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Editorials
also known as ‘Obamacare’), which expanded Medicaid eligibility. The authors report reduced early mortality in post-ACA versus pre-ACA patients, and also that location of care played a key role: Patients diagnosed/treated at National Cancer Institute-Designated Cancer Centers had lower mortality rates and better overall survival than did patients treated elsewhere.
This report is important in several areas that help to clarify previous observations (and the discordance among observations). First, it underscores that in APL, healthcare access is at least as important as are other factors influ- encing early deaths. Indeed, in the absence of timely access, none of the other factors - early diagnosis, imme- diate ATRA availability, vigorous correction of coagu- lopathy, etc. - really matters. As a Canadian enjoying uni- versal healthcare access, I am moved by this realization. Second, treaters’ experience and expertise with APL are important. This study confirms previous suggestions regarding better APL outcomes at ‘teaching’ or ‘universi- ty’ hospitals. And third, the improved outcomes over time in this report suggest that efforts to eradicate early deaths have been effective, at least in part, and provide hope that with further efforts, we can solve the problem of early deaths in patients with APL.
In the right circumstances, APL is a curable disease. Potential cure is an opportunity that should be available to all afflicted individuals.
Disclosures
No conflicts of interest to disclose.
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