Cure and Care: Delicate Balance in Global Pediatric Acute Myeloid Leukemia
“The most important factor determining whether a child diagnosed with cancer will survive is not the biology of the disease, but the country in which the child is treated.” This reflects the profound global disparities in childhood cancer outcomes. While survival exceeds 80% in high-income countries, it often remains below 30% in low- and middle-income countries, where most children with cancer live. This thesis focuses on pediatric acute myeloid leukemia (AML), a malignant disorder of the bone marrow with particularly poor outcomes in resource limited settings. Unfortunately, there is no simple cure for AML. Treating AML requires a careful balance between anti-cancer treatment and supportive care: delivering sufficiently intensive treatment to achieve cure, while preventing treatment-related morbidity and mortality. This balance is highly context-dependent and shapes global survival differences. The studies presented provide a global perspective on pediatric AML, identify new treatment strategies, and aim to enhance supportive care. By combining global perspectives with clinical and translational research, this thesis aims to contribute to more equitable, context-appropriate, and ultimately curative strategies for children with AML worldwide.
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