For young adults with blood cancer, pediatric centers may improve survival

April 18, 2018

(WASHINGTON, April 18, 2018) -- Adolescents and young adults with acute leukemia have a survival advantage if they receive treatment at a pediatric cancer center versus an adult center, according to a new study.

The study, published online today in Blood Advances, a journal of the American Society of Hematology, also suggests that treatment at a center affiliated with the National Cancer Institute (NCI) improves overall survival.

Background: Evidence suggests that adolescents and young adults (AYA) with acute lymphocytic leukemia (ALL) fare better when treated with pediatric protocols, which are not uniformly used in adult cancer centers. This study was designed to provide a real-world understanding of the location of care and front-line regimens administered to newly diagnosed AYAs with ALL.

Study methods: Researchers reviewed California Cancer Registry data from 2004-2014 and identified 1,473 newly diagnosed ALL patients ages 15-39. They then designated the patients' center of care as either pediatric or adult, noting whether the facility was affiliated with the NCI, and assessed overall survival based on treatment setting.

Results: 475 of 1,473 (32%) AYA patients with ALL received care in a pediatric setting; 422 (89%) of these patients received front-line ALL therapy at NCI-designated cancer centers. Among the 998 patients treated in an adult setting, only 406 (28%) received care in an NCI-designated center. Treatment in a pediatric setting was independently associated with a significantly higher overall survival compared to treatment in an adult setting (hazard ratio=.53), as was treatment in an NCI-designated center (hazard ratio=.80).

"Physicians and treatment teams in pediatric and NCI-designated cancer settings may be more experienced in caring for acute lymphocytic leukemia in adolescents and young adults, and this may in part may explain why we are seeing better outcomes in these centers," said lead author Lori Muffly, MD, of Stanford University Department of Medicine.

Study authors note that ALL treatment guidelines were updated in recent years to recommend the treatment of AYA patients with pediatric protocols. Although the authors found that only a minority of AYAs treated in adult cancer centers received these types of protocols during the time period studied, survival of AYA patients with ALL treated in adult cancer centers is expected to improve as more adult cancer centers update their practice to use these protocols since the 2014 data cutoff.

Conclusion: This study suggests that referral of newly diagnosed AYA patients with ALL to pediatric and NCI-designated centers should be strongly considered.

Additional Notes: Findings from this study were presented during an oral presentation at the 59th American Society of Hematology Annual Meeting in Atlanta.
-end-
Blood Advances is a peer-reviewed, online-only, open access journal of the American Society of Hematology (ASH), the world's largest professional society concerned with the causes and treatment of blood disorders.

ASH's mission is to further the understanding, diagnosis, treatment, and prevention of disorders affecting blood, bone marrow, and the immunologic, hemostatic, and vascular systems by promoting research, clinical care, education, training, and advocacy in hematology.

Blood Advances® is a registered trademark of the American Society of Hematology.

Contact:
Stephen Fitzmaurice, American Society of Hematology
sfitzmaurice@hematology.org; 202-552-4927

American Society of Hematology

Related Adolescents Articles from Brightsurf:

Differences in well-being amongst Somali, Latino and Hmong adolescents
U of M School of Nursing researchers found that acculturation was positively associated with substance use and negatively with academic achievement in adolescence.

Nicotine vapour more rewarding for adolescents than adults
University of Guelph researchers are the first to discover that adolescents react differently to e-cigarette vapour than adults.

Interest in quitting vaping among adolescents
Adolescents using electronic cigarettes were asked if they had seriously thought about or tried to quit vaping.

New guidelines for children and adolescents with T2D
A team of paediatric specialists, including an expert from the University of Adelaide, has produced new guidelines regarding assessment and management of type 2 diabetes (T2D) in Australian and New Zealand children and adolescents.

What influences adolescents to continuously use e-cigarettes?
In a Public Health Nursing study of adolescents who have used e-cigarettes in the past month, certain factors were associated with frequent use.

Fertility preservation use among transgender adolescents
Transgender adolescents often seek hormonal intervention to achieve a body consistent with their gender identity and those interventions affect reproductive function.

Mental health care for adolescents
Researchers examined changes over time in the kinds of mental health problems for which adolescents in the United States received care and where they got that care in this survey study with findings that should be interpreted within the context of several limitations including self-reported information.

Migraine prevention in children and adolescents
Two medicines already used to prevent migraine in adults also showed efficacy in adolescents with migraine.

Smoking cessation treatment targets adolescents
The primary focus of smoking cessation research has been adults in the past, but a new study in JAMA Pediatrics zeroed in on adolescents.

Patterns of substance use and co-use by adolescents
Using in-depth interviews with adolescents (16-19 years of age) who used alcohol and marijuana, this study examines the role that social and physical contexts play in adolescent decision-making about simultaneous use of alcohol and marijuana.

Read More: Adolescents News and Adolescents Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.