Childhood cancer care beyond the ‘six common and curable types’: A comparative case series on acute myeloid leukemia in Kenya and the Netherlands

Noa Wijnen*, Larissa Klootwijk*, Alice Gichemi, Lilian Apadet, Festus Njuguna, Kim Klein, Minke Huibers, Bianca F. Goemans, Saskia Mostert, Gertjan Kaspers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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’.

Original languageEnglish
Article number100565
Number of pages7
JournalAsia-Pacific Journal of Oncology Nursing
Volume11
Issue number10
DOIs
Publication statusPublished - Oct 2024

Keywords

  • Health services accessibility
  • Low- and middle-income country
  • Myeloid leukemia
  • Pediatric neoplasms
  • Supportive care

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