Outcomes of patients older than 60 years with acute lymphoblastic leukemia: Survey from the Surveillance, Epidemiology, and End Results (SEER) program.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6532-6532
Author(s):  
Jae Hong Park ◽  
Sean Devlin ◽  
Martin S. Tallman ◽  
Dan Douer
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Survival Rates ◽  
Early Death ◽  
Cancer Registries ◽  
Population Based ◽  
Time Period ◽  
Outcome Information ◽  
Actuarial Methods ◽  
Poor Tolerance

6532 Background: The cure rate of pediatric acute lymphoblastic leukemia (ALL) has increased over the last 4 decades to above 80%, compared to a much smaller improvement in adults aged < 60 years. However, outcome information on older ALL patients (age ≥ 60 years) is limited. Only a few clinical trials include the older patients, apply the same regimens developed for adults of all ages, and report a very poor outcome with no improvement over time. We therefore conducted a population-based survey of older ALL patients focusing on early death (ED) rates and changes in outcome over the last 30 years. Methods: Data from 9 population-based cancer registries that participate in the National Cancer Institute’s SEERprogram were used to identify patients aged 60 or older with a diagnosis of ALL. Survival rates at 1, 6, 12 and 24 months were estimated using actuarial methods for 4 calendar periods: 1980-1985, 1986-1992, 1993-1999, and 2000-2006. ED was defined as death occurring within one month of ALL diagnosis. Results: A total of 1066 ALL patients were identified. The ED rate significantly improved over the four study time periods from 20.2% in 1980-1985 to 13.2% in 2000-2006 (p=0.03). The overall survival (OS) at 6 months improved from 32.8% in 1980-1985 to 45.3% in 2000-2006, but at 24 months, only a modest difference in OS was noted across the time period (13.1% in 1980-85 vs. 17.5% in 2000-06). The median survival increased from 3 months to 6 months from the period 1980-1999 to 2000-2006. Conclusions: Although the long-term OS for patients aged 60 and over remains poor, there has been a slight improvement in early mortality and median OS from 1980s to the early 21st century. While the progress in reducing ED and increasing survival at 6 months is encouraging, and may be reflecting better supportive care measures, the limited improvement indicates poor tolerance and lack of efficacy of the toxic, long and complex chemotherapy regimens designed for younger adults. Therefore, future studies should be designed specifically for older ALL patients, focusing on novel, effective, but less toxic therapies, to further improve the short-term OS seen in the past decades and possibly a better overall outcome.

scholarly journals Improved Survival for Children and Adolescents With Acute Lymphoblastic Leukemia Between 1990 and 2005: A Report From the Children's Oncology Group

2012 ◽  
Vol 30 (14) ◽  
pp. 1663-1669 ◽  
Author(s):  
Stephen P. Hunger ◽  
Xiaomin Lu ◽  
Meenakshi Devidas ◽  
Bruce M. Camitta ◽  
Paul S. Gaynon ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Acute Lymphoblastic Leukemia ◽  
High Risk ◽  
Children And Adolescents ◽  
Lymphoblastic Leukemia ◽  
Survival Rates ◽  
Population Based ◽  
Oncology Group ◽  
Clinical Covariates ◽  
The Impact

Purpose To examine population-based improvements in survival and the impact of clinical covariates on outcome among children and adolescents with acute lymphoblastic leukemia (ALL) enrolled onto Children's Oncology Group (COG) clinical trials between 1990 and 2005. Patients and Methods In total, 21,626 persons age 0 to 22 years were enrolled onto COG ALL clinical trials from 1990 to 2005, representing 55.8% of ALL cases estimated to occur among US persons younger than age 20 years during this period. This period was divided into three eras (1990-1994, 1995-1999, and 2000-2005) that included similar patient numbers to examine changes in 5- and 10-year survival over time and the relationship of those changes in survival to clinical covariates, with additional analyses of cause of death. Results Five-year survival rates increased from 83.7% in 1990-1994 to 90.4% in 2000-2005 (P < .001). Survival improved significantly in all subgroups (except for infants age ≤ 1 year), including males and females; those age 1 to 9 years, 10+ years, or 15+ years; in whites, blacks, and other races; in Hispanics, non-Hispanics, and patients of unknown ethnicity; in those with B-cell or T-cell immunophenotype; and in those with National Cancer Institute (NCI) standard- or high-risk clinical features. Survival rates for infants changed little, but death following relapse/disease progression decreased and death related to toxicity increased. Conclusion This study documents ongoing survival improvements for children and adolescents with ALL. Thirty-six percent of deaths occurred among children with NCI standard-risk features emphasizing that efforts to further improve survival must be directed at both high-risk subsets and at those children predicted to have an excellent chance for cure.

scholarly journals Advances in the Diagnosis and Treatment of Pediatric Acute Lymphoblastic Leukemia

2021 ◽  
Vol 10 (9) ◽  
pp. 1926
Author(s):  
Hiroto Inaba ◽  
Ching-Hon Pui
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Detailed Analysis ◽  
Residual Disease ◽  
Lymphoblastic Leukemia ◽  
Survival Rates ◽  
Treatment Strategies ◽  
Chemotherapeutic Agents ◽  
Response To Treatment ◽  
Pediatric Acute Lymphoblastic Leukemia ◽  
Therapeutic Implications

