{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:28:32Z","timestamp":1785770912721,"version":"3.56.0"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T00:00:00Z","timestamp":1637539200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pediatric acute myeloid leukemia (AML) is a challenging disease to treat in low\u2010 and middle\u2010income countries (LMICs). Literature suggests that survival in LMICs is poorer compared with survival in high\u2010income countries (HICs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study evaluates the outcomes of Kenyan children with AML and the impact of sociodemographic and clinical characteristics on outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>A retrospective medical records study was performed at Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya, between January 2010 and December 2018. Sociodemographic and clinical characteristics, and treatment outcomes were evaluated. Chemotherapy included two \u201c3\u2009+\u20097\u201d induction courses with doxorubicin and cytarabine and two \u201c3\u2009+\u20095\u201d consolidation courses with etoposide and cytarabine. Supportive care included antimicrobial prophylaxis with cotrimoxazole and fluconazole, and blood products, if available. Seventy\u2010three children with AML were included. The median duration of symptoms before admission at MTRH was 1 month. The median time from admission at MTRH to diagnosis was 6\u2009days and to the start of AML treatment 16\u2009days. Out of the 55 children who were started on chemotherapy, 18 (33%) achieved complete remission, of whom 10 (56%) relapsed. The abandonment rate was 22% and the early death rate was 46%. The 2\u2010year probabilities of event\u2010free survival and overall survival were 4% and 7%, respectively. None of the sociodemographic and clinical characteristics were significantly associated with outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Survival of Kenyan children with AML is dismal and considerably lower compared with survival in HICs. Strategies to improve survival should be put in place including better supportive care, optimization of the treatment protocol, and reduction of the abandonment rate and time lag to diagnosis with sooner start of treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1576","type":"journal-article","created":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T07:57:33Z","timestamp":1637654253000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Outcomes of pediatric acute myeloid leukemia treatment in Western Kenya"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8485-5126","authenticated-orcid":false,"given":"Romy E.","family":"van Weelderen","sequence":"first","affiliation":[{"name":"Pediatric Oncology Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Pediatric Oncology Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Festus","family":"Njuguna","sequence":"additional","affiliation":[{"name":"Child Health and Pediatrics Moi University\/Moi Teaching and Referral Hospital  Eldoret Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9794-1071","authenticated-orcid":false,"given":"Kim","family":"Klein","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Wilhelmina Children's Hospital\/University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia","family":"Mostert","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Pediatric Oncology Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Langat","sequence":"additional","affiliation":[{"name":"Child Health and Pediatrics Moi University\/Moi Teaching and Referral Hospital  Eldoret Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry A.","family":"Vik","sequence":"additional","affiliation":[{"name":"Pediatrics Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7795-8474","authenticated-orcid":false,"given":"Gilbert","family":"Olbara","sequence":"additional","affiliation":[{"name":"Child Health and Pediatrics Moi University\/Moi Teaching and Referral Hospital  Eldoret Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Kipng'etich","sequence":"additional","affiliation":[{"name":"Child Health and Pediatrics Moi University\/Moi Teaching and Referral Hospital  Eldoret Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gertjan J. 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