title: Anaplastic Large Cell Lymphoma in Central America: A Report From the Central American Association of Pediatric Hematology Oncology (AHOPCA).
abstract: BACKGROUND
  Although anaplastic large cell lymphoma (ALCL) is curable in high-income countries (HIC), data from low- and middle-income countries (LMIC) are lacking. We therefore conducted a retrospective study of the Central American Association of Pediatric Hematology Oncology (AHOPCA) experience in treating ALCL.
  
  
  METHODS
  We included all patients age <18 years newly diagnosed with ALCL treated between 2000 and 2013 in seven AHOPCA institutions. Retrospective data were extracted from the Pediatric Oncology Network Database.
  
  
  RESULTS
  Thirty-one patients met inclusion criteria. Twenty-five (81%) had advanced disease (stages III and IV), six (19%) were treated on the APO (doxorubicin, prednisone, vincristine) regimen, 15 (49%) on multi-agent chemotherapy designed for T-cell lineage malignancies (GuatALCL protocol), and 10 (32%) on BFM-based treatment regimens. Five-year overall event-free survival and overall survival were, respectively, 67.1 ± 8.6% and 66.7 ± 8.7%. All 10 events occurred in patients treated on BFM-based treatment regimens or the GuatALCL protocol, none on APO treatment: two patients experienced relapse, six treatment related mortality (TRM), and two abandonment.
  
  
  CONCLUSIONS
  Treatment of ALCL in countries with limited resources is feasible with similar outcomes as in HIC, though the causes of treatment failure differ. Less intensive regimens may be preferable in order to decrease TRM and improve outcomes. Prospective clinical trials determining the ideal treatment for LMIC children with ALCL are necessary.
authors.affiliation: Division of Haematology/Oncology, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ceppi
authors.affiliation: Department of Pediatric Oncology, Manuel de Jesus Rivera Hospital, Managua, Nicaragua.
authors.forename: Roberta
authors.initials: R
authors.lastname: Ortiz
authors.affiliation: National Pediatric Oncology Unit, Francisco Marroquín Medical School, Guatemala City, Guatemala.
authors.forename: Federico
authors.initials: F
authors.lastname: Antillón
authors.affiliation: Department of Onco-Hematology, Hospital Benjamin Bloom, San Salvador, El Salvador.
authors.forename: Roberto
authors.initials: R
authors.lastname: Vasquez
authors.affiliation: Department of Hematology-Oncology, Dr. Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic.
authors.forename: Wendy
authors.initials: W
authors.lastname: Gomez
authors.affiliation: Department of Hematology-Oncology, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", San José, Costa Rica.
authors.forename: Jessica
authors.initials: J
authors.lastname: Gamboa
authors.affiliation: National Pediatric Oncology Unit, Francisco Marroquín Medical School, Guatemala City, Guatemala.
authors.forename: Claudia
authors.initials: C
authors.lastname: Garrido
authors.affiliation: Department of Hemato-oncology, Hospital JP Garrahan, Buenos Aires, Argentina.|International Outreach Program, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Chantada
authors.affiliation: Department of Pediatric Hemato-Oncology, Hospital Escuela-Universitario, Tegucigalpa, Honduras.
authors.forename: Armando
authors.initials: A
authors.lastname: Peña
authors.affiliation: Division of Haematology/Oncology, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sumit
authors.initials: S
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D002489:Central America / Q000453:epidemiology; D002648:Child; D005260:Female; D006405:Hematology; D006801:Humans; D017728:Lymphoma, Large-Cell, Anaplastic / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008495:Medical Oncology; D012189:Retrospective Studies; D012955:Societies, Medical
keywords: anaplastic large cell lymphoma; child; developing countries; outcomes research; survival