Tomás Letona

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Patricia Valverde

Children's Hospital Colorado

Clàudia Garrido

Universidad Francisco Marroquín

Andrea Ferrari

Fondazione IRCCS Istituto Nazionale dei Tumori

Jessica Blanco

Centre International de Recherche sur le Cancer

Verónica Girón

Universidad Francisco Marroquín

Ricardo Mack

Universidad Francisco Marroquín

Maria Grazia Valsecchi

University of Milano-Bicocca

Valentino Conter

Azienda Ospedaliera San Gerardo

Monika L. Metzger

St. Jude Children's Research Hospital

Raul C. Ribeiro

St. Jude Children's Research Hospital

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St. Jude Children's Research Hospital

University of Colorado Denver

Children's Hospital Colorado

Universidad Francisco Marroquín

Istituti di Ricovero e Cura a Carattere Scientifico

University of Milano-Bicocca

Stanford University

Hospital Nacional de Niños Bloom

Fondazione IRCCS Istituto Nazionale dei Tumori

Azienda Ospedaliera San Gerardo

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Impact of a Regional Pediatric Hematology/Oncology Fellowship Program in Guatemala

JCO Global Oncology (2024)

Daniel C. Moreira Clàudia Garrido Roy Enrique Rosado Verónica Girón Tomás Letona

PURPOSE This study aimed to describe and assess the regional experience of a pediatric hematology/oncology fellowship program based in Guatemala. METHODS The Unidad Nacional de Oncología Pediátrica (UNOP) in Guatemala City, Guatemala, is the only hospital in Central America dedicated exclusively to childhood and adolescent cancer. To address the regional need for specialists, a fellowship program in pediatric hematology/oncology was launched in 2003. The UNOP fellowship program comprises 3 years of training. Although the program is based at UNOP, it also includes rotations locally and internationally to enhance clinical exposure. The curriculum is based on international standards to cover clinical expertise, research, professionalism, communication, and health advocacy. Trainees are selected according to country or facility-level need for pediatric hematologists/oncologists, with a plan for them to be hired immediately after completing their training. RESULTS Forty physicians from 10 countries in Latin America have completed training. In addition, there are currently 13 fellows from five countries in training. Of the graduates, 39 (98%) are now practicing in pediatric hematology/oncology in Latin America. Moreover, many of them have leadership positions within their institutions and participate in research, advocacy, and policy making. Graduates from the UNOP program contribute to institutions by providing care for an increasing number of patients with pediatric cancer. The UNOP program is the first pediatric hematology/oncology fellowship program in the world to be accredited by Accreditation Council for Graduate Medical Education-International, an international body accrediting clinical training programs. CONCLUSION The UNOP program has trained specialists to increase the available care for children with cancer in Latin America. This regional approach to specialist training can maximize resources and serve as a model for other programs and regions.

Graduate medical education

Pediatric Oncology

10.1200/go.23.00474

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Rhabdomyosarcoma in low‐ and middle‐income countries: A report from the Asociacion de Hemato‐oncología Pediatrica de Centro América (AHOPCA)

Pediatric Blood & Cancer (2022)

Clàudia Garrido Tomás Letona Susana Godoy Federico Antillón Patricia Valverde

Abstract This report describes the results of an observational study dedicated to rhabdomyosarcoma developed by the Asociación de Hemato‐oncología Pediatrica de Centro América (AHOPCA) between 2001 and 2018. Overall, 337 previously untreated patients < 18 years old were included in the analysis; 58% had unresected disease, and 19% were metastatic at diagnosis. With a median follow‐up of 6.6 years, five‐year event‐free and overall survival rates were 30% and 33%, respectively. Local progression/relapse was the main cause of treatment failure.

10.1002/pbc.29669

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The treatment of childhood acute lymphoblastic leukemia in Guatemala: Biologic features, treatment hurdles, and results

Cancer (2016)

Federico G Antillon Jessica Blanco Patricia Valverde Mauricio Castellanos Clàudia Garrido

The National Pediatric Oncology Unit (UNOP) is the only pediatric hemato-oncology center in Guatemala.Patients ages 1 to 17 years with acute lymphoblastic leukemia (ALL) were treated according to modified ALL Intercontinental Berlin-Frankfurt-Münster (IC-BFM) 2002 protocol. Risk classification was based on age, white blood cell count, immunophenotype, genetics (when available), and early response to therapy.From July 2007 to June 2014, 787 patients were treated, including 160 who had standard-risk ALL, 450 who had intermediate-risk ALL, and 177 who had high-risk ALL. The induction death rate was 6.6%, and the remission rate was 92.9%. The rates of death and treatment abandonment during first complete remission were 4.8% and 2.5%, respectively. At a median observation time of 3.6 years, and with abandonment considered an event, the 5-year event-free survival and overall survival estimates ( ± standard error) were 56.2% ± 2.1% and 64.1% ± 2.1%, respectively, with a 5-year cumulative incidence of relapse of 28.9% ± 2.0%. Twenty-one of 281 patients (7.5%) investigated were positive for the ets variant 6/runt-related transcription factor 1 (ETV6/RUNX1) fusion.A well organized center in a low-middle-income country can overcome the disadvantages of malnutrition and reduce abandonment. Outcomes remain suboptimal because of late diagnosis, early death, and a high relapse rate, which may have a partly genetic basis. Earlier diagnosis, better management of complications, and better knowledge of ALL will improve outcomes. Cancer 2017;123:436-448. © 2016 American Cancer Society.

Immunophenotyping

Cumulative incidence

10.1002/cncr.30257

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Citations (37)