AYA leukemia survivors have poorer long-term survival outcomes than the general population

Disclosures:
The Archer Foundation, LyondellBasell and NCI/NIH supported the study. Roth does not report any relevant financial information. Please see the study for relevant financial information from all other authors.


We have not been able to process your request. Please try again later. If you continue to have this problem, please contact customerservice@slackinc.com.

According to a study published in Cancer epidemiology, biomarkers and prevention.

The researchers also observed disparities in long-term survival among this population based on age, gender, and ethnicity.

Ten-year survival rate.

Data from Berkman AM, et al. Biomarkers of cancer epidemiol Previous. 2022;doi:10.1158/1055-9965.EPI-21-1388.

Rationale and methods

Cure rate for teenagers and young adults (AJA) diagnosed with cancer have increased in recent decades; however, little is known about the long-term outcomes of these patients, Michael E. Roth, MD, associate professor and co-director of the adolescent and young adult oncology program, and director of the childhood cancer survivorship program at the University of Texas MD Anderson Cancer Center, Healio told Healio.

Michael E. Roth, MD

Michael E. Roth

“AYAs with leukemia receive intensive chemotherapy and many have allogeneic stem cell transplantation,” he added. “Many patients who receive these treatments experience serious and life-threatening long-term side effects and develop chronic health problems. We sought to understand whether AYA leukemia survivors lived normal lifespans and identify risk factors for having a shortened lifespan. Importantly, these patients are diagnosed in adolescence, between the ages of 20 and 30, and therefore potentially have 50 to 70 years of life to live after their cancer diagnosis and treatment.

Researchers reviewed data on 5-year survivors of AYA acute myeloid leukemia (AML; n=1938; median age at diagnosis, 28 years; 58% white) and acute lymphoblastic leukemia (ALL; n = 2350; median age at diagnosis, 23 years). years ; 59% white) included in the SEER database between 1975 and 2011.

They compared long-term survival rates with a national US cohort obtained from the National Vital Statistics Report.

The median follow-up from diagnosis of ALL was 12.3 years and 12.7 years for people with AML.

Main findings

The results showed 10-year survival rates of 87% among ALL survivors, 89% among AML survivors, and 99% for the general population. The differences persisted through 30 years of follow-up, and leukemia remained the most common cause of death during the early survival period.

The researchers specifically observed worse survival in those diagnosed at older ages, with each additional year at diagnosis being associated with a 6% decrease in long-term survival for ALL and a 5% decrease in survival for LAM.

Additionally, male AML survivors experienced significantly lower survival than females (survival duration ratio = 0.61; 95% CI, 0.45-0.82). Asian or Pacific Islander survivors of ALL experienced longer survival than Hispanics. However, Hispanic ALL survivors survived 56% as long as white survivors, but the difference did not reach statistical significance after the researchers adjusted for socioeconomic status.

Long-term overall survival has improved in recent decades of diagnosis, with people diagnosed in the 1990s and 2000s living more than twice as long as people diagnosed in the 1980s. the researchers observed no additional improvement in long-term survival in people diagnosed in the 2000s compared to the 1990s for ALL or AML.

“Some of these patients are not completely cured of their initial cancer, so between 5 and 10 years after the initial diagnosis, most deaths are associated with disease progression or relapse, whereas after that, the most deaths result from late side effects of treatment, including cardiovascular disease and secondary cancers,” Roth said in a press release. “We believe we are likely to see much more progress in cure rates over the over the next 2 decades, in patients diagnosed between 2010 and 2020, due to newer immunotherapy and targeted agents used more frequently for these patients.”

The researchers noted limitations of the study, including the relative underrepresentation of racial/ethnic minorities, which may limit the ability to detect disparities in long-term survival among these patient populations. Additionally, the researchers were unable to capture differences in survival based on socioeconomic status.

Consequences

“AYA survivors of leukemia are at high risk of early mortality. While intensive treatment leads to more cures, this therapy also likely leads to the development of many chronic health problems,” Roth said. remains the most important outcome, long-term health and health-related quality of life must be considered when we treat patients during and after treatment More attention needs to be paid to patient access long-term, high-quality survivorship care.”

Further research should be conducted to understand why certain patient populations, such as men and racial/ethnic minorities, are at higher risk of early death, he added.

“We need to identify opportunities to intervene early to improve the long-term health of these patients,” Roth said. “It can be about ensuring that patients have lifelong access to preventative health care, getting timely cancer screening, and maximizing their health by increasing exercise and improving their nutrition. AYA survivors need high-quality survivorship care and efforts are needed to ensure that survivorship care is accessible to everyone, regardless of age, gender, race, ethnicity or socio-economic status.

For more information:

Michael E. Roth, MD, can be contacted at University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77479; email: mroth1@mdanderson.org.

References:

Teenagers and young adult leukemia survivors face higher death rates than the general population for decades after diagnosis (press release). https://www.eurekalert.org/news-releases/952547. Published May 13, 2022. Accessed May 13, 2022.
Berkman AM, et al. Biomarkers of cancer epidemiol Prev. 2022;doi:10.1158/1055-9965.EPI-21-1388.

#AYA #leukemia #survivors #poorer #longterm #survival #outcomes #general #population

Leave a Comment

Your email address will not be published. Required fields are marked *