The outcomes of pediatric acute lymphoblastic leukemia (ALL) have improved remarkably during the last five decades. Such improvements were made possible by the incorporation of new diagnostic technologies, the effective administration of conventional chemotherapeutic agents, and the provision of better supportive care. With the 5-year survival rates now exceeding 90% in high-income countries, the goal for the next decade is to improve survival further toward 100% and to minimize treatment-related adverse effects. Based on genome-wide analyses, especially RNA-sequencing analyses, ALL can be classified into more than 20 B-lineage subtypes and more than 10 T-lineage subtypes with prognostic and therapeutic implications. Response to treatment is another critical prognostic factor, and detailed analysis of minimal residual disease can detect levels as low as one ALL cell among 1 million total cells. Such detailed analysis can facilitate the rational use of molecular targeted therapy and immunotherapy, which have emerged as new treatment strategies that can replace or reduce the use of conventional chemotherapy.

scholarly journals Secondary Solid Organ Neoplasm in Patients with Acute Lymphoblastic Leukemia: A Nationwide Population-Based Study in Taiwan

PLoS ONE ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. e0152909
Author(s):  
Chung-Jen Teng ◽  
Leh-Kiong Huon ◽  
Yu-Wen Hu ◽  
Chiu-Mei Yeh ◽  
Sheng-Hsuan Chien ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Population Based ◽  
Solid Organ ◽  
Population Based Study

No Advantage of Dexamethasone Over Prednisolone for the Outcome of Standard- and Intermediate-Risk Childhood Acute Lymphoblastic Leukemia in the Tokyo Children's Cancer Study Group L95-14 Protocol

2005 ◽  
Vol 23 (27) ◽  
pp. 6489-6498 ◽  
Author(s):  
Shunji Igarashi ◽  
Atsushi Manabe ◽  
Akira Ohara ◽  
Masaaki Kumagai ◽  
Tomohiro Saito ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Controlled Trial ◽  
Survival Rates ◽  
Maintenance Phase ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Intermediate Risk ◽  
Free Survival ◽  
Prospective Randomized Controlled Trial ◽  
Standard Risk

Purpose To evaluate whether dexamethasone (DEXA) yields a better outcome than prednisolone (PRED) in a prospective, randomized, controlled trial for the treatment of childhood acute lymphoblastic leukemia (ALL). Patients and Methods Two hundred thirty-one standard-risk (SR) patients and 128 intermediate-risk (IR) non–B-cell ALL patients were registered from March 1995 to March 1999. After random assignment in each group, the PRED arm patients received PRED 60 mg/m2 during induction followed by PRED 40 mg/m2 over four intensifications in the SR group and three intensifications in the IR group. DEXA arm patients received DEXA 8 mg/m2 during induction and DEXA 6 mg/m2 during the intensifications. The maintenance phase was continued until week 104. Results Event-free survival rates at 8 years in the DEXA and PRED arms were 81.1% ± 3.9% (n = 117) and 84.4% ± 5.2% (n = 114), respectively, in the SR group (P = .217) and 84.9% ± 4.6% (n = 62) and 80.4% ± 5.1% (n = 66), respectively, in the IR group (P = .625). The primary reason for treatment failure was marrow relapse. Only two extramedullary relapses occurred in the DEXA arm compared with seven relapses in the PRED arm. Although complications were more prevalent in the DEXA arm than in the PRED arm, fatal toxicity was rare both groups. Conclusion DEXA administered at 8 mg/m2 during induction and 6 mg/m2 during intensification showed no advantage over PRED administered at 60 mg/m2 during induction and 40 mg/m2 during intensification in both the SR and IR groups.

An analysis of the incidence and survival rates of bone sarcoma patients in thailand: reports from population-based cancer registries 2001–2015

2022 ◽  
Vol 76 ◽  
pp. 102056
Author(s):  
Jeerawan Klangjorhor ◽  
Donsuk Pongnikorn ◽  
Areerak Phanphaisarn ◽  
Parunya Chaiyawat ◽  
Pimpisa Teeyakasem ◽  
...  
Keyword(s):  
Survival Rates ◽  
Bone Sarcoma ◽  
Cancer Registries ◽  
Population Based

scholarly journals Approach to the Adult Acute Lymphoblastic Leukemia Patient

2019 ◽  
Vol 8 (8) ◽  
pp. 1175 ◽  
Author(s):  
Valentina Sas ◽  
Vlad Moisoiu ◽  
Patric Teodorescu ◽  
Sebastian Tranca ◽  
Laura Pop ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Molecular Mechanisms ◽  
High Throughput Sequencing ◽  
Kinase Inhibitors ◽  
Lymphoblastic Leukemia ◽  
Survival Rates ◽  
High Risk Patient ◽  
Late Relapse ◽  
Published Data ◽  
Hematopoietic Stem

