{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:24:18Z","timestamp":1791483858403,"version":"4.3.4"},"reference-count":66,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe clinical characteristics, treatment outcomes, and overall survival (OS) of Ecuadorian adults with B\u2010cell acute lymphoblastic leukemia (B\u2010ALL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective multicenter cohort study was conducted in patients &gt;\u200915\u2009years diagnosed with B\u2010ALL between 2015 and 2022 across eight tertiary centers in Ecuador. Medical records of 734 acute lymphoblastic leukemia cases classified by the 2016 WHO criteria were reviewed; 653 B\u2010ALL patients were included. Multiple frontline chemotherapy regimens were used, and Philadelphia\u2010positive (Ph+) cases were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 653 patients, 50.4% were male, with a median age of 31\u2009years (interquartile range, 20\u201347). Most (93%) received chemotherapy, achieving a complete remission (CR) rate of 53.3% (311\/583) and minimal residual disease (MRD) negativity in 49.1% (211\/430). Relapse occurred in 62.4% (194\/310), and 16 of 164 underwent allogeneic hematopoietic stem cell transplantation (HSCT). Treatment\u2010related mortality was 31.5%, higher in pediatric\u2010inspired protocols (34.4% vs. 21.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Patients &lt;\u200930\u2009years showed better CR (58.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026) and longer survival (median OS 15 vs. 8\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Median OS for the cohort was 11\u2009months, with a 5\u2010year OS of 22.4%. High\u2010risk patients had inferior OS (11 vs. 14\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036), while no difference was observed between Ph\u2009+\u2009and Ph\u2013 (12 vs. 11\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.319).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adult Ecuadorian patients with B\u2010ALL show lower survival than international cohorts, mainly due to high treatment\u2010related mortality and limited transplantation access. Age was independently associated with response and OS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71625","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:50:10Z","timestamp":1773013810000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Multicenter Survival Analysis of Adults Type B\u2010Acute Lymphoblastic Leukemia in Ecuador. A Retrospective Study of the Real World"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4462-5411","authenticated-orcid":false,"given":"Brenner","family":"Sabando","sequence":"first","affiliation":[{"name":"IRHED Medical Specialties Center  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jairo","family":"Quinonez","sequence":"additional","affiliation":[{"name":"IRHED Medical Specialties Center  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Orquera","sequence":"additional","affiliation":[{"name":"Hematology Service Carlos Andrade Mar\u00edn Hospital  Quito Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Navarrete","sequence":"additional","affiliation":[{"name":"Hemato\u2010Oncology and Medicine Transfusion Department Solca Cancer Institute  Manab\u00ed Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jhoanna","family":"Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Hematology Service Teodoro Maldonado Carbo Hospital  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Department of Hematology Abel Gilbert Ponton Hospital  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodoro","family":"Chisesi","sequence":"additional","affiliation":[{"name":"Angela Serra Association for Cancer Research  Lecce Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Oliveros","sequence":"additional","affiliation":[{"name":"Hematology Service Luis Vernaza Hospital  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda 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