Adolescents and young adults with acute lymphoblastic leukemia have a better outcome when treated with pediatric-inspired regimens: Systematic review and meta-analysis

2012 ◽  
Vol 87 (5) ◽  
pp. 472-478 ◽  
Author(s):  
Ron Ram ◽  
Ofir Wolach ◽  
Liat Vidal ◽  
Anat Gafter-Gvili ◽  
Ofer Shpilberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Young Adults ◽  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Meta Analysis ◽  
Adolescents And Young Adults

Adolescents and Young Adults with Acute Lymphoblastic Leukemia Have Better Outcomes When Treated with Pediatric-Inspired Regimens - Systematic Review and Meta-Analysis of Comparative Trials

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2591-2591
Author(s):  
Ron Ram ◽  
Ofir Wolach ◽  
Liat Vidal ◽  
Anat Gafter-Gvili ◽  
Ofer Shpilberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Young Adults ◽  
Acute Lymphoblastic Leukemia ◽  
Complete Remission ◽  
Induction Chemotherapy ◽  
Remission Rate ◽  
Lymphoblastic Leukemia ◽  
Meta Analysis ◽  
All Cause Mortality ◽  
Comparative Trials

Abstract Abstract 2591 Background: Survival of adults with acute lymphoblastic leukemia (ALL) is inferior to pediatric patients. Therefore, strategies to improve long-term results in this population are warranted. Objectives: This study aims to evaluate the efficacy and safety of pediatric-inspired regimens given to adolescents and young adults (AYA) with ALL. Methods: Systematic review and meta-analysis of comparative trials of AYA patients with ALL given induction chemotherapy with either pediatric-inspired regimens or conventional adult chemotherapy was conducted. Cochrane Library, MEDLINE and conference proceedings were searched (up-to May, 2011). Outcomes assessed were: all-cause mortality, number of patients achieving complete remission after induction chemotherapy and toxicity of the regimen (evaluated by non-relapse mortality). Relative risks (RR) with 95% confidence intervals (CIs) were estimated and pooled. Results: Our search yielded 11 trials, including 2489 patients. The age of AYA patients ranged between 10 and 57 years. Studies were published between the years 2003 and 2009. AYA patients given pediatric-inspired regimens had a statistically significant lower all cause mortality at 3 years (RR 0.58; 95% CI 0.51–0.79, 7 trials) beyond 3 years (RR 0.58; 95% CI 0.51–0.65, 8 trials) and at the end of study period (RR 0.59; 95% CI 0.52–0.66, 9 trials, Figure). Sensitivity analysis for all cause mortality including studies in which the two cohorts were well compared in either age or disease risk also showed decreased all cause mortality in patients given pediatric-inspired regimen (RR 0.53; 95% CI 0.41–0.70, I2=50%, 4 trials). However, this superiority in survival for pediatric-inspired regimens was not maintained when studies including only patients older than 20 years were analyzed (RR 0.49; 95% CI 0.23–1.06, I2=67%, 2 trials). Complete remission rate after induction chemotherapy was superior in patients given pediatric-inspired regimens when compared to patients given conventional adult chemotherapy (RR 1.05; 95% CI 1.01–1.10, I2=55%, 7 trials) with comparable non-relapse mortality in both groups (RR 0.53; 95% CI 0.19–1.48, I2=56%, 4 trials). Conclusions: For patients up to the age of 20 years, pediatric-inspired regimens are superior to conventional adult chemotherapy in terms of ACM and complete remission rate with similar non relapse mortality. Randomized controlled trials to further investigate the feasibility of this approach in adult ALL patients are warranted. Disclosures: No relevant conflicts of interest to declare.

