Acute lymphoblastic leukemia mortality rate trends in Chile from 2002 to 2023
DOI:
https://doi.org/10.52611/confluencia.2025.1424Keywords:
Leukemia lymphoid, Mortality, Mortality indicators, ChileAbstract
Introduction: Acute lymphoblastic leukemia is a malignant hematological neoplasm that affects the lymphoid precursor within the hematopoiesis process. It is the most common neoplasm with high associated mortality in children and adolescents. Objective: To describe the mortality associated with acute lymphoblastic leukemia in Chile. Methodology: Quantitative research based on data from the Department of Health Statistics and Information for the period 2002-2023. The variables included crude mortality rate, age group, region, and standardized mortality rate. Descriptive statistical analysis was performed. Results: There were 2,930 deaths from acute lymphoblastic leukemia. There was a percentage variation of -33.71% in the crude mortality rate between the two years. The 80+ age group had the highest rate (1.87 per 100,000). The highest standardized mortality ratio was recorded in the Arica and Parinacota Region, exceeding the national average by 2.1 times. Discussion: The trend can be attributed to the Explicit Health Guarantees, which since 2005 have ensured universal diagnosis and treatment of the disease. They have improved access to gold standard therapies and reduced mortality. The higher mortality in older adults could be explained by resistance to chemotherapy, lower tolerance to treatment, comorbidities, and frailty. Mortality in Arica and Parinacota could be associated with rurality, poverty, exposure to polymetals, and ethnic composition. Conclusion: Mortality from acute lymphoblastic leukemia in Chile has remained stable, with higher rates in older adults and rural regions, highlighting territorial inequalities and the need to improve equitable access to treatment.
Downloads
References
Terwilliger T, Abdul-Hay M. Acute lymphoblastic leukemia: a comprehensive review and 2017 update. Blood Cancer J. [Internet]. 2017 [citado el 14 de julio 2025];7(6):e577. Disponible en: https://doi.org/10.1038/bcj.2017.53
Horton TM, Steuber CP, Aster JC. Overview of the clinical presentation and diagnosis of acute lymphoblastic leukemia/lymphoma in children [Internet]. USA: UpToDate; 2024 [citado el 14 de julio 2025]. Disponible en: https://www.uptodate.com/contents/overview-of-the-clinical-presentation-and-diagnosis-of-acute-lymphoblastic-leukemia-lymphoma-in-children
Seiter K. Acute Lymphoblastic Leukemia (ALL) [Internet]. USA: Medscape; 2024 [citado el 14 de julio 2025]. Disponible en: https://emedicine.medscape.com/article/207631-overview
Inaba H, Teachey D, Annesley C, Batra S, Beck J, Colace S et al. Pediatric Acute Lymphoblastic Leukemia, Version 2.2025, NCCN Clinical Practice Guidelines In Oncology. J Natl Compr Canc Netw [Internet]. 2025 [citado el 14 de julio 2025];23(2):41-62. Disponible en: https://doi.org/10.6004/jnccn.2025.0006
Pui CH, Relling MV, Downing JR. Acute lymphoblastic leukemia. N Engl J Med [Internet]. 2004 [citado el 14 de julio 2025];350(15):1535-48. Disponible en: https://doi.org/10.1056/nejmra023001
Onciu M. Acute lymphoblastic leukemia. Hematol Oncol Clin North Am [Internet]. 2009 [citado el 14 de julio 2025];23(4):655-74. Disponible en: https://doi.org/10.1016/j.hoc.2009.04.009
Pilcante-Sanhueza J, Cao-Pochintesta C. Guías Prácticas Clínicas para el diagnóstico y tratamiento de la leucemia linfoblástica aguda [Internet]. Santiago: Sociedad Chilena de Hematología; 2016 [citado el 14 de julio 2025]. Disponible en: https://www.sochihem.cl/bases/arch1746.pdf
