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IntroductionAcute lymphoblastic Leukemia (ALL) is the most common pediatric malignancy. While the survival rate for childhood ALL exceeds 90% in high-income countries, the estimated survival in low-and middle-income countries ranges from 22-79%, depending on the region and local resources.MethodsThis study retrospectively reviewed demographic, biological, and clinical parameters of children under 18 years of age with newly diagnosed ALL presenting between 2013-2017 across five pediatric centers in 4 countries in South America. Survival analyses were estimated using the Kaplan-Meier method.ResultsAcross the five centers, 752 patients were analyzed (Bolivia [N=9], Ecuador [N=221], Paraguay [N=197], Peru [N=325]) and 92.1% (n=690) patients were diagnosed with B-cell and 7.5% (n= 56) with T-cell ALL. The median age was 5.5 years old (IQR 7.29). At diagnosis, 47.8% of patients were categorized as standard and 51.9% as high risk per their institutional regimen. Advanced diagnostics availability varied between modalities. MRD was evaluated in 69.1% of patients; molecular testing was available for ETV6-RUNX, BCR-ABL1, TCF3-PBX1, and KMT2A-rearranged ALL in 75-81% of patients; however, karyotyping and evaluation for iAMP21 were only performed in 42-61% of patients. Central nervous system (CNS) involvement was evaluated at diagnosis in 57.3% (n=429) patients; of these, 93.7% (n=402) were CNS 1, 1.6% (n=7) were CNS 2, 0.7% (n=11) were CNS3, 1.9% (n=8) had cranial nerve palsy, and 2.1% (n=9) results unavailable. Chemotherapy delays >2 weeks were reported in 56.0% (n=421) patients during treatment. Delays were attributed to infection in 63.2% (n=265), drug-related toxicities in 47.3% (n=198), and resource constraints, including lack of bed availability in 23.2% (n=97) of patients. The 3-year Abandonment-sensitive EFS and OS were 61.0±1.9% and 67.2±1.8%, respectively. The 3-year EFS and OS were 71.0±1.8% and 79.6±1.7%, respectively.DiscussionThis work reveals opportunities to improve survival, including addressing severe infections, treatment interruptions, and modifications due to drug shortages. In 2018, healthcare professionals across South America established the Pediatric Oncology Latin America (POLA) group in collaboration with St. Jude Children’s Research Hospital. POLA collaborators developed an evidence-based, consensus-derived, adapted treatment guideline, informed by preliminary results of this evaluation, to serve as the new standard of care for pediatric ALL in participating institutions.

Resumen: En este escrito abordaré algunos puntos en común entre aspectos teóricos referidos a las juventudes y su participación política en el espacio público con la experiencia de la toma de las Escuelas Medias de la Universidad Nacional del Sur, (en adelante EMUNS), que se llevó a cabo en la ciudad de Bahía Blanca, Argentina en agosto 2018, cuyos impulsores fueron el colectivo de estudiantes de escuelas secundarias, universitarios y terciarios bahienses. Para abordar esta experiencia, tomaré como datos empíricos algunas publicaciones vertidas en algún medio de comunicación referidas a “la toma” y las manifestaciones (datos, recuerdos, anécdotas, percepciones, valoraciones) emitidas, en una entrevista colectiva, por parte de un grupo de estudiantes secundarios, y una docente de las EMUNS, que participaron activamente en el hecho. Resumo: Neste artigo, abordarei alguns pontos em comum entre aspectos teóricos relacionados à juventude e sua participação política no espaço público, com a experiência de ocuppy escolar as escolas de ensino médio da Universidade Nacional do Sul (em diante EMUNS), o que levou a realizada na cidade de Bahía Blanca, Argentina, em agosto de 2018, cujos promotores eram o grupo de estudantes de escolas secundárias, universidades e bahienses terciários. Para abordar essa experiência, tomarei como dados empíricos algumas publicações derramadas em alguns meios relacionados à “tomada” e às manifestações (dados, memórias, anedotas, percepções, avaliações) emitidas, em entrevista coletiva, por um grupo de Alunos do ensino médio e um professor da EMUNS que participaram ativamente do evento. Abstract: In this paper I will address some common points between theoretical aspects related to youth and their political participation in the public space with the experience of school occupation the Middle Schools of the National University of the South, (onwards EMUNS), which led to held in the city of Bahía Blanca, Argentina in August 2018, whose promoters were the group of students from secondary schools, universities and tertiary bahienses. To address this experience, I will take as empirical data some publications spilled in some media related to “the taking” and the manifestations (data, memories, anecdotes, perceptions, assessments) issued, in a collective interview, by a group of Secondary students and an EMUNS teacher who actively participated in the event.