Quality of life in adolescents and young adults with CHD is not reduced: a systematic review and meta-analysis

2015 ◽  
Vol 26 (3) ◽  
pp. 415-425 ◽  
Author(s):  
Morten Schrøder ◽  
Kirsten A. Boisen ◽  
Jesper Reimers ◽  
Grete Teilmann ◽  
Jesper Brok
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Young Adults ◽  
Meta Analysis ◽  
Adolescents And Young Adults ◽  
Analysis Model ◽  
Significant Difference ◽  
Newcastle Ottawa Scale ◽  
First Time

AbstractPurposeWe performed a systematic review and meta-analysis of observational studies assessing quality of life in adolescents and young adults born with CHD compared with age-matched controls.MethodsWe carried out a systematic search of the literature published in Medline, Embase, PsychINFO, and the Cochrane Library’s Database (1990–2013); two authors independently extracted data from the included studies. We used the Newcastle–Ottawa scale for quality assessment of studies. A random effects meta-analysis model was used. Heterogeneity was assessed using the I2-test.ResultsWe included 18 studies with 1786 patients. The studies were of acceptable-to-good quality. The meta-analysis of six studies on quality of life showed no significant difference – mean difference: −1.31; 95% confidence intervals: −6.51 to +3.89, I2=90.9% – between adolescents and young adults with CHD and controls. Similar results were found in 10 studies not eligible for the meta-analysis. In subdomains, it seems that patients had reduced physical quality of life; however, social functioning was comparable or better compared with controls.ConclusionFor the first time in a meta-analysis, we have shown that quality of life in adolescents and young adults with CHD is not reduced when compared with age-matched controls.

Endothelial dysfunction and thromboembolism in children, adolescents, and young adults with acute lymphoblastic leukemia

Leukemia ◽  
2021 ◽  
Author(s):  
Liv Andrés-Jensen ◽  
Kathrine Grell ◽  
Cecilie Utke Rank ◽  
Birgitte Klug Albertsen ◽  
Ruta Tuckuviene ◽  
...  
Keyword(s):  
Young Adults ◽  
Acute Lymphoblastic Leukemia ◽  
Endothelial Dysfunction ◽  
Lymphoblastic Leukemia ◽  
Adolescents And Young Adults

scholarly journals Examining the Association and Directionality between Mental Health Disorders and Substance Use among Adolescents and Young Adults in the U.S. and Canada—A Systematic Review and Meta-Analysis

2018 ◽  
Vol 7 (12) ◽  
pp. 543 ◽  
Author(s):  
Sarvenaz Esmaeelzadeh ◽  
John Moraros ◽  
Lilian Thorpe ◽  
Yelena Bird
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Substance Use ◽  
Young Adults ◽  
Meta Analysis ◽  
Mental Health Disorders ◽  
Adolescents And Young Adults ◽  
Health Disorders ◽  
The U.S

Background: The purpose of this systematic review was to examine the association and directionality between mental health disorders and substance use among adolescents and young adults in the U.S. and Canada. Methods: The following databases were used: Medline, PubMed, Embase, PsycINFO, and Cochrane Library. Meta-analysis used odds ratios as the pooled measure of effect. Results: A total of 3656 studies were screened and 36 were selected. Pooled results showed a positive association between depression and use of alcohol (odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.24–1.83), cannabis (OR = 1.29, 95% CI: 1.10–1.51), and tobacco (OR = 1.65, 95% CI: 1.43–1.92). Significant associations were also found between anxiety and use of alcohol (OR = 1.54, 95% CI: 1.19–2.00), cannabis (OR = 1.36, 95% CI: 1.02–1.81), and tobacco (OR = 2.21, 95% CI: 1.54–3.17). A bidirectional relationship was observed with tobacco use at baseline leading to depression at follow-up (OR = 1.87, CI = 1.23–2.85) and depression at baseline leading to tobacco use at follow-up (OR = 1.22, CI = 1.09–1.37). A unidirectional relationship was also observed with cannabis use leading to depression (OR = 1.33, CI = 1.19–1.49). Conclusion: This study offers insights into the association and directionality between mental health disorders and substance use among adolescents and young adults. Our findings can help guide key stakeholders in making recommendations for interventions, policy and programming.

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