The COVID-19 pandemic has caused treatment delays and modifications for pediatric cancer patients worldwide, but patients in low- and middle-income countries (LMIC) have been more severely affected, new data suggest. 

The data also showed that pediatric cancer patients in LMICs had a nearly 16-fold higher risk of all-cause mortality within 30 days of presentation, when compared with their counterparts in high-income countries (HICs). 

These findings were presented at the AACR Annual Meeting 2022 and concurrently published in BMJ Open.1,2 


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To evaluate the impact of the pandemic on pediatric cancer care, researchers collected data from 91 hospitals and cancer centers around the world. The team looked specifically at data from March 2020 to December 2020. 

The data set included 1660 patients who were under the age of 18 and had recently been diagnosed with cancer or were in active treatment for cancer. Cancer types included acute lymphoblastic leukemia (n=614), Wilms tumor (n=159), glioma (n=142), neuroblastoma (n=128), non-Hodgkin lymphoma (n=118), Hodgkin lymphoma (n=101), retinoblastoma (n=91), medulloblastoma (n=88), rhabdomyosarcoma (n=86), osteosarcoma (n=70), and Ewing sarcoma (n=63).  

In all, 1104 patients were from LMICs, and 556 were from HICs. In the entire cohort, 38 patients had confirmed COVID-19, and 8 had probable COVID-19.

A total of 219 patients had changes to their treatment due to the pandemic. Most of these patients (83.1%, n=182) lived in LMICs.

At 30 days after presentation, 4.3% of LMIC patients had died, as had 0.4% of patients from HICs (P <.0001). At 90 days, the all-cause mortality rate was 6.0% and 0.9%, respectively (P <.0001). 

Patients from LMICs had 12.1 times the risk of death at 30 days and 7.9 times the risk of death at 90 days when compared with patients from HICs (P <.001 for both). After adjustment for confounders, patients from LMICs had 15.6 times the risk of death at 30 days (P <.001). 

“This study illustrates the stark disparities that continue to exist in children’s cancer care, and the multiple impacts that the COVID-19 pandemic has had on health care systems across the globe,” study author Muhammed Elhadi, MBBCh, of the University of Tripoli in Libya, said in a statement. 

“This pandemic has become the defining crisis of our generation, and its ramifications may stretch beyond the acute crisis and have far-reaching consequences for the future. Understanding its true impact, taking on key lessons, and identifying vulnerabilities within health systems helps us develop solutions, which will also prove critical on our path toward equitable global pediatric oncology care,” Dr Elhadi concluded.

References

1. Elhadi M, Bandyopadhyay S, Peter N, Lakhoo K. The impact of the COVID-19 pandemic on 30-day survival in pediatric cancer patients in low, middle, and high-income countries: An international, observational cohort study. Presented at AACR 2022; April 8-13, 2022. Abstract 1999/3.

2. Global Health Research Group on Children’s Non-Communicable Diseases Collaborative. Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: A multicentre, international, observational cohort study. BMJ Open. 2022;12:e054690. doi:10.1136/bmjopen-2021-054690

This article originally appeared on Cancer Therapy Advisor