More than 80 percent of the world's children live in resource-poor countries where the cure rate for ALL is usually 35 percent or less, according to Raul C. Ribeiro, M.D., director of the St. Jude International Outreach Program and senior author of the JAMA article.
The increase in the cure rate for ALL in Recife, from 32 percent to 63 percent, falls short of the current 80 percent cure rate in the U.S. and Europe. However, the cure-rate increase occurred in a relatively short time span compared to the rate of improvement in the U.S. and Europe over the past 40 years.
"This rapid rate of improvement demonstrates that the most advanced treatments for ALL can be used successfully in a community that lacks a major medical institution, and whose patients are generally from poor families with limited ability to travel to health care facilities," Ribeiro said.
The St. Jude investigators reviewed the outcomes of 375 children (age 0.1 to 17.2 years) with ALL diagnosed between 1980 and 2002. ALL was diagnosed in 83 children during the early period of the study (1980-1989). At that time Recife lacked a dedicated pediatric oncology unit. The site also had no protocol-based therapy, specially trained nurses, 24-hour on-site physician coverage or adequate access to intensive care. In the middle period (1994-1997), 78 children were treated according to the most advanced St. Jude treatment protocol then available (Total XI). These children were cared for in the general hospi
Contact: Bonnie Cameron
St. Jude Children's Research Hospital