Treatment and Survival in Acute Leukemia: A New South Wales Study Comparing Adolescents and Young Adults with Children and Adults

Li, M; Anazodo, A; Dalla-Pozza, L; Baeza, PK; Roder, D; Currow, D

Treatment and Survival in Acute Leukemia: A New South Wales Study Comparing Adolescents and Young Adults with Children and Adults

Li, M Anazodo, A Dalla-Pozza, L Baeza, PK Roder, D Currow, D

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Publisher:: Hindawi
Publication Type:: Journal Article
Citation:: European Journal of Cancer Care, 2023, 2023, pp. 1-12
Issue Date:: 2023-01-01

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Field	Value	Language
dc.contributor.author	Li, M
dc.contributor.author	Anazodo, A
dc.contributor.author	Dalla-Pozza, L
dc.contributor.author	Baeza, PK
dc.contributor.author	Roder, D
dc.contributor.author	Currow, D https://orcid.org/0000-0003-1988-1250
dc.contributor.editor	Batra, L
dc.date.accessioned	2023-09-21T04:45:42Z
dc.date.available	2023-09-21T04:45:42Z
dc.date.issued	2023-01-01
dc.identifier.citation	European Journal of Cancer Care, 2023, 2023, pp. 1-12
dc.identifier.issn	0961-5423
dc.identifier.issn	1365-2354
dc.identifier.uri	http://hdl.handle.net/10453/172235
dc.description.abstract	Objective. To investigate age differences in treatment and survival from acute lymphoblastic (ALL) and acute myeloid leukemia (AML). Methods. 1053 ALL/566 AML patients diagnosed in 2003-2015 on the New South Wales Cancer Registry were included. Treatment within 12 months from diagnosis was assessed using linked registry, hospital, and health-insurance data. Differences by age at diagnosis in treatment and survival were investigated using socio-demographically adjusted regression analyses, with adolescents and young adults (AYA, 15-24 years) as the reference category. Results. Children were less likely than AYA to start ALL treatment >3 days from diagnosis (adjusted odds ratio (aOR 0.39, 95% CI 0.27-0.57)) and to have multiple treatment types (aOR 0.22, 95% CI 0.14-0.34). For AML, aOR of treatment start >3 days was 0.16 (95% CI 0.09-0.29) for children compared with AYA, with no age differences in treatment types. Five-year disease-specific survival for ALL was 84%. Children were less likely than AYA to die from ALL (adjusted subhazard ratio (aSHR 0.32, 95% CI 0.22-0.50)). For AML, the corresponding survival was 73% without an age difference. Children having multiple treatment types for ALL had an increased risk of mortality at aSHR 2.67 (95% CI 1.53-4.67), but not adults at 1.26 (95% CI 0.67-2.47) (interaction p = 0.017). Time from diagnosis to initial treatment start and initial treatment type were not associated with mortality outcomes after adjusting for socio-demographic variables. Conclusion. Children with ALL had better survival. ALL Mortality were negatively associated with multiple treatment types.
dc.language	en
dc.publisher	Hindawi
dc.relation.ispartof	European Journal of Cancer Care
dc.relation.isbasedon	10.1155/2023/8600327
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1110 Nursing, 1112 Oncology and Carcinogenesis, 1117 Public Health and Health Services
dc.subject.classification	Oncology & Carcinogenesis
dc.subject.classification	3211 Oncology and carcinogenesis
dc.subject.classification	4205 Nursing
dc.title	Treatment and Survival in Acute Leukemia: A New South Wales Study Comparing Adolescents and Young Adults with Children and Adults
dc.type	Journal Article
utslib.citation.volume	2023
utslib.for	1110 Nursing
utslib.for	1112 Oncology and Carcinogenesis
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	open_access	*
dc.date.updated	2023-09-21T04:45:41Z
pubs.publication-status	Published
pubs.volume	2023

Abstract:

Objective. To investigate age differences in treatment and survival from acute lymphoblastic (ALL) and acute myeloid leukemia (AML). Methods. 1053 ALL/566 AML patients diagnosed in 2003-2015 on the New South Wales Cancer Registry were included. Treatment within 12 months from diagnosis was assessed using linked registry, hospital, and health-insurance data. Differences by age at diagnosis in treatment and survival were investigated using socio-demographically adjusted regression analyses, with adolescents and young adults (AYA, 15-24 years) as the reference category. Results. Children were less likely than AYA to start ALL treatment >3 days from diagnosis (adjusted odds ratio (aOR 0.39, 95% CI 0.27-0.57)) and to have multiple treatment types (aOR 0.22, 95% CI 0.14-0.34). For AML, aOR of treatment start >3 days was 0.16 (95% CI 0.09-0.29) for children compared with AYA, with no age differences in treatment types. Five-year disease-specific survival for ALL was 84%. Children were less likely than AYA to die from ALL (adjusted subhazard ratio (aSHR 0.32, 95% CI 0.22-0.50)). For AML, the corresponding survival was 73% without an age difference. Children having multiple treatment types for ALL had an increased risk of mortality at aSHR 2.67 (95% CI 1.53-4.67), but not adults at 1.26 (95% CI 0.67-2.47) (interaction p = 0.017). Time from diagnosis to initial treatment start and initial treatment type were not associated with mortality outcomes after adjusting for socio-demographic variables. Conclusion. Children with ALL had better survival. ALL Mortality were negatively associated with multiple treatment types.

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http://hdl.handle.net/10453/172235