Introduction: The objective of the current study was to determine the survival probabilities of children and adolescents with acute lymphocytic leukemia treated with adapted Berlin–Frankfurt–Münster (BFM) protocols and compare our results with the original BFM reports. Methods: This retrospective study included 695 patients up to 19 years old treated with adapted BFM protocols between 1997 and 2018 in four hospitals in Rio de Janeiro. The 1997–2007 and 2008–2018 cohorts were analyzed separately. Results: More than half of the patients were stratified into the high-risk BFM classification. Overall and event-free survivals were, in the 1997–2007 period, respectively, 88% and 80% (BFM standard risk group—SRG), 75% and 67% (intermediate risk group—IRG), and 48% and 33% (high-risk group—HRG). The corresponding numbers for the 2008–2018 period were 93% and 84% (SRG), 75% and 63% (IRG), and 64% and 57% (HRG). In the second period, both the OS (HR = 0.71, p = 0.011) and EFS (HR = 0.62, p < 0.001) were higher. Except for the intermediate-risk group, the latter results are comparable to the BFM. Conclusion: The BFM protocol adaptations can be safely implemented in developing countries, accounting for local specificities.

Background/Objectives: The Brazilian Unified Health System was established in 1988 as a public health system with principles of universality, equity, and integrality. One of Brazil’s main strategies to strengthen universal healthcare is the Family Health Strategy (FHS), a primary health care policy established in 1994 and fully incorporated in the country in 2006. This study aims to describe the time trends of FHS coverage in Brazil and its states from 2008 to 2023 and to correlate this coverage with the states’ Human Development Index (HDI). Methods: Data on the number of FHS teams, population, and HDI during the period were collected for each Brazilian state in the Brazilian Ministry of Health’s public-access databases. Prais–Winsten regression was used to conduct a time series analysis for each state and country. The annual percentage change (APC) was used to describe time trends in time series. Linear regression was used to identify a correlation between HDI and FHS coverage across states. Results: The FHS coverage in the country increased from 66.81% to 84.66% from 2009 to 2023. Disparities in coverage between regions are evident throughout the entire study period. The Northeast region (NE) exhibited higher FHS coverage but lower APC rates compared to other regions. Results suggest a negative correlation between HDI and FHS coverage in all Brazilian states for 2009, 2012, 2015, 2018, 2021, and 2023. Conclusions: The FHS coverage increased in Brazil and its states during the period. The highest coverages were found in states from the North (N) and NE regions, and the lowest were in the Southeast region. Nine federative units achieved full coverage (100%) and maintained it afterward, with seven from the N and NE. A negative correlation was found between FHS and HDI, suggesting that the expansion of FHS effectively targets vulnerable populations.

The incidence of cancer in children living with HIV (CLWH) is high and lymphomas are the most common type of cancer in this population. The combined antiretroviral therapy (cART) changed the natural history of HIV infection. To determine the incidence and profile of these CLWH malignancies in Rio de Janeiro (RJ), Brazil, we conducted a retrospective and observational study of vertically infected CLWH, ranging from 0–20 incomplete years, from 1995 to 2018, at five reference centers. The study period was divided into three eras in accordance with the widespread use of cART in Brazil. 1306 patients were included. Of the 25 lymphomas found, 19 were AIDS-defining malignancies (ADM); 6 were non-AIDS-defining malignancies (NADM). The incidence rate (IR) of lymphoma developing was 1.70 per 1000 children-year (95% CI 1.09–2.50). ADM development IR decreased from 2.09–1.75–0.19 per 1000 children-year (p < 0.001) through cART eras. Cumulative Nelson–Aalen hazards of developing ADM over a 20-year period were 3.73% in the Early-cART era, 3.07% in the Mid-cART era, and 0.32% in the Late-cART era (p = 0.013). This study demonstrates the IR of lymphoma in CLWH in RJ, Brazil, as well as the benefit of cART in reducing ADM and death occurrence in the Post-cART era.

