[Acute lymphoblastic leukaemia in Danish children and young people 10 to 19 years of age. Should young adults with acute lymphoblastic leukaemia be treated in the same way as children?]

Abstract

Introduction: Data seem to indicate that young adults with acute lymphoblastic leukemia (ALL) have a better survival rate when treated with paediatric protocols than with adult ALL protocols. The purpose of this study was to report the clinical characteristics and outcome of all children and young adults 10-19 years of age diagnosed with ALL in Denmark between 1992 and 2001.

Materials and methods: The study included 99 patients 10-19 years of age with ALL in Denmark during a 10-year period found in the complete NOPHO (Nordic Society of Pediatric Hematology and Oncology) registry and through the Danish Cancer Registry and local pathology databases. Data were retrieved by reviewing patients' medical charts. 61 children (10-14 years) were treated on paediatric protocols, and 38 young adults (15-19 years) were diagnosed with ALL. Data were reported as of 1 January 2005.

Results: There were no differences between the two groups with respect to the distribution of T-ALL, CNS leukemia, total WBC and high-risk chromosomal abnormalities. There was a statistically significant lower event-free survival rate (EFS) (p < 0.01) and lower overall survival rate (p < 0.01) in young adults than in 10-14-year-old children (0.38 vs. 0.60 and 0.47 vs. 0.67). There were more transplant-related deaths in the young adults. The higher treatment intensity in children may be an explanatory factor. Children were given more prednisone, vincristine and high-dose methotrexate than were the young adults.

Conclusion: Young adult patients with ALL might benefit from therapy with paediatric NOPHO ALL protocols.