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Boletín Médico del Hospital Infantil de México

2012, Number 3

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Bol Med Hosp Infant Mex 2012; 69 (3)

Treatment abandonment in pediatric patients with acute lymphoblastic leukemia

Klünder-Klünder M, Miranda-Lora AL, Dorantes-Acosta E, Zapata-Tarrés M, Carranco-Hernández T, Escamilla-Núñez A, Cortés-Gallo G, Muñoz-Hernández O, Garduño-Espinosa J, Villasís-Keever MÁ

Language: Spanish
References: 28
Page: 226-232
PDF size: 536.07 Kb.


ABSTRACT

Background. Abandonment is at the end of the spectrum of noncompliance. In children with cancer, whatever the cause that leads to treatment abandonment results in disease progression, recurrence and death. Therefore, the purpose of this study was to determine the frequency of treatment abandonment in pediatric patients with acute lymphoblastic leukemia (ALL) affiliated with the Seguro Popular insurance program.
Methods. We conducted a systematic review of the literature on the frequency of abandonment and a retrospective cohort study of clinical files of patients diagnosed during 2001 to 2003 and 2007 to 2009 in seven Mexican states.
Results. A review of the literature shows that, among pediatric patients with ALL, treatment abandonment is seen almost only in developing countries and the documented rates may be as high as 64%, but with a diminishing tendency. The abandonment rate for children affiliated with the Seguro Popular insurance program was 13.3% during 2007 to 2009. In contrast, there was a rate of 21.4% of patients who abandoned before their implementation. The highest rates of treatment abandonment were observed during early treatment stages and were seen in hospitals from the states of Hidalgo and Puebla.
Conclusions. In comparison to other countries, a lower rate of treatment abandonment has been seen in pediatric patients with ALL affiliated with the Seguro Popular insurance program. This observation would be related to the social and economic support provided by this program; however, the rate of abandonment is still high, making it necessary to introduce additional actions in order to improve this issue.


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