23 May 2022

Survivors of leukaemia in adolescence or young adulthood (AYA) have an increased mortality risk for several decades after diagnosis compared to the general population, according to a new analysis.

A team led by Dr Michael Roth at the University of Texas MD Anderson Cancer Center, USA, used a cancer registry to analyse long-term outcomes among those who lived for more than five years after treatment for acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia (AML).

The analysis involved 1,938 participants with ALL and 2,350 with AML, followed up for a median duration of around 12 years.

Ten-year survival rates were 87% for AYA diagnosed with ALL, and 89% for those diagnosed with AML. However, survival “remained below that of the age-adjusted general population at up to 30 years of follow-up”, write the researchers in Cancer Epidemiology Biomarkers & Prevention.

Relapse was the most common cause of death up to around 15 years post-diagnosis, but non-cancer causes of death became more prevalent in later decades of follow-up. The authors add that among AML survivors, men had significantly worse survival than women.

They report: “While there have been improvements in late mortality, long-term survival for adolescent and young adult leukaemia survivors remains below that of the general population.

“Studies investigating risk factors for mortality and disparities in late effects among long-term adolescent and young adult leukaemia survivors are needed."

Dr Roth said: “We need to think about the long-term life span and the quality of life for our patients. Cure is not enough for our adolescent and young adult cancer survivors.

“Once these patients reach the survivorship stage of their journey, they may encounter additional side effects as a result of intensive treatment, lack of access to quality health care, and other issues that may negatively impact their health and overall survival.”

Source: Berkman AM, Andersen CR, Cuglievan B, McCall DC, Lupo PJ, Parsons SK, DiNardo CD, Short NJ, Jain N, Kadia TM, Livingston JA, Roth ME. (2022) “Long-Term Outcomes among Adolescent and Young Adult Survivors of Acute Leukemia: A Surveillance, Epidemiology, and End Results Analysis.” Cancer Epidemiology Biomarkers & Prevention, doi: 10.1158/1055-9965.EPI-21-1388

Link: https://aacrjournals.org/cebp/article/doi/10.1158/1055-9965.EPI-21-1388/698868/Long-Term-Outcomes-among-Adolescent-and-Young

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