During recent decades, understanding of the molecular mechanisms of acute lymphoblastic leukemia (ALL) has improved considerably, resulting in better risk stratification of patients and increased survival rates. Age, white blood cell count (WBC), and specific genetic abnormalities are the most important factors that define risk groups for ALL. State-of-the-art diagnosis of ALL requires cytological and cytogenetical analyses, as well as flow cytometry and high-throughput sequencing assays. An important aspect in the diagnostic characterization of patients with ALL is the identification of the Philadelphia (Ph) chromosome, which warrants the addition of tyrosine kinase inhibitors (TKI) to the chemotherapy backbone. Data that support the benefit of hematopoietic stem cell transplantation (HSCT) in high risk patient subsets or in late relapse patients are still questioned and have yet to be determined conclusive. This article presents the newly published data in ALL workup and treatment, putting it into perspective for the attending physician in hematology and oncology.

scholarly journals Methionine synthase A2756G polymorphism influences pediatric acute lymphoblastic leukemia risk: a meta-analysis

2019 ◽  
Vol 39 (1) ◽  
Author(s):  
Li-Min Ma ◽  
Hai-Ping Yang ◽  
Xue-Wen Yang ◽  
Lin-Hai Ruan
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Large Scale ◽  
Lymphoblastic Leukemia ◽  
Meta Analysis ◽  
Population Based ◽  
Methionine Synthase ◽  
China National Knowledge Infrastructure ◽  
Pediatric Acute Lymphoblastic Leukemia ◽  
Pediatric All ◽  
And Control

Abstract Plenty of studies have investigated the effect of methionine synthase (MTR) A2756G polymorphism on risk of developing pediatric acute lymphoblastic leukemia (ALL), but the available results were inconsistent. Therefore, a meta-analysis was conducted to derive a more precise estimation of the association between MTR A2756G polymorphism and genetic susceptibility to pediatric ALL. The PubMed, Embase, Google Scholar, Web of Science, ScienceDirect, Wanfang Databases and China National Knowledge Infrastructure were systematically searched to identify all the previous published studies exploring the relationship between MTR A2756G polymorphism and pediatric ALL risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were applied to evaluate the strength of association. Sensitivity analysis and publication bias were also systematically assessed. This meta-analysis finally included ten available studies with 3224 ALL cases and 4077 matched controls. The results showed that there was significant association between MTR A2756G polymorphism and risk of pediatric ALL in overall population (AG vs. AA: OR = 1.13, 95%CI = 1.02–1.26, P = 0.02; AG+GG vs. AA: OR = 1.13, 95%CI = 1.02–1.25, P = 0.01; G allele vs. A allele: OR = 1.10, 95%CI = 1.01–1.20, P = 0.03). In the stratification analyses by ethnicity, quality score and control source, significant association was found in Caucasians, population-based designed studies and studies assigned as high quality. In conclusion, this meta-analysis suggests that MTR A2756G polymorphism may influence the development risk of pediatric ALL in Caucasians. Future large scale and well-designed studies are required to validate our findings.

scholarly journals Expression Patterns of Coagulation Factor XIII Subunit A on Leukemic Lymphoblasts Correlate with Clinical Outcome and Genetic Subtypes in Childhood B-cell Progenitor Acute Lymphoblastic Leukemia

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2264
Author(s):  
Bettina Kárai ◽  
Katalin Gyurina ◽  
Anikó Ujfalusi ◽  
Łukasz Sędek ◽  
Gábor Barna ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Acute Lymphoblastic Leukemia ◽  
B Cell ◽  
Genetic Risk ◽  
Lymphoblastic Leukemia ◽  
Expression Patterns ◽  
Survival Rates ◽  
Coagulation Factor ◽  
Genetic Alterations ◽  
Subunit A

Background: Based on previous retrospective results, we investigated the association of coagulation FXIII subunit A (FXIII-A) expression pattern on survival and correlations with known prognostic factors of B-cell progenitor (BCP) childhood acute lymphoblastic leukemia (ALL) as a pilot study of the prospective multi-center BFM ALL-IC 2009 clinical trial. Methods: The study included four national centers (n = 408). Immunophenotyping by flow cytometry and cytogenetic analysis were performed by standard methods. Copy number alteration was studied in a subset of patients (n = 59). Survival rates were estimated by Kaplan-Meier analysis. Correlations between FXIII-A expression patterns and risk factors were investigated with Cox and logistic regression models. Results: Three different patterns of FXIII-A expression were observed: negative (<20%), dim (20–79%), and bright (≥80%). The FXIII-A dim expression group had significantly higher 5-year event-free survival (EFS) (93%) than the FXIII-A negative (70%) and FXIII-A bright (61%) groups. Distribution of intermediate genetic risk categories and the “B-other” genetic subgroup differed significantly between the FXIII-A positive and negative groups. Multivariate logistic regression confirmed independent association between the FXIII-A negative expression characteristics and the prevalence of intermediate genetic risk group. Conclusions: FXIII-A negativity is associated with dismal survival in children with BCP-ALL and is an indicator for the presence of unfavorable genetic alterations.

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