REFERENCES
- World Health Organization. (2021). Cure All framework: WHO global
initiative for childhood cancer: increasing access, advancing quality,
saving lives. World Health Organization.
https://apps.who.int/iris/handle/10665/347370 - Google Search.
- Reedijk AMJ, Coebergh JWW, de Groot-Kruseman HA, et al. Progress
against childhood and adolescent acute lymphoblastic leukaemia in the
Netherlands, 1990–2015. Leukemia (2021);35(4):1001–1011.
- Abdelmabood S, Fouda AE, Boujettif F, & Mansour A. Treatment outcomes
of children with acute lymphoblastic leukemia in a middle-income
developing country: high mortalities, early relapses, and poor
survival. Jornal de Pediatria 2020; 96(1):108–116.
- Metzger ML, Howard SC, Fu LC, et al. outcome of childhood acute
lymphoblastic leukaemia in resource-poor countries. Lancet2003;362(9385):706–708.
- Mostert S, Sitaresmi MN, Gundy CM, Sutaryo, & Veerman AJP. Influence
of socioeconomic status on childhood acute lymphoblastic leukemia
treatment in Indonesia. Pediatrics 2006;118(6):1600-1606.
- Jabeen K, Ashraf MS, Iftikhar S, & Belgaumi AF. The Impact of
Socioeconomic Factors on the Outcome of Childhood Acute Lymphoblastic
Leukemia (ALL) Treatment in a Low/Middle Income Country (LMIC).Journal of Pediatric Hematology/Oncology 2016; 38(8):587–596.
- Rubagumya F, Xu MJ, May L, et al. Outcomes of low-intensity treatment
of acute lymphoblastic leukemia at Butaro Cancer Center of Excellence
in Rwanda. Journal of Global Oncology 2018; 4:1–11.
- Kersten E, Scanlan P, Dubois SG, & Matthay KK. Current treatment and
outcome for childhood acute leukemia in Tanzania. Pediatric
Blood and Cancer 2013;60(12): 2047–2053.
- Olbara G, van der Wijk T, Njuguna F, et al. Childhood acute
lymphoblastic leukemia treatment in an academic hospital in Kenya:
Treatment outcomes and health-care providers’ perspectives.Pediatric Blood & Cancer 2021;68(12): e29366.
- Population, total - Kenya | Data. (n.d.). Retrieved January
27, 2023, from
https://data.worldbank.org/indicator/SP.POP.TOTL?locations=KE - Google
Search. (Retrieved January 31, 2023).
- Poverty: Development news, research, data | World Bank.
(n.d.). Retrieved January 27, 2023, from
https://www.worldbank.org/en/topic/poverty - Google Search. (Retrieved
January 31, 2023).
- National Council for Population and Development; The State of Kenya
Population 2020. https://www.unfpa.org/sites/default/files/admin
resource/FINALPSAREPORT_0.pdf
- Barasa E, Rogo K, Mwaura N, & Chuma J. Kenya national hospital
insurance fund reforms: Implications and lessons for universal health
coverage. Health Systems and Reform 2018; 4(4):346–361.
- Veerman AJP, Hählen K, Kamps WA, et al. High Cure Rate with a
Moderately Intensive Treatment Regimen in Non-High-Risk Childhood
Acute Lymphoblastic Leukemia: Results of Protocol ALL VI from the
Dutch Childhood Leukemia Study Group. Journal of Clinical
Oncology 1996;14(3), 911–918.
- Arora RS, Pizer B, & Eden T. Understanding refusal and abandonment in
the treatment of childhood cancer. Indian Pediatrics2010;47(12):1005–1010.
- Olbara G, Martijn HA, Njuguna F, et al. Influence of health insurance
status on childhood cancer treatment outcomes in Kenya.Supportive Care in Cancer 2020;28(2):917–924.
- Ko RH, Ji L, Barnette P, et al. outcome of patients treated for
relapsed or refractory acute lymphoblastic leukemia: A therapeutic
advances in childhood leukemia consortium study. Journal of
Clinical Oncology 2010;28(4), 648–654.
- Borowitz MJ, Devidas M, Hunger SP, et al. Clinical significance of
minimal residual disease in childhood acute lymphoblastic leukemia and
its relationship to other prognostic factors: a Children’s Oncology
Group study. Blood 2008;111(12):5477-85.
- Borowitz MJ, Wood BL, Devidas M, et al. Prognostic significance of
minimal residual disease in high-risk B-ALL: a report from Children’s
Oncology Group study AALL0232. Blood 2015;126(8):964-71.
- Messinger Y, & Uckun FM. A critical risk-benefit assessment argues
against the use of anthracyclines in induction regimens for newly
diagnosed childhood acute lymphoblastic leukemia. Leukemia and
Lymphoma 1999;34(5–6):415–432.
- Hunger S, Reyes D, Negrin O, et al. Decreased early mortality and
increased survival with less intensive therapy for acute lymphoblastic
leukemia in the Dominican Republic. Pediatric Blood Cancer 2011
57(5):761-761
- Yeh TC, Liu HC, Hou JY, et al. Severe infections in children with
acute leukemia undergoing intensive chemotherapy can successfully be
prevented by ciprofloxacin, voriconazole, or micafungin prophylaxis.Cancer , 2014;120(8):1255–1262.
- Burns JE, Pérez DR, Li Y, et al. Assessment of the impact of inpatient
infectious events in pediatric patients with newly diagnosed acute
leukemia at Dr. Robert Reid Cabral Children’s Hospital, Dominican
Republic. PLOS ONE 2020;15(12): e0243795.
- Njuguna F, Martijn H, Langat S, et al. Factors influencing time to
diagnosis and treatment among pediatric oncology patients in Kenya.Pediatr Hematol Oncol 2016;33(3):186-99.
- Kulkarni KP, & Marwaha RK. Symptom diagnosis interval in childhood
acute lymphoblastic leukemia: Prognostic impact and association with
clinico-demographic factors. Indian Journal of Medical and
Paediatric Oncology 2012;33(03):188–188.
- Dai Q, Liu R, Wang Y, et al. Longer Time Intervals from Symptom Onset
to Diagnosis Affect the Overall Survival in Children with Acute
Lymphoblastic Leukemia. Journal of Pediatric
Hematology/Oncology 2022;44(6):285–292.
- Rivera GK, & Ribeiro RC. Improving treatment of children with acute
lymphoblastic leukemia in developing countries through technology
sharing, collaboration, and partnerships. Expert Review of
Hematology 2014;7(5):649-657.FIGURE LEGENDSFigure 1. Comparison of survival of children through the induction
phase of therapy between the two cohorts before (n=136) and after
(n=123)
Figure 2. Comparison of treatment abandonment between the two cohorts
before (n=136) and after (n=123)
Figure 3: (A) Comparisons of event-free survival of children with low
WBC (<50 x 109/L) to those with high WBC (>50 x
109/L), (B) comparison of event-free survival by age group.
Figure 4: (A) comparisons of event-free survival estimates before
(n=136) and after (n=123) (B) overall-survival estimates for the
2017-2020 cohort (n=123)
TABLE 1 Socio-demographic and clinical characteristics of patients for
the two periods