Programa de Drogas Antineoplásicas para Niños. Impacto emocional [Internet]. Chile: PINDA; 2024 [citado el 14 de julio 2025]. Disponible en: https://www.pindachile.cl/impacto-emocional/
Programa de Drogas Antineoplásicas para Niños. Impacto en la familia [Internet]. Chile: PINDA; 2024 [citado el 14 de julio 2025]. Disponible en: https://www.pindachile.cl/impacto-en-la-familia/
Ministerio de Salud de Chile. Resumen Ejecutivo. Guía de Práctica Clínica Leucemias en menores de 15 años [Internet]. Santiago: MINSAL; 2024 [citado el 14 de julio 2025]. Disponible en: https://diprece.minsal.cl/wp-content/uploads/2024/03/Final-Resumen-Ejecutivo-GPC-Leucemias-infantiles_2023_v3.pdf
Ministerio de Salud de Chile. Guía Clínica Leucemia en menores de 15 años [Internet]. Santiago: MINSAL; 2005 [citado el 14 de julio 2025]. Disponible en: https://www.saludquillota.cl/informacion_ges/Guias%20Clinicas%20GES/GES%202005/Guia%20GES%20Ca%20menores%2015%20a%C3%B1os1%202005%20Leucemia.pdf
Hunger SP, Mullighan CG. Acute Lymphoblastic Leukemia in Children. N Engl J Med [Internet]. 2015 [citado el 14 de julio 2025];373(16):1541-52. Disponible en: https://doi.org/10.1056/NEJMra1400972
Juliusson G, Hough R. Leukemia. Prog Tumor Res [Internet]. 2016 [citado el 14 de julio 2025];43:87-100. Disponible en: https://doi.org/10.1159/000447076
Gatta G, Botta L, Rossi S, Aareleid T, Bielska-Lasota M, Clavel J, et al. Childhood cancer survival in Europe 1999-2007: results of EUROCARE-5—a population-based study. Lancet Oncol [Internet]. 2014 [citado el 14 de julio 2025];15(1):35-47. Disponible en: https://doi.org/10.1016/S1470-2045(13)70548-5
Aristizabal P, Winestone LE, Umaretiya P, Bona K. Disparities in Pediatric Oncology: The 21st Century Opportunity to Improve Outcomes for Children and Adolescents With Cancer. Am Soc Clin Oncol Educ Book [Internet]. 2021 [citado el 14 de julio 2025];(41):e315-26. Disponible en: https://doi.org/10.1200/edbk_320499
Maude SL, Teachey DT, Porter DL, Grupp SA. CD19-targeted chimeric antigen receptor T-cell therapy for acute lymphoblastic leukemia. Blood [Internet]. 2015 [citado el 14 de julio 2025];125(26):4017-23. Disponible en: https://doi.org/10.1182/blood-2014-12-580068
Locatelli F, Zugmaier G, Mergen N, Bader P, Jeha S, Schlegel PG, et al. Blinatumomab in pediatric patients with relapsed/refractory acute lymphoblastic leukemia: RIALTO expanded access study. Blood Cancer J [Internet]. 2020 [citado el 14 de julio 2025];10(77):2215-24. Disponible en: https://doi.org/10.1038/s41408-020-00342-x
Kantarjian HM, O'Brien S, Smith TL, Cortes J, Giles FJ, Beran M, et al. Results of treatment with hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol [Internet]. 2000 [citado el 14 de julio 2025];18(3):547-61. Disponible en: https://doi.org/10.1200/JCO.2000.18.3.547
Juliusson G. Older Patients With Acute Myeloid Leukemia Benefit From Intensive Chemotherapy: An Update From the Swedish Acute Leukemia Registry. Clin Lymphoma Myeloma Leuk [Internet]. 2011 [citado el 14 de julio 2025];11(1):S54-9. Disponible en: https://doi.org/10.1016/j.clml.2011.02.003
Salinas Tejada MN, Avilés González C, Belmar Prieto J. Diagnósticos Regionales con Enfoque DSS.
Diagnósticos Regionales de Salud Región de Arica y Parinacota. [Internet]. Chile: Subsecretaría de Salud Pública; 2016 [citado el 14 de julio 2025]. Disponible en: https://epi.minsal.cl/wp-content/uploads/2016/03/DiagArica_y_Parinacota.pdf
Patillo J. Incidencia y factores étnicos en leucemia linfoblástica aguda en población indígena en Chile. Rev Chil Hematol Oncol [Internet]. 2017 [citado el 14 de julio 2025];12(3):45-52. Disponible en: https://www.sochihem.cl/bases/arch1746.pdf
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Revista Confluencia

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.