A partnership between a public children’s referral hospital and a specialized diagnostic laboratory managed to accelerate the detection of blood cancer in children and reduce costs per sample by up to 24%.
The technique consists of carrying out specific tests after an initial screening based on molecular and cytology (cellular) data, thus reducing the need for other tests for which the diagnosis of the disease would not be indicated.
The use of technology known as reflex testing offers a return of exam results within 24 hours. The partnership, which has lasted eight years, has also seen an increase in screening tests for leukemia and residual disease by 34% and reduced annual recurring costs in relation to tests carried out in the hospital by 5%.
The research with the main results was carried out by the laboratory specialized in onco-hematological diagnosis (blood cancers) Flow Diagnósticos, in São Paulo, and Hinsg (Hospital Infantil Nossa Senhora da Glória), in Vitória (ES). The work was published this Friday (22) in the specialized journal American Association for Clinical Chemistry.
Hinsg is the only reference hospital for pediatric oncology in Espírito Santo, and serves all childhood cancer patients through the state’s SUS (Unified Health System).
According to Rodrigo Proto-Siqueira, director of research and genomics at Flow Diagnósticos, with the protocol for carrying out reflex exams, there is a saving of time at the beginning of treatment. “Classical laboratories collect a sample, send it for analysis and, if it is negative for a certain type of cancer, they collect new samples. This takes a lot of time. In our case, the screening test, for example, for acute leukemia, takes It will now lead to additional tests that will assist in the diagnosis according to that first screening result.”
In general terms, the reflex exam is a methodology in which the definition of the next steps is based on the determination of the previous step. “It is already widely used in the United States, where they don’t wait for a negative result for an investigation to start over from scratch, they already do the screening detection and, with that result, they move on to a more specific exam”, explains the researcher.
Bottlenecks in oncological tests in the country represent one of the challenges in diagnosing and treating cancers in the country, especially children.
For Gláucia Zouain-Figueiredo, pediatric oncologist at Hinsg, the accuracy of diagnosing childhood cancer is what can often help with that child’s survival. “In general, childhood cancer has a survival rate [sobrevivência após a doença] 85%, 90%, but this is for rich countries; in low- and middle-income countries, this rate is much lower. And this has the effect of several factors, but certainly early diagnosis, diagnostic accuracy and, therefore, starting appropriate treatment are factors that contribute to survival.”
As many pediatric oncology patients arrive at the hospital in a serious condition, the agility in detecting the type of leukemia, for example, can mean an improvement in symptoms and even a reduction in side effects — that is, without the need for therapies that do not are effective—in the first 36 hours.
“We recently received a five-year-old boy here with an elevated white blood cell count. [chamada hiperleucocitose], indicative of leukemia, with severe bone pain. After the initial analysis, we achieved a response within 24 hours and started treatment the following night, saving time for this patient. In the end, his grandmother said that he spent the night much better”, says the doctor.
According to data from Inca (National Cancer Institute), in the period 2023–2025, 7,930 new cases of childhood cancer will be diagnosed each year. Currently, in Brazil, the average chance of curing cancer in children and adolescents is around 64%.
“Thinking about the impact on public health, onco-hematological cancers represent 5% to 6% of neoplasm cases per year, and this low-cost and highly accessible diagnostic investigation strategy has a huge impact on cancer diagnosis children”, says Proto-Siqueira.