Papers by Soad Fuentes-Alabi
Revista Panamericana de Salud Pública
The Global Initiative for Childhood Cancer (GICC) aims to increase the cure rate for children wit... more The Global Initiative for Childhood Cancer (GICC) aims to increase the cure rate for children with cancer globally by improving healthcare access and quality. The Pan American Health Organization (PAHO), St. Jude Children’s Research Hospital (St. Jude), and collaborators have joined efforts to improve outcomes of children with cancer in Latin America and the Caribbean (LAC) using the CureAll framework. In this article, we describe the process of developing regional resources aimed at accelerating the GICC implementation in LAC. In March 2021, PAHO formed regional working groups to develop core projects aligned with CureAll pillars and enablers. Seven working groups emerged from regional dialogues: early detection, nursing, psychosocial, nutrition, supportive care, treatment abandonment, and palliative care. PAHO arranged regular online meetings under the mentorship and support of St. Jude regional/transversal programs and international mentors. Between April and December 2021, 202 m...
The ongoing COVID-19 pandemic strained medical systems worldwide. We report on the impact on pedi... more The ongoing COVID-19 pandemic strained medical systems worldwide. We report on the impact on pediatric oncology care in Latin American (LATAM) during its first year. Four cross-sectional surveys were electronically distributed among pediatric onco-hematologist in April/June/October 2020, and April/2021 through the Latin American Society of Pediatric Oncology (SLAOP) email list and St Jude Global regional partners. 453 pediatric onco-hematologists from 20 countries responded the first survey with subsequent surveys response rates above 85%. More than 95% of participants reported that treatment continued without interruption for new and active on-going patients, though with disruptions in treatment availability. During the first three surveys, respondents reported suspensions of outpatient procedures (54.2%), a decrease in oncologic surgeries (43.6%), radiotherapy (28.4%), stem cell transplants (SCT) (69.3%), and surveillance consultations (81.2%). Logistic regression analysis showed ...
The Lancet Child & Adolescent Health, 2021
Note: This article was posted on the Archives Web site as an Early Online Release. Early Online R... more Note: This article was posted on the Archives Web site as an Early Online Release. Early Online Release articles have been peer reviewed, copyedited, and reviewed by the authors. Additional changes or corrections may appear in these articles when they appear in a future print issue of the Archives. Early Online Release articles are citable by using the Digital Object Identifier (DOI), a unique number given to every article. The DOI will typically appear at the end of the abstract.
The Lancet Oncology, 2020
BMJ Supportive & Palliative Care, 2021
ObjectivesPaediatric patients with leukaemia with relapse or induction failure have poor prognosi... more ObjectivesPaediatric patients with leukaemia with relapse or induction failure have poor prognosis. Anticipated quality of life (QoL) is important in treatment decision making. The objective was to determine if curative intent at relapse or induction failure, when compared with palliative intent, was associated with child’s physical health, pain or general fatigue and parents’ QoL over time among patients with paediatric leukaemia in El Salvador.MethodsThis was a prospective observational cohort study. Children 2–18 years with acute leukaemia at first relapse or induction failure were eligible. Assessments occurred every 2 months for up to 2 years using validated proxy report and self-report scales, where guardians were the primary respondents. Initial curative or palliative intent was categorised at enrolment by physicians. The impact of initial intent on QoL was assessed using linear mixed effects models and interaction between QoL and time.ResultsOf the 60 families enrolled, init...
Cancer, 2020
Interdisciplinary teamwork supports high‐quality cancer care and effective utilization of limited... more Interdisciplinary teamwork supports high‐quality cancer care and effective utilization of limited resources. This study purposed to examine the value, structure, process, and effectiveness of interdisciplinary care (IDC) among pediatric oncology providers in low‐income and middle‐income countries in Central America and the Caribbean.
Archives of Pathology & Laboratory Medicine, 2020
Context.— Several countries of the Central America and Caribbean region have been sharing regiona... more Context.— Several countries of the Central America and Caribbean region have been sharing regional neuroblastoma (NB) treatment guidelines. However, there is no standardization in the diagnosis, subclassification, or tumor biology to aid in the risk stratification of these patients. Objective.— To examine the histology and assess the accuracy of the local pathology reports; to evaluate the usefulness of manual MYCN immunohistochemistry (IHC); and to use NB as a model to identify the needs to establish a central pathology review (CPR) program in this region. Design.— A retrospective CPR of specimens derived from patients with a diagnosis of NB and treated under the regional NB guidelines between 2012 and 2017 was conducted, allowing for a comparison between local diagnoses and the CPR diagnoses. Manual MYCN IHC was performed in the confirmed NB specimens and the results compared with known fluorescence in situ hybridization or automated IHC results, when available. Results.— The 156 ...
