Chiattone Carlos S, Gabus Raul, Pavlovsky Miguel A, Akinola Norah O, Varghese Abraham M, Arrais-Rodrigues Celso
Hematology and BMT Department, Hospital Maciel, Montevideo, Uruguay.
FUNDALEU, Clinical Research Center, Buenos Aires, Argentina.
Cancer J. 2021;27(4):314-319. doi: 10.1097/PPO.0000000000000533.
Despite the practice-changing advances achieved in the prognostic stratification and treatment of chronic lymphocytic leukemia (CLL), a large fraction of the world population resides in countries where access to many of these advances remains unavailable or subject to severe constraints. Although some of these countries display incidence rates of CLL that are lower than those of developed Western countries, a large number of patients are expected to be diagnosed with CLL in these regions every year. In this article, we review issues regarding management of CLL in some less-resourced countries, with a focus on the evidence basis for epidemiological and clinical information on this disease, the availability of diagnostic and therapeutic resources, and participation in clinical trials. Going forward, challenges that still need to be addressed include the development of unified countrywide registries, guidelines for management applicable to each country, wider availability of prognostic tools, access to new drugs, and policies that ensure these drugs are affordable to all patients worldwide.
尽管在慢性淋巴细胞白血病(CLL)的预后分层和治疗方面取得了改变实践的进展,但世界上很大一部分人口所在的国家仍无法获得或在很大程度上受限获得许多这些进展。虽然其中一些国家的CLL发病率低于西方发达国家,但预计这些地区每年仍会有大量患者被诊断为CLL。在本文中,我们回顾了一些资源较少国家中CLL管理的相关问题,重点关注该疾病流行病学和临床信息的证据基础、诊断和治疗资源的可及性以及参与临床试验的情况。展望未来,仍需解决的挑战包括建立统一的全国登记系统、适用于每个国家的管理指南、更广泛地提供预后工具、获取新药以及确保全球所有患者都能负担得起这些药物的政策。