RESUMEN
Despite its low incidence, pediatric cancer makes up a significant portion of childhood illnesses. Yet information on pediatric cancer in Latin America is scarce. Since the early 2000s the World Health Organization (WHO) has been highlighting the role of cancer registries in cancer surveillance and control. This article describes the main aspects of pediatric cancer registration in Latin America, highlighting the successes of Argentina's national pediatric cancer registry, Registro Oncopediátrico Hospitalario Argentino (ROHA), which allows for better health care and contributes to improved outcomes for children with cancer, to provide a rationale for the expansion and enhancement of pediatric cancer registration in other Latin American countries.
A pesar de tener una incidencia baja, el cáncer pediátrico representa una proporción significativa de las enfermedades de la niñez. Sin embargo, en América Latina hay poca información al respecto. Desde comienzos del siglo XXI, la Organización Mundial de la Salud (OMS) ha puesto de relieve la función que tienen los registros oncológicos en la vigilancia y el control del cáncer. En este artículo se describen los principales aspectos de los registros de cáncer pediátrico en América Latina y se pone el acento en los éxitos del Registro Oncopediátrico Hospitalario Argentino (ROHA), que permite mejorar la atención de salud y ayuda a obtener mejores resultados en los niños con cáncer, lo cual puede servir de fundamento para la ampliación y el perfeccionamiento de los registros de cáncer pediátrico en otros países latinoamericanos.
Apesar da incidência baixa, o câncer em crianças representa uma parcela considerável das afecções infantis. Porém, existem poucos dados sobre o câncer em crianças na América Latina. Desde o princípio dos anos 2000, a Organização Mundial da Saúde (OMS) trabalha para reforçar o papel dos registros de câncer no controle e vigilância da doença. Este artigo examina as principais características dos registros do câncer em crianças na América Latina e põe em relevo os bons resultados obtidos com o registro nacional da Argentina (Registro Oncopediátrico Hospitalario Argentino, ROHA), como melhoria da assistência de saúde e dos desfechos aos pacientes pediátricos, servindo de base para a ampliação e o aperfeiçoamento do registro de câncer em crianças em outros países latino-americanos.
RESUMEN
OBJECTIVE: To evaluate real-world annualized bleeding rates (ABRs), dosing frequency, and factor consumption of four recombinant FVIII (rFVIII) products using pooled data from centers in the US, Germany, and Italy. METHODS: De-identified patient medical chart data were collected from 48 hemophilia treatment centers in the US, Germany, and Italy. Patients included in this analysis had hemophilia A and were treated with rVIII-SingleChain, rFVIIIFc, octocog alfa, or BAY 81-8973 for ≥12 weeks. Where possible, patient selection considered age and disease severity in order to balance patient groups across products. Summary statistics were presented descriptively by product for dosing frequency, consumption, ABR/annualized spontaneous bleeding rate (AsBR), and corresponding percentage of patients with zero bleeds. Logistic regression was performed for patients with zero bleeds or zero spontaneous bleeds (vs. patients with any such bleeds). Generalized linear model regression was performed for ABR, AsBR, and consumption. All regression models included the product variable for comparison as well as additional independent variables for adjustment (age, weight, severity, and country for the consumption model, with the addition of consumption for the bleeding outcomes models). RESULTS: Overall, 616 patients were included (rVIII-SingleChain, n = 129; rFVIIIFc, n = 159; octocog alfa, n = 181; BAY 81-8973, n = 147). Dosing frequency was ≤2 times a week for 65.9%, 75.5%, 25.4%, and 40.1% of patients treated with rVIII-SingleChain, rFVIIIFc, octocog alfa, and BAY 81-8973, respectively. ABRs were not significantly different among products, with mean (median) values of 1.1 (0.0), 1.0 (0.0), 1.4 (1.0), and 1.9 (1.0) for rVIII-SingleChain, rFVIIIFc, octocog alfa, and BAY 81-8973, respectively. The percentage of patients with zero bleeds was comparable between rVIII-SingleChain and rFVIIIFc (59.7% vs. 62.3%; p =.916) and significantly higher for rVIII-SingleChain compared with octocog alfa (p <.001) and BAY 81-8973 (p =.003). Comparison of mean weekly consumption showed: rVIII-SingleChain (83.0 IU/kg/week) vs. rFVIIIFc (96.9; p =.055) and significantly lower for rVIII-SingleChain vs. octocog alfa (108.6; p <.001) and BAY 81-8973 (104.3; p =.001). The median values for weekly consumption were 85.7, 90.1, 100.1, and 98.5 IU/kg/week for rVIII-SingleChain, rFVIIIFc, octocog alfa, and BAY 91-8973, respectively. Similar trends were observed for all outcomes when analyzing the subgroups of patients aged ≥12 years and patients with severe disease (all age and ≥12 years). CONCLUSIONS: rVIII-SingleChain prophylaxis may provide improved bleed protection, less frequent dosing, and lower consumption compared with standard-acting FVIII products, and comparable protection and consumption to the other long-acting FVIII product, in patients with hemophilia A.
Asunto(s)
Hemofilia A , Esquema de Medicación , Alemania , Hemofilia A/tratamiento farmacológico , Hemorragia/tratamiento farmacológico , Hemorragia/prevención & control , Humanos , Resultado del Tratamiento , Estados UnidosRESUMEN
ABSTRACT Despite its low incidence, pediatric cancer makes up a significant portion of childhood illnesses. Yet information on pediatric cancer in Latin America is scarce. Since the early 2000s the World Health Organization (WHO) has been highlighting the role of cancer registries in cancer surveillance and control. This article describes the main aspects of pediatric cancer registration in Latin America, highlighting the successes of Argentina's national pediatric cancer registry, Registro Oncopediátrico Hospitalario Argentino (ROHA), which allows for better health care and contributes to improved outcomes for children with cancer, to provide a rationale for the expansion and enhancement of pediatric cancer registration in other Latin American countries.
RESUMEN A pesar de tener una incidencia baja, el cáncer pediátrico representa una proporción significativa de las enfermedades de la niñez. Sin embargo, en América Latina hay poca información al respecto. Desde comienzos del siglo XXI, la Organización Mundial de la Salud (OMS) ha puesto de relieve la función que tienen los registros oncológicos en la vigilancia y el control del cáncer. En este artículo se describen los principales aspectos de los registros de cáncer pediátrico en América Latina y se pone el acento en los éxitos del Registro Oncopediátrico Hospitalario Argentino (ROHA), que permite mejorar la atención de salud y ayuda a obtener mejores resultados en los niños con cáncer, lo cual puede servir de fundamento para la ampliación y el perfeccionamiento de los registros de cáncer pediátrico en otros países latinoamericanos.
RESUMO Apesar da incidência baixa, o câncer em crianças representa uma parcela considerável das afecções infantis. Porém, existem poucos dados sobre o câncer em crianças na América Latina. Desde o princípio dos anos 2000, a Organização Mundial da Saúde (OMS) trabalha para reforçar o papel dos registros de câncer no controle e vigilância da doença. Este artigo examina as principais características dos registros do câncer em crianças na América Latina e põe em relevo os bons resultados obtidos com o registro nacional da Argentina (Registro Oncopediátrico Hospitalario Argentino, ROHA), como melhoria da assistência de saúde e dos desfechos aos pacientes pediátricos, servindo de base para a ampliação e o aperfeiçoamento do registro de câncer em crianças em outros países latino-americanos.