Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/18165
Title: Clinical management of Australian adolescents and young adults with acute lymphoblastic and myeloid leukemias: A national population-based study.
Authors: White, V M;Skaczkowski, Gemma;Pinkerton, R;Coory, M;Osborn, M;Bibby, H;Nicholls, W;Orme, L M;Conyers, R;Phillips, M B;Harrup, R;Walker, R;Thompson, K;Anazodo, A
Affiliation: Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
School of Psychology, Deakin University, Burwood, Victoria, Australia
School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia
Royal Adelaide Hospital, South Australia, Adelaide, Australia
Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Princess Margaret Hospital for Children, Perth, Western Australia, Australia
Royal Hobart Hospital, Hobart, Tasmania, Australia
Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
School of Women's and Children's Health, University of New South Wales, Randwick, New South Wales, Australia
Issue Date: 24-Jul-2018
EDate: 2018-07-24
Citation: Pediatric blood & cancer 2018: e27349
Abstract: While several studies have examined the treatment of adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL), studies of acute myeloid leukemia (AML) are rare. Using national data for Australia, we describe (i) the number and type of treatment centers caring for AYAs, (ii) induction/first-line treatments, and (iii) survival outcomes. National population-based study assessing treatment of 15- to 24-year-olds diagnosed with ALL or AML between 2007 and 2012. Treatment details were abstracted from hospital medical records. Treatment centers were classified as pediatric or adult (adult AYA-focused or other adult; and by AYA volume [high/low]). Cox proportional hazard regression analyses examined associations between treatment and overall, event-free, and relapse-free survival outcomes. Forty-seven hospitals delivered induction therapy to 351 patients (181 ALL and 170 AML), with 74 (21%) treated at pediatric centers; 70% of hospitals treated less than two AYA leukemia patients per year. Regardless of treatment center, 82% of ALL patients were on pediatric protocols. For AML, pediatric protocols were not used in adult centers, with adult centers using a non-COG 7+3-type induction protocol (51%, where COG is Cooperative Oncology Group) or an ICE-type protocol (39%, where ICE is idarubicin, cytarabine, etoposide). Exploratory analyses suggested that for both ALL and AML, AYAs selected for adult protocols have worse overall, event-free, and relapse-free survival outcomes. Pediatric protocols were commonly used for ALL patients regardless of where they are treated, indicating rapid assimilation of recent evidence by Australian hematologists. For AML, pediatric protocols were only used at pediatric centers. Further investigation is warranted to determine the optimal treatment approach for AYA AML patients.
URI: http://ahro.austin.org.au/austinjspui/handle/1/18165
DOI: 10.1002/pbc.27349
ORCID: 0000-0001-6619-8484
0000-0003-0715-3563
0000-0002-2344-1365
PubMed URL: 30039912
Type: Journal Article
Subjects: ALL
AML
adolescents and young adults
population-based study
survival
treatment
Appears in Collections:Journal articles

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