{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T12:29:58Z","timestamp":1786364998184,"version":"build-2736575974"},"reference-count":63,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cancer Control"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Relapsed or refractory B-cell acute lymphoblastic leukaemia (B-ALL) carries a poor prognosis in adults. Although immunotherapies have expanded treatment options, access to these life-extending therapies remains a challenge in many resource-constrained healthcare systems. This study explored healthcare professionals\u2019 perspectives on the immunotherapy landscape for adult B-ALL in Malaysia\u2019s public sector.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative study was conducted using in-depth, semi-structured interviews with 11 healthcare professionals from two tertiary centres in Malaysia. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six themes characterised the current implementation landscape. While the clinical benefits of immunotherapy were widely recognised, its use remained largely restricted to salvage or bridging therapy. Financial constraints, fragmented funding mechanisms, administrative burden, infrastructure constraints, limited clinical expertise or experience, and the absence of standardised treatment pathways hindered wider integration into routine care. These collectively contributed to inequitable access and delayed treatment initiation in a setting of a rapidly progressive disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Healthcare professionals recognise the therapeutic value of immunotherapy for adult B-ALL, but its implementation in Malaysia\u2019s public sector remains selective and constrained. Systemic reforms across funding, formulary policy, workforce development, and clinical governance may be needed to close the gap between therapeutic potential and patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10732748261476852","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T23:42:51Z","timestamp":1786146171000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Immunotherapy Landscape for Acute Lymphoblastic Leukaemia (ALL) in Malaysia: A Qualitative Study Among Healthcare Professionals From Two National Referral Centres"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5463-3602","authenticated-orcid":false,"given":"Mei Pin","family":"Ngu","sequence":"first","affiliation":[{"name":"Faculty of Pharmacy, Universiti Malaya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noorasyikin","family":"Shamsuddin","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Universiti Malaya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasniza","family":"Zaman Huri","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Universiti Malaya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei Lim","family":"Chong","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Universiti Malaya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izyan","family":"A Wahab","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Universiti Malaya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/bcj.2017.53"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-12-399287"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajco.13609"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/16078454.2022.2111992"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1509277"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020009098"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01222-8"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/14796694.2025.2577005"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11523-025-01129-5"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2406526"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.24.00321"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-025-06399-1"},{"key":"e_1_3_8_14_2","article-title":"NCCN clinical practice guidelines in oncology: acute lymphoblastic leukemia (version 1.2026)","author":"National Comprehensive Cancer Network","unstructured":"National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: acute lymphoblastic leukemia (version 1.2026). NCCN. https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/all.pdf, Accessed 19 June 2026.","journal-title":"NCCN"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-022-00700-7"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2024-011258"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-022-00310-5"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.4455"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.31547\/bct-2023-023"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcyt.2025.08.005"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2020.104889"},{"key":"e_1_3_8_22_2","article-title":"High-income countries 2026","author":"World Population Review","unstructured":"World Population Review. High-income countries 2026. World Population Review. https:\/\/worldpopulationreview.com\/country-rankings\/high-income-countries, Accessed 19 June 2026.","journal-title":"World Population Review"},{"key":"e_1_3_8_23_2","doi-asserted-by":"publisher","DOI":"10.1200\/GO-25-00206"},{"key":"e_1_3_8_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-025-02629-8"},{"key":"e_1_3_8_25_2","volume-title":"National Policy for Rare Diseases in Malaysia","author":"Ministry of Health Malaysia","unstructured":"Ministry of Health Malaysia. National Policy for Rare Diseases in Malaysia. Malaysia: Ministry of Health. https:\/\/kkm.synchronet.my\/images\/04-penerbitan\/penerbitan-klinikal\/perkhidmatan-OG-dan-pediatrik\/genetik_rare_disease\/National_Policy_for_Rare_Diseases_in_Malaysia.pdf, Accessed 19 June 2026."