (AML) among children treated in Brazilian institutions. Methods: A structured online questionnaire was sent to pediatric oncologists affiliated to the Brazilian Society of Pediatric Oncology. The physicians and institutions were unidentified. Results: One hundred and four pediatric oncologists in all Brazilian regions answered the questionnaire. The treatment-related mortality rate was reported to be higher than 30% by 29.8% of the participants. Difficulty in accessing the intensive care unit (ICU) was reported by 54.8%. About 85% had access to cytogenetics, 78% to molecular testing, 94% to the measurement of residual disease by flow cytometry. About 90% of participants reported access to HSCT, but 86% of them had difficulties in providing HSCT timely. About 95% of the respondents indicated the need to create a national treatment protocol, and 89.4% are willing to collaborate with a national study group. Conclusion: Our study demonstrated large gaps in the treatment of pediatric AML in Brazil. To improve outcome, a national protocol will have to consider the regional differences and adapt the management according to the local resources.