Abstract:
In low- and middle-income countries (LMICs), limited resources, suboptimal risk stratification,
and disproportionate patient-to-infrastructure ratio result in low survival of patients with acute
myeloid leukemia (AML). A high incidence of relapse, inherent to the biology, renders management
arduous. The challenge of treating AML in LMICs is of balancing the intensity of myelosuppressive
chemotherapy, which appears necessary for cure, with available supportive care, which influences
treatment-related mortality. The recommendations outlined in this paper are based on published
evidence and expert opinion. The principle of this adapted protocol is to tailor treatment to
available resources, reduce preventable toxic death, and direct limited resources toward those
children who are most likely to be cured.
