Outcomes of adolescents with acute lymphoblastic leukaemia.
Hong Kong Med J
; 28(3): 204-214, 2022 06.
Article
de En
| MEDLINE
| ID: mdl-35697524
ABSTRACT
INTRODUCTION:
Compared with young children who have acute lymphoblastic leukaemia (ALL), adolescents with ALL have unfavourable disease profiles and worse survival. However, limited data are available regarding the characteristics and outcomes of adolescents with ALL who underwent treatment in clinical trials. The aim of this study was to investigate the causes of treatment failure in adolescents with ALL.METHODS:
We retrospectively analysed the outcomes of 711 children with ALL, aged 1-18 years, who were enrolled in five clinical trials of paediatric ALL treatment between 1993 and 2015.RESULTS:
Among the 711 children with ALL, 530 were young children (1-9 years at diagnosis) and 181 were adolescents (including 136 younger adolescents [10-14 years] and 45 older adolescents [15-18 years]). Compared with young children who had ALL, adolescents with ALL were less likely to have favourable genetic features and more likely to demonstrate poor early response to treatment. The 10-year overall survival and event-free survival rates were significantly lower among adolescents than among young children (77.9% vs 87.6%, P=0.0003; 69.7% vs 76.5%, P=0.0117). There were no significant differences in the 10-year cumulative incidence of relapse, but the 10-year cumulative incidence of treatment-related death (TRD) was significantly greater among adolescents (7.2%) than among young children (2.3%; P=0.002). Multivariable analysis showed that both younger and older adolescents (vs young children) had worse survival and greater incidence of TRD.CONCLUSION:
Adolescents with ALL had worse survival because they experienced a greater incidence of TRD. There is a need to investigate optimal treatment adjustments and novel targeted agents to achieve better survival rates (without excessive toxicity) among adolescents with ALL.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Leucémie-lymphome lymphoblastique à précurseurs B et T
/
Récidive tumorale locale
Type d'étude:
Incidence_studies
/
Observational_studies
/
Prognostic_studies
Limites:
Adolescent
/
Child
/
Child, preschool
/
Humans
Langue:
En
Journal:
Hong Kong Med J
Sujet du journal:
MEDICINA
Année:
2022
Type de document:
Article
Pays d'affiliation:
Hong Kong