Survival Improvements in Adolescents and Young Adults following Myeloablative Allogeneic Transplantation for Acute Lymphoblastic Leukemia.

Publication Type:

Journal Article

Source:

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation (2014)

Keywords:

2014, April 2014, Clinical Research Division

Abstract:

Adolescents and young adults (AYAs, ages 15-40 years) with cancer have not experienced survival improvements to the same extent as younger and older patients. We compared changes in survival following myeloablative allogeneic hematopoietic cell transplantation (HCT) for acute lymphoblastic leukemia (ALL) among children (N=981), AYAs (N=1218) and older adults (N=469) who were transplanted over three time periods: 1990-1995, 1996-2001 and 2002-2007. Five-year survival varied inversely with age group. Survival improved over time in AYAs and paralleled that seen in children; however, overall survival did not change over time forolder adults. Survival improvements were primarily related to lower rates of early treatment related mortality in the most recent era. For all cohorts, relapse rates did not change over time. A subset of 222 AYAs between the ages of 15-25 at 46 pediatric or 49 adult centers werealso analyzed to describe differences by center type. In this subgroup, there were differences in transplant practices among pediatric and adult centers, although HCT outcomes did not differ by center type. Survival for AYAs undergoing myeloablative allogeneic HCT for ALL improved at a similar rate as survival for children.