ASPG and acute lymphoblastic leukemia: Although this is expectedly poor compared with outcomes for AYAs in high-resource settings (3-year progression free survival of 59% in CALGB10403),7 it is similar to published outcomes among pediatric ALL from the region.12,15,16 For reference, the 2-year OS rate for a predominantly pediatric population receiving an asparaginase-based pediatric regimen for ALL in Rwanda was 22%.12 Unsurprisingly, in our study, poor outcomes were related to ALL progression and NOT toxicity, similar to published data for ALL among children in Malawi and Rwanda.12,16