Leukemia: Social Inequality Shapes Child Mortality in Brazil

Why do children with lymphatic leukemia in Brazil have varying survival rates depending on the region? In a joint study, researchers from LMU and the Universidade Federal do Rio de Janeiro (UFRJ) examined trends in mortality from lymphatic leukemia among children in Brazil over more than two decades and analyzed how regional development and healthcare infrastructure are related to the observed differences. The findings were published in the journal *The Lancet Regional Health – Americas*.

The analysis shows that mortality has increased, particularly in the socioeconomically disadvantaged regions of northern and northeastern Brazil, while it has remained stable or declined in more affluent regions. According to the researchers, improvements in primary care alone are not sufficient to bridge these regional disparities. Rather, targeted, region-specific strategies are needed to strengthen specialized pediatric oncology care and to improve access to early specialized diagnosis and timely treatment.

“Our findings clearly show that social inequalities have a lasting impact on the survival rates of children with leukemia. To sustainably improve the survival rates of children with leukemia in all regions, it is particularly important to break down structural barriers to access to high-quality cancer care,” says doctoral candidate and first author Bárbara Sarni Sanches.

“The strength of the study lies in its integration of longitudinal data on leukemia mortality with complex socioeconomic and health-related information. Using appropriate biostatistical methods, we were able to combine this information into two meaningful indices, model their impact on mortality, and examine the association with regional differences in mortality trends,” says Dr. Ursula Berger , Privatdozent at the Institute for Medical Information Processing, Biometry, and Epidemiology (IBE) at LMU.

Professor Marcelo Gerardin Poirot Land of the UFRJ School of Medicine emphasizes that the findings provide important evidence for planning measures to reduce health inequalities. At the same time, the study highlights the importance of international scientific collaborations and research networks for addressing complex issues in the field of public health. The collaboration between UFRJ and LMU brings together expertise in epidemiology, biostatistics, and public health, laying the groundwork for innovative analyses of the factors influencing mortality from lymphatic leukemias among children in Brazil.

Bárbara Sarni Sanches, Isadora Lima Oliveira, Ciana Duque Estrada Botelho, Nathalia Lopez Duarte, Ursula Berger & Marcelo Gerardin Poirot Land: Spatiotemporal analysis and socioeconomic determinants of pediatric lymphoid leukemias mortality in Brazil from 2000 to 2021: an ecological study. The Lancet Regional Health – Americas 2026