Lymphomas related to HIV are generally aggressive and have a poor prognosis, despite the use of combined antiretroviral therapy (cART) and effective chemotherapy treatment. To determine survival and prognostic factors in children and adolescents living with HIV (CLWH) in Rio de Janeiro (RJ), Brazil, who developed lymphomas, we performed a retrospective and observational study of vertically infected CLWH aged from 0 to 20 incomplete years during1995 to 2018 at five reference centers for cancer and HIV/AIDS treatment. Of the 25 lymphomas, 19 were AIDS-defining malignancies (ADM) and 6 were non-AIDS-defining malignancies (NADM). The 5-year overall survival (OS) and 5-year event-free survival (EFS) probabilities were both 32.00% (95% CI = 13.72–50.23%), and the 5-year disease-free survival (DFS) probability was 53.30% (95% CI = 28.02–78.58%). In the multivariate Cox regression analysis, performance status 4 (PS 4) was considered a poor prognostic factor for OS (HR 4.85, 95% CI = 1.81–12.97, p = 0.002) and EFS (HR 4.95, 95% CI = 1.84–13.34, p = 0.002). For the DFS, higher CD4+ T-cell counts were considered a better prognostic factor (HR 0.86, 95% CI = 0.76–0.97, p = 0.017) in the multivariate Cox regression analysis. This study demonstrates, for the first time, survival and prognostic factors for CLWH who developed lymphomas in RJ, Brazil.

Background: Hepatoblastoma is a rare malignant liver tumor that accounts for 1–2% of pediatric cancers. Despite its low incidence, it is a significant cause of cancer-related mortality in early childhood. Methods: This ecological study analyzed hepatoblastoma mortality in Brazilian children and adolescents (2008–2023) using data from the Mortality Information System (SIM/DATASUS). Mortality rates were calculated using official population estimates. Temporal trends were assessed using Prais-Winsten regression. Age and sex differences were analyzed using the chi-square test. Global mortality estimates (2008–2021) were obtained from the Global Burden of Disease Study for descriptive comparison. Results: A total of 267 deaths were recorded, most (66.7%) in children aged 0–4 years. Males accounted for 61.4% of cases. Although no significant mortality trends were observed for younger age groups, a significant annual decline was found among adolescents aged 15–19 years (Annual Percent Change (APC) = −38.4%, p = 0.016). Regional disparities were evident, with the Southeast presenting the highest number of deaths. Globally, the estimated number of deaths and age-specific mortality rate (ASMR) decreased over time, particularly among children under five. Conclusions: Hepatoblastoma remains a significant cause of mortality in early childhood. While Brazilian mortality rates remained stable in younger groups, mortality in adolescents showed a marked reduction. Global estimates suggest a progressive reduction in mortality.

Malignant lymphoma is an unusual form of gallbladder neoplasm. Almost all of these tumors are diffuse large B-cell lymphomas or mucosa-associated lymphoid tissue-type lymphomas. Herein, we report a rare case of a gallbladder Burkitt’s lymphoma (BL) in a child living with HIV. As far as we are concerned, this is the secondfirst report in the pediatric population and the first one in an individual living with HIV. The patient (a five-year-old black female child) attended the Federal Hospital of Lagoa, Rio de Janeiro, Brazil, underwent cholecystectomy and the postoperative pathological analysis of the gallbladder revealed a diagnosis of BL (EBV-positive). Also, HIV serology was performed and returned positive. She was transferred to the Martagão Gesteira Institute of Pediatrics and Childcare for oncological treatment, dying from sepsis and disease progression about 18 months later. Patient did not undergo ART/cART. Previous cases of gallbladder BL were herein described and analyzed to characterize the clinicopathological features and possible similarities. BL can occur in the gallbladder both in the context of HIV infection and in the pediatric population. Biopsy is mandatory in cases with suggestive findings of lymphoma, and an early diagnosis can change the course of the disease. Furthermore, the case highlights the importance of an early initiation of ART/cART in people living with HIV (PLWH).