The document discusses the Latin American Group of Lymphomas (GELL) and its efforts to standardize lymphoma diagnosis, treatment and follow-up care across Latin America. It notes that Latin America is a unique and diverse region with significant differences in lymphoma distributions and risk factors between countries. GELL was formed in 2016 with the goal of presenting real regional data as a group rather than individual countries. Initial efforts involved six countries and publishing results. GELL has since established legal status, developed consensus guidelines, presented findings at international conferences, and is now collecting new epidemiological data on follicular lymphoma to further characterize the disease burden in Latin America.

1. EVOLUCION-GELL
GRUPO DE ESTUDIO
LATINOAMERICANO DE
LINFOMAS

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??

5. GENETIC
ANCESTRY
E. Norris, K. jordan .BMC Genomics (2018)

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

11. START TO PUBLISH: OUR DATA

12. …TO LOOKING FOR COLLABORATORS
Getting a position as reference…
1. Our country
2. Our region

13. MEETING AND NETWORKING
• AMERON
• ASH
• LUGANO
• Emails.

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.

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)

25. Publicar REFERENTES
NETWORKING-
MEETING
BUSCAR LOS
COLABORADORES
ORGANIZACION-
LEGAL-
INVESTIGACION
PUBLICAR COMO
GRUPO
IDEA

26. GRACIAS