Children and adolescents with non-Hodgkin lymphoma in Brazil: A national survey identifies the challenges encountered and documents the diversity of care

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dc.contributor.authorCosta, Ana Rosa S. [UNESP]
dc.contributor.authorCosta, Juliana T.
dc.contributor.authorBreviglieri, Carla Nolasco Monteiro
dc.contributor.authorMelgares, Lucélia M.P.
dc.contributor.authorGodinho, Patrick R.
dc.contributor.authorMetzger, Monika L.
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionHospital Martagão Gesteira
dc.contributor.institutionHospital Samaritano Higienópolis
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionHospital da Criança José de Alencar
dc.contributor.institutionHospital de Amor da Amazônia
dc.contributor.institutionSt Jude Children's Research Hospital
dc.date.accessioned2022-04-29T08:46:15Z
dc.date.available2022-04-29T08:46:15Z
dc.date.issued2022-01-01
dc.description.abstractIntroduction: Brazil has many inequities in the healthcare provided nationwide. Therefore, in order to access challenges in treatment, available resources and current practices, to identify barriers in delivering a good quality of care among Brazilian centers treating children and adolescents with Non-Hodgkin Lymphoma (NHL) and to generate a future prospective guideline, a customized online survey was distributed to pediatric hematologists and oncologists across the country. Results: A total of 97 surveys were completed (35% response rate), from 47 cities in all Brazilian regions and 79 units of care, with a median of 1 answer by the center (range 1 - 5). Most respondents work at an institution supported exclusively by public/philanthropic resources (58%), with an average of 5 to 9 new cases/year (49%), and 41% have 4 to 6 oncologists/centers. Additionally, 22% have no easy access to the intensive care unit, 26% have no access to Rasburicase, 28% have no access to Rituximabe as front-line therapy and 41% have unreliable methotrexate monitoring levels. Those differences cannot be explained thoroughly by regional wealth variances, nor by the financing model. Regarding the pathology service, 70% consider having reasonable quality assistance, but the timeframe to deliver diagnosis is satisfactory to 46%. There is no uniform management of care, with the current guideline from the Sociedade Brasileira de Oncologia Pediátrica being adopted by 54 to 59%, depending on the NHL subtype. Conclusion: This study provides insights into the heterogeneity of care among Brazilian centers. Recognizing those diversities will support the design of effective strategies and collaboration nationwide.en
dc.description.affiliationFaculdade de Medicina de Botucatu Universidade Estadual Paulista (UNESP), Av. Prof. Mário Rubens Guimarães Montenegro, s/n, CEP 18618687
dc.description.affiliationHospital Martagão Gesteira
dc.description.affiliationHospital Samaritano Higienópolis
dc.description.affiliationInstituto do Tratamento do Câncer Infantil (ITACI) Hospital das Clínicas Universidade de São Paulo
dc.description.affiliationHospital da Criança José de Alencar
dc.description.affiliationFundação Pio-XII Hospital de Amor da Amazônia
dc.description.affiliationSt Jude Children's Research Hospital
dc.description.affiliationUnespFaculdade de Medicina de Botucatu Universidade Estadual Paulista (UNESP), Av. Prof. Mário Rubens Guimarães Montenegro, s/n, CEP 18618687
dc.identifierhttp://dx.doi.org/10.1016/j.htct.2021.11.013
dc.identifier.citationHematology, Transfusion and Cell Therapy.
dc.identifier.doi10.1016/j.htct.2021.11.013
dc.identifier.issn2531-1387
dc.identifier.issn2531-1379
dc.identifier.scopus2-s2.0-85122057759
dc.identifier.urihttp://hdl.handle.net/11449/231581
dc.language.isoeng
dc.relation.ispartofHematology, Transfusion and Cell Therapy
dc.sourceScopus
dc.subjectBrazil
dc.subjectLymphoma
dc.subjectNon-Hodgkin
dc.titleChildren and adolescents with non-Hodgkin lymphoma in Brazil: A national survey identifies the challenges encountered and documents the diversity of careen
dc.typeArtigo
unesp.author.orcid0000-0002-7372-1330[1]
unesp.author.orcid0000-0002-5753-9619[5]
unesp.author.orcid0000-0002-7102-4611[6]

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Artigos - Hospital das Clínicas (HC) - Botucatu