Adolescents and young adult acute myeloid leukemia outcomes at pediatric vs adult centers: A population‐based study
Pediatric Blood & Cancer Feb 12, 2021
Gupta S, Baxter NN, Sutradhar R, et al. - Researchers focused on the effect of locus of care (adult vs pediatric) in a population of adolescents and young adults (AYA) with acute myeloid leukemia (AML). In the IMPACT cohort, there were data for all Ontario, Canada, AYA aged 15‐21 years who received a diagnosis of AML between 1992 and 2012; these data were joined to population‐based health administrative data. Therapy was received by 51 (36.4%) of 140 AYA at pediatric centers. For the whole cohort, 5‐year event‐free survival and overall survival were estimated to be 35.0% ± 4.0% and 53.6% ± 4.2%, respectively. Findings showed no difference in AYA AML survival results between pediatric and adult settings. There were differences in the reasons for treatment failure, with correlation between higher intensity pediatric protocols and higher treatment‐related mortality (TRM) but lower relapse/progression. A substantial benefit to AYA with AML may be conferred by careful risk stratification and enhanced supportive care, resulting in allocation of maximal treatment intensity to cases who most benefit while reducing the risk of TRM. LOC was not predictive of either EFS or OS, as seen in multivariable analyses.
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