},{"key":"e_1_3_8_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-34567-8_10"},{"key":"e_1_3_8_27_2","doi-asserted-by":"publisher","DOI":"10.15212\/fmch.2016.0101"},{"key":"e_1_3_8_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/1525822x05279903"},{"key":"e_1_3_8_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"e_1_3_8_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.13031"},{"key":"e_1_3_8_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_3_8_32_2","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_3_8_33_2","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_279151"},{"key":"e_1_3_8_34_2","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2017.1344127"},{"key":"e_1_3_8_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-019-00812-6"},{"key":"e_1_3_8_36_2","volume-title":"Blinatumomab (Blincyto): Indication: For the treatment of patients with Philadelphia chromosome-negative, CD19-positive B-cell precursor acute lymphoblastic leukemia in the consolidation phase of multiphase chemotherapy: Reimbursement Recommendation","author":"Canadian Agency for Drugs and Technologies in Health","unstructured":"Canadian Agency for Drugs and Technologies in Health. Blinatumomab (Blincyto): Indication: For the treatment of patients with Philadelphia chromosome-negative, CD19-positive B-cell precursor acute lymphoblastic leukemia in the consolidation phase of multiphase chemotherapy: Reimbursement Recommendation. CADTH. https:\/\/www.cda-amc.ca, Accessed 19 June 2026."},{"key":"e_1_3_8_37_2","volume-title":"Yakka kijun shusai hinmoku risuto oyobi kohatsu iyakuhin ni kansuru joho ni tsuite (Reiwa 8-nen 6-gatsu 12-nichi tekiyo)","author":"Ministry of Health, Labour and Welfare","unstructured":"Ministry of Health, Labour and Welfare. Yakka kijun shusai hinmoku risuto oyobi kohatsu iyakuhin ni kansuru joho ni tsuite (Reiwa 8-nen 6-gatsu 12-nichi tekiyo). Ministry of Health, Labour and Welfare. https:\/\/www.mhlw.go.jp\/, Accessed 19 June 2026."},{"key":"e_1_3_8_38_2","volume-title":"Pan-Canadian oncology drug review final recommendation for blinatumomab (Blincyto) for acute lymphoblastic leukemia","author":"Canadian Agency for Drugs and Technologies in Health","unstructured":"Canadian Agency for Drugs and Technologies in Health. Pan-Canadian oncology drug review final recommendation for blinatumomab (Blincyto) for acute lymphoblastic leukemia. CADTH. https:\/\/www.cda-amc.ca\/. Accessed 19 June 2026."},{"key":"e_1_3_8_39_2","volume-title":"Final appraisal determination: blinatumomab for previously treated Philadelphia-chromosome-negative acute lymphoblastic leukaemia","author":"National Institute for Health and Care Excellence","unstructured":"National Institute for Health and Care Excellence. Final appraisal determination: blinatumomab for previously treated Philadelphia-chromosome-negative acute lymphoblastic leukaemia. NICE. https:\/\/www.nice.org.uk\/, Accessed 19 June 2026."},{"key":"e_1_3_8_40_2","volume-title":"Japan's NHI drug price system","author":"Pharmaceuticals and Medical Devices Agency","unstructured":"Pharmaceuticals and Medical Devices Agency. Japan's NHI drug price system. PMDA. https:\/\/www.pmda.go.jp\/, Accessed 19 June 2026."},{"key":"e_1_3_8_41_2","volume-title":"Subsidies for drugs on the Standard Drug List (SDL) at public healthcare institutions","author":"Ministry of Health Singapore","unstructured":"Ministry of Health Singapore. Subsidies for drugs on the Standard Drug List (SDL) at public healthcare institutions. Singapore: Ministry of Health. https:\/\/www.moh.gov.sg\/, Accessed 19 June 2026."},{"key":"e_1_3_8_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12672-025-01860-5"},{"key":"e_1_3_8_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2021.100292"},{"key":"e_1_3_8_44_2","doi-asserted-by":"publisher","DOI":"10.21315\/mjms2023.30.2.1"},{"key":"e_1_3_8_45_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10102097"},{"key":"e_1_3_8_46_2","volume-title":"National Strategic Plan for Cancer Control Programme 2021-2025","author":"Ministry of Health Malaysia","unstructured":"Ministry of Health Malaysia. National Strategic Plan for Cancer Control Programme 2021-2025. Malaysia: Ministry of Health. https:\/\/www.moh.gov.my, Accessed 19 June 2026."},{"key":"e_1_3_8_47_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.636068"},{"key":"e_1_3_8_48_2","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_100036"},{"key":"e_1_3_8_49_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-024-03836-7"},{"key":"e_1_3_8_50_2","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn121090-20240319-00102"},{"key":"e_1_3_8_51_2","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2024-009611"},{"key":"e_1_3_8_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.12.003"},{"key":"e_1_3_8_53_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04787-x"},{"key":"e_1_3_8_54_2","doi-asserted-by":"publisher","DOI":"10.46989\/001c.115793"},{"key":"e_1_3_8_55_2","doi-asserted-by":"publisher","DOI":"10.7399\/fh.11333"},{"key":"e_1_3_8_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcpo.2022.100375"},{"key":"e_1_3_8_57_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2016-0301"},{"key":"e_1_3_8_58_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-019-05274-2"},{"key":"e_1_3_8_59_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2024.102582"},{"key":"e_1_3_8_60_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32116"},{"key":"e_1_3_8_61_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2019.04.020"},{"key":"e_1_3_8_62_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-08-798322"},{"key":"e_1_3_8_63_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2024027500"},{"key":"e_1_3_8_64_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2312948"}],"container-title":["Cancer Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10732748261476852","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10732748261476852","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10732748261476852","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T11:47:46Z","timestamp":1786362466000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10732748261476852"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":63,"alternative-id":["10.1177\/10732748261476852"],"URL":"https:\/\/doi.org\/10.1177\/10732748261476852","relation":{},"ISSN":["1073-2748","1526-2359"],"issn-type":[{"value":"1073-2748","type":"print"},{"value":"1526-2359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"article-number":"10732748261476852"}}