Childhood Acute Leukemias in Developing Nations: Successes and Challenges

Abstract

Purpose of review: Acute leukemias represent a tremendous threat to public health around the globe and the main cause of death due to disease in scholar age children from developing nations. Here, we review their current status in Mexico, as a paradigm of study, and the major challenges to control systemic diseases like childhood cancer.

Recent findings: A unique molecular epidemiology, late/low precision diagnosis, limited access to treatment, toxicity associated with therapy, continuous exposure to environmental risk factors, and the high frequency of early relapses are some of the factors cooperating to low rates of survival in low-to-medium-income countries. Deliberative dialogues and exhaustive programs have emerged as promising means of advancing evidence-informed policy, by providing a structured forum for key stakeholders to integrate scientific and pragmatic knowledge about complex health concerns. A system-wide strategy based on the comprehensive leukemia identity is essential for a meaningful decline in early childhood mortality.

Keywords: Acute lymphoblastic leukemia; Bone marrow; Childhood cancer; Leukemia burden; Leukemia stratification; Leukemia-initiating cells; Low-to-middle-income countries; Systemic diseases; Tumor microenvironment.