2. Latin America
• 33 countries
• 600 million population
• Complex region, high heterogeneity
• diverse health-care systems, access to
care, socioeconomic, geographic,
environmental( Caribbean sea, coasts,
mountain range, jungle), cultural, and
ethnic factors
• Others: geographic isolation,
language barriers, low education
level
3. Latin America: Differences
Javier A. Laurini and et. Classification of non-Hodgkin lymphoma in Central and South America: a review of 1028 cases. Blood 2012; 120 (24)
4. Latin America: Differences
• Significant differences are observed from individual countries
• For instance:
• Argentina, Venezuela and Chile have NHL distributions that are somewhat
similar to North America (NA).
• In contrast for example, Guatemala and Peru had much lower frequencies of
low-grade B-cell NHL, particularly FL, Mantle cell, CLL, and Hodgkin
lymphomas.
• Also, in Guatemala, Mexico and Peru, there is a significant higher
frequencies of T-cell NHL, as much as that observed in the Middle East
and Asia.
• Peru had a particular greater frequency of PTCL and ATLL while Mexico
Nasal NK/T cell Lymphoma. Greater EBV incidence??
6. Latin America an Unique Region
• Native Americans display the lowest genetic diversity of any
continental group, but there is high divergence among subpopulations
• At the present-day American indigenous populations (and individuals
with indigenous ancestry) may harbour local private alleles rare or
absent elsewhere
• Mexico, Guatemala, and Peru serves as an important focal point for
such analyses because they harbours one of the largest sources of
pre-Columbian diversity and has a long history of complex civilizations
with diverse contributions to the present-day population.
7. Latin America an Unique Region
• The Asian origin of the Native American population has been
postulated as an mechanism for introduction of human T-cell
leukemia virus type 1 into Central and South America.
• In the specific case of Peru, significant Japanese immigration in the
distant and recent past could also explain the increased frequency of
ATLL and T cell histology
8. Latin America The Unmet Needs
• Understanding we belong to an unique region with an unique
admixture population and enormous potential
• Mentoring programmes developed with partnership are an
excellent way to experience scientific growth
• The strengthening and funding of Latin American cancer research
centers and networks will also provide good opportunities for the
development of cancer research in our countries adapted to the
specific features of our populations
9. Our First Efforts: LACOG GROUP
• It was a first intent to get together for
planning and works as a region
• Back in 2003 until 2008
• The route however was probably wrong
• Highly dependent on Pharmacy industry initiative
and effort
• Work planning resulted more in the individual
effort as independent countries than in a group
effort as a whole
10. A New Intent to Revitalize Latin America
Group. 2016
• With the aim to improve and standardize lymphomas
diagnostics, treatment and follow-up care, in 2016, on
the initiative of Dr. Brady Beltrand, the GELL
collaborative group idea came through
• A more effective idea of concentrating efforts around a
single disease: GELL, GRUPO ESTUDIO LATINOAMERICANO
DE LINFOMAS, Latin American Group of Lymphomas
• Coordination Center, Lima, Peru
• Main Objetive: To present real Latin American data, as a
group, but not as individual countries
IDEA
14. Countries Got on Board, (6)
• Argentina
• Chile
• Colombia
• Mexico
• Peru
• Venezuela
15. AMERON 2018
ORGANIZACIÓN DEL GRUPO :
OBJETIVOS A CORTO Y LARGO PLAZO
ESTABLECIMIENTO DE “ REGLAS DE
JUEGO”
POSIBLES CONFLICTOS CON BASES DE
DATOS
CC: CONSOLIDACIÓN EN ASH 2018
MENTORS
16. It has been worthy
• ASH Dec, 2018, San Diego: 2 abstracts approved
meeting with other members
Oral session at the HTLV World Congress. Lima Peru. April 2019. One
paper
• International Conference on Malignant Lymphomas ( Lugano, June
2019): 1 abstract presented
• ASH 2019 Orlando: 4 Abstracts submitted and accepted
17. Some Milestones On Our Path
• Formally, Non-profit legal scientific organization took place June
2019
18. Some Milestones On Our Path
• Group Work Concept:
• To publish scientific high quality data from the region
• Pharmaceuticals companies works under groups initiative and not other way around
• Mentoring from international chairman for a common objective
• Dr. Eduardo Soto Mayor Director of the GW Cancer Center and Professor of Medicine at
The George Washington University School of Medicine & Health Sciences.
• Dr. Jorge Castillo Associate Professor of Medicine, Harvard Medical School. Clinical
Director - Bing Center Clinic, Center for Walderstrom Macroglobulinemia.
19.
20.
21.
22.
23.
24. Next Immediate Goal
1.- GELL is recollecting epidemiological data on Follicular
Lymphoma to be presented in EHA 2020. ( 15 year following, 100 patients
minimum for each 6 countries)
2.-First Latin American Consensus in:
• Diffuse Large B cell lymphomas, December 2019 (ASH meeting in Orlando)
• Follicular Lymphomas, April 2020 ( Ameron Meeting Lima Peru)
National health systems developed as a coexistence of many subsystems (public entities, social security, and private providers with varying levels of quality
Genetic ancestry and admixture in Latin American populations. The ancestry contributions of putative ancestral source populations to four
modern, admixed Latin American populations are shown. a Triangle plots showing the relative ancestry contributions – African, European, Native
American – to admixed individuals from four Latin American populations. b PCA plot showing the genetic relationships among individuals from
admixed Latin American populations compared to putative ancestral source populations. Each population is bounded by a minimum spanning
ellipse. c Admixture plots showing the fractions of African, Native American and European ancestry among admixed individuals from four Latin
American populations. Each individual is represented as a column with the admixture fractions color coded as shown in the legend. d Violin plots
showing distributions of ancestry fractions among individuals from four Latin American populations. e Pie charts showing the average ancestry
values for each population next to its geographic location
Los nativos americanos muestran la diversidad genética más baja de cualquier grupo continental, pero existe una gran divergencia entre las subpoblaciones
En la actualidad, las poblaciones indígenas estadounidenses (y los individuos con ascendencia indígena) pueden albergar alelos privados locales raros o ausentes en otros lugares
México, Guatemala y Perú sirven como un punto focal importante para tales análisis porque albergan una de las mayores fuentes de diversidad precolombina y tienen una larga historia de civilizaciones complejas con diversas contribuciones a la población actual.
Las necesidades insatisfechas
Comprender que pertenecemos a una región única con una población de mezcla única y un enorme potencial
Los programas de mentoría desarrollados una asociación son una excelente manera de experimentar el crecimiento científico.
El fortalecimiento y la financiación de los centros y redes latinoamericanos de investigación del cáncer también brindarán buenas oportunidades para el desarrollo de la investigación del cáncer en nuestros países, adaptados a las características específicas de nuestras poblaciones.
