Wijnen Noa, Klootwijk Larissa, Gichemi Alice, Apadet Lilian, Njuguna Festus, Klein Kim, Huibers Minke, Goemans Bianca F, Mostert Saskia, Kaspers Gertjan
Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands.
Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Asia Pac J Oncol Nurs. 2024 Aug 7;11(10):100565. doi: 10.1016/j.apjon.2024.100565. eCollection 2024 Oct.
Annually, over 400,000 children develop cancer, with the majority living in low- and middle-income countries (LMICs). Survival rates in high-income countries (HICs; ≥ 75%-80%) significantly exceed those in LMICs (< 30%). Acute myeloid leukemia (AML) is a childhood cancer with high mortality rates in LMICs and is not included in the World Health Organization (WHO)'s 'six common and curable types of cancer'. This case report explores two pediatric AML cases in Kenya (LMIC) and the Netherlands (HIC), highlighting differences and similarities in both patient journeys. The first case is a 15-year-old Kenyan boy who initially experienced dizziness and fatigue. After repeated blood transfusions without a definitive diagnosis, AML was confirmed via bone marrow aspiration (BMA) 63 days later, and treatment followed the SIOP PODC AML guidelines for LMICs. The second case is a 6-year-old Dutch boy with fatigue and malaise. Initially diagnosed with post-viral bone marrow failure, a BMA performed 61 days after symptom onset revealed AML, and treatment followed the NOPHO-DBH AML-2012 protocol. Both patients faced frequent febrile neutropenia, managed per local guidelines, illustrating the balance between anti-cancer treatment and supportive care. Despite challenges, both boys completed treatment and are in complete remission. This case series highlights the potential for effective AML treatment in resource-constrained settings and underscores the need to address cancers beyond the 'six common and curable types'.
每年有超过40万儿童患上癌症，其中大多数生活在低收入和中等收入国家（LMICs）。高收入国家（HICs；生存率≥75%-80%）的生存率显著高于低收入和中等收入国家（<30%）。急性髓系白血病（AML）是一种在低收入和中等收入国家死亡率很高的儿童癌症，它未被世界卫生组织（WHO）列入“六种常见且可治愈的癌症类型”。本病例报告探讨了肯尼亚（低收入和中等收入国家）和荷兰（高收入国家）的两例儿童AML病例，突出了两个患者就医过程中的差异和相似之处。第一个病例是一名15岁的肯尼亚男孩，他最初出现头晕和疲劳症状。在反复输血但未确诊后，63天后通过骨髓穿刺（BMA）确诊为AML，并按照针对低收入和中等收入国家的SIOP PODC AML指南进行治疗。第二个病例是一名6岁的荷兰男孩，有疲劳和不适症状。最初被诊断为病毒感染后骨髓衰竭，症状出现61天后进行的骨髓穿刺显示为AML，并按照NOPHO-DBH AML-2012方案进行治疗。两名患者都频繁出现发热性中性粒细胞减少症，按照当地指南进行处理，这说明了抗癌治疗与支持性护理之间的平衡。尽管面临挑战，两个男孩都完成了治疗并处于完全缓解状态。这个病例系列突出了在资源有限的环境中有效治疗AML的潜力，并强调了应对“六种常见且可治愈的癌症类型”之外的癌症的必要性。
