The site of cancer care may partially explain survival differences between children and adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL), according to a study published in Cancer Epidemiology, Biomarkers & Prevention. Investigators reported that AYAs with ALL and acute myeloid leukemia (AML) who were not treated at specialized cancer centers had significantly worse 5 year survival compared with children who were treated at specialized cancer centers.1
Researchers used data from the Los Angeles County Cancer Surveillance Program to identify patients diagnosed with ALL or AML from ages 1 to 39. Included in the analysis were 978 patients diagnosed with ALL as a child (ages 1 to 14), 402 patients diagnosed with ALL as an AYA (ages 15 to 39), 131 patients diagnosed with AML as a child, and 359 patients diagnosed with AML as an AYA.
Five-year relative survival rates declined with age for both patients with ALL and AML. The researchers found that AYAs diagnosed at ages 15 to 21 and 22 to 29 who were treated at specialized cancer centers had comparable overall and leukemia-specific survival to children diagnosed with ALL from ages 10 to 14 and treated at a specialized cancer center. Using the same referent population, AYAs in these age groups who were not treated at specialized cancer centers had an approximately 2-fold increased risk of death.
1. Wolfson J, Sun CL, Wyatt L, et al. Adolescents and young adults with acute lymphoblastic leukemia and acute myeloid leukemia: impact of care at specialized cancer centers on survival outcome. Cancer Epidemiol Biomarkers Prev. 2017 Feb 16. doi: 10.1158/1055-9965.EPI-16-0722 [Epub ahead of print]