The Lancet Oncology, 2020
The Lancet Oncology, 2020
Journal of Global Oncology, 2019
PURPOSE The educational needs of parents at the time of their child’s cancer diagnosis are often ... more PURPOSE The educational needs of parents at the time of their child’s cancer diagnosis are often unclear, and research on this topic in low- and middle-income countries is limited. This study evaluated the educational needs of families at major pediatric oncology centers in Central America and Mexico. METHODS A qualitative study involving 72 in-person interviews and 4 focus groups was conducted using a semistructured interview guide. Key informants included family members, physicians, nurses, psychosocial providers, foundation leadership, volunteers, and communication professionals. The study sites included pediatric oncology centers in El Salvador, Guatemala, Mexico, and Panama. NVivo was used for thematic analysis. RESULTS Across all sites, parents had common questions and educational needs. Questions from families focused on their child’s likelihood of dying from cancer and feelings of guilt that were based on their perception that they caused the disease. The origin of cancer, n...
Journal of Clinical Oncology, 2019
PURPOSE Treatment abandonment because of enucleation refusal is a limitation of improving outcome... more PURPOSE Treatment abandonment because of enucleation refusal is a limitation of improving outcomes for children with retinoblastoma in countries with limited resources. Furthermore, many children present with buphthalmos and a high risk of globe rupture during enucleation. To address these unique circumstances, the AHOPCA II protocol introduced neoadjuvant chemotherapy with delayed enucleation. PATIENTS AND METHODS Patients with advanced unilateral intraocular disease (International Retinoblastoma Staging System [IRSS] stage I) were considered for upfront enucleation. Those with diffuse invasion of the choroid, postlaminar optic nerve, and/or anterior chamber invasion received six cycles of adjuvant chemotherapy (vincristine, carboplatin, and etoposide). Patients with buphthalmos and those with a perceived risk for enucleation refusal and/or abandonment were given two to three cycles of chemotherapy before scheduled enucleation followed by adjuvant chemotherapy to complete six cycle...
Journal of Clinical Oncology, 2015
e12624 Background: With progress made towards meeting the Millennium Development Goals, cancer is... more e12624 Background: With progress made towards meeting the Millennium Development Goals, cancer is now an important contributor to childhood mortality in CA. Hospital-based data suggests regional differences in cancer incidence compared to estimates in Europe and North America. PBCR are needed for rational cancer planning and to support descriptive and molecular epidemiology research in childhood cancer specific to the region. Methods: Two pediatric PBCR were created in Guatemala (GU) and El Salvador (ES) in 2013. A four-step process was followed. First, training of coordinators and registrars was completed, and CanReg5 was implemented with the support of the International Association of Cancer Registries and the Global Initiative for Cancer Registry Development. Second, the support of health authorities was secured to ensure regulatory compliance and long-term sustainability. Third, involvement of public and private stakeholders (oncologists, pathologists, and laboratories) was sought to ensure access to ...
Pediatric Blood & Cancer, 2019
Journal of Global Oncology, 2017
The Central America Four (CA-4) region, comprising Guatemala, Honduras, El Salvador, and Nicaragu... more The Central America Four (CA-4) region, comprising Guatemala, Honduras, El Salvador, and Nicaragua, is the largest low- and middle-income country region in the Western Hemisphere, with over 36 million inhabitants. The CA-4 nations share a common geography, history, language, and development indices, and unified with open borders in 2006. The growing CA-4 cancer burden among the noncommunicable diseases is expected to increase 73% by 2030, which argues for a regional approach to cancer control. This has driven efforts to establish population-based cancer registries as a central component of the cancer control plans. The involvement of international and academic partners in an array of initiatives to improve cancer information and control in the CA-4 has accelerated over the past several years. Existing data underscore that the infectious cancers (cervical, stomach, and liver) are a particular burden. All four countries have committed to establishing regional population-based cancer r...
Journal of Global Oncology, 2016
57 Background: Patients with WT in AHOPCA present late with large abdominal masses, in poor clini... more 57 Background: Patients with WT in AHOPCA present late with large abdominal masses, in poor clinical condition. This analysis focuses on treatment failure. Methods: Between 2012 and 2015, 182 evaluable patients were diagnosed with unilateral WT. Patients were staged with abdominal ultrasound/computed tomography and thorax radiograph/CT. Therapy was adapted from National Wilms Tumor Study-5 except for patients with large abdominal masses and/or severe malnutrition who received preoperative doxorubicin, vincristine, actinomycin-D for 4 to 6 weeks. Treatment failure was defined as abandonment of therapy, recurrent/progressive disease (PD), and death: early (< 2 weeks from diagnosis) or toxic (> 2 weeks after diagnosis). Results: 49% were male; 23% were <2 years (median age 3.5y). Stage distribution: I, 8; II, 21; III, 116; IV, 37 cases. For 123/181 (68%) preoperative therapy was warranted (volume 579cm3). Treatment failures were: recurrence/PD 28; abandonment 19; early death 3...
Pediatric Blood & Cancer, 2016
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Papers by Soad Fuentes-Alabi