Dr Caitlyn Duffy speaks to ecancer about a qualitative study looking at multilevel challenges and emerging insights from clinicians on delivering blinatumomab to children with relapsed or refractory acute leukaemia in low- and middle-income countries.

Interviews with physician leads in India, Pakistan and Vietnam identified barriers including regulatory delays, limited supplies, staff turnover and restricted inpatient capacity.

Philanthropic funding, multidisciplinary training, ongoing technical support and strong caregiver acceptance helped facilitate implementation.

The findings highlight the importance of local infrastructure, workforce capacity and cross departmental coordination in supporting the safe delivery and equitable scale-up of novel immunotherapies in resource-constrained settings.