scholarly journals Biologic and clinical characteristics of adolescent and young adult cancers: Acute lymphoblastic leukemia, colorectal cancer, breast cancer, melanoma, and sarcoma

Cancer ◽  
2016 ◽  
Vol 122 (7) ◽  
pp. 1017-1028 ◽  
Author(s):  
James V. Tricoli ◽  
Donald G. Blair ◽  
Carey K. Anders ◽  
W. Archie Bleyer ◽  
Lisa A. Boardman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Acute Lymphoblastic Leukemia ◽  
Young Adult ◽  
Clinical Characteristics ◽  
Lymphoblastic Leukemia ◽  
Adolescent And Young Adult ◽  
Cancer Breast

scholarly journals Late Effects in Survivors of Adolescent and Young Adult Acute Lymphoblastic Leukemia

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Lori Muffly ◽  
Frances B Maguire ◽  
Qian Li ◽  
Vanessa Kennedy ◽  
Theresa H Keegan
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Young Adult ◽  
Late Effects ◽  
Hematopoietic Cell Transplantation ◽  
Lymphoblastic Leukemia ◽  
Large Population ◽  
Population Based ◽  
Adolescent And Young Adult ◽  
Second Neoplasms ◽  
Multivariable Analyses

Abstract Background Knowledge regarding late effects (medical conditions and subsequent neoplasms) in survivors of adolescent and young adult (AYA) acute lymphoblastic leukemia (ALL) is lacking. Methods Using the population-based California Cancer Registry linked with California hospitalization data, we evaluated late effects in 1069 AYAs (aged 15–39 years) diagnosed with ALL in California between 1995 and 2012 and surviving a minimum of 3 years from diagnosis. Results The estimated 10-year cumulative incidence of subsequent endocrine disease (28.7%, 95% confidence interval [CI] = 25.8% to 31.6%) and cardiac disease (17.0%, 95% CI = 14.6% to 19.5%) were strikingly high; avascular necrosis (9.6%, 95% CI = 7.8% to 11.6%), liver disease (6.5%, 95% CI = 5.0% to 8.3%), respiratory disease (6.2%, 95% CI = 4.8% to 8.0%), seizure and/or stroke (4.3%, 95% CI = 3.1% to 5.8%), renal disease (3.1%, 95% CI = 2.1% to 4.4%), and second neoplasms (1.4%, 95% CI = 0.7% to 2.4%) were estimated to occur at 10 years with the reported frequencies. Multivariable analyses including the entire patient cohort demonstrated that public or no insurance (vs private and/or military insurance) and receipt of hematopoietic cell transplantation were independently associated with the occurrence of all late effects considered. In multivariable analyses limited to the 766 AYAs who were not transplanted, we continued to find a statistically significant association between public and no insurance and the occurrence of all late effects. Frontline regimen type (pediatric vs adult) was not statistically significantly associated with any of the late effect categories. Conclusions This large population-based analysis is among the first to describe late effects in survivors of AYA ALL. The strong association between insurance type and late effects suggests that AYAs with public or no insurance may have reduced access to survivorship care following completion of ALL therapy.

scholarly journals Survival outcomes of a population-based cohort of adolescent and young adult (AYA), acute lymphoblastic leukemia (ALL) patients in Ontario, Canada: The IMPACT Cohort

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Cindy Lau ◽  
Jason Pole ◽  
Rinku Sutradhar ◽  
Nancy Baxter ◽  
Paul Nathan ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Lymphoblastic Leukemia ◽  
Young Adult ◽  
Lymphoblastic Leukemia ◽  
Population Based ◽  
Adolescent And Young Adult ◽  
Survival Outcomes ◽  
Event Free Survival ◽  
Free Survival ◽  
The Impact

IntroductionAdolescents and young adults (AYA) are an understudied population in cancer research. The Initiative to Maximize Progress in Adolescent and Young Adult Cancer Therapy (IMPACT) cohort includes Ontario individuals aged 15-21 years, diagnosed with a malignancy during 1992-2011. This cohort contains a rich source of patient, disease, and treatment data. Objectives and ApproachThe IMPACT cohort was created using chart review and linkages to population-based health services databases. The cohort is comprised of AYA with a primary diagnosis of acute leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, sarcoma, or testicular cancer. For the current study, we focused on acute lymphoblastic leukemia (ALL) patients, and examined survival outcomes of those treated at pediatric vs adult centers, with adult vs pediatric protocols. We assessed 5-year event-free survival (first of relapse, progression, secondary malignant neoplasm, or death) and overall survival. ResultsThe IMPACT cohort contains 2,963 patients, of which 152/271 ALL patients were treated at adult centers. The 5-year event-free survival (EFS ± standard error) among those treated at a pediatric vs. adult center was 72%±4% vs. 56%±4% (p = 0.03), respectively. The 5-year overall survival (OS) was 82%±4% vs. 64%±4% (p Conclusion/ImplicationsALL patients treated with a pediatric protocol at a pediatric center experienced better, crude survival outcomes compared to those at an adult center. The IMPACT cohort offers the opportunity to study a myriad of questions on different cancer groups, with the ultimate goal of improving outcomes among the AYA population.

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