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. 2014 Jun;20(6):829-36.
doi: 10.1016/j.bbmt.2014.02.021. Epub 2014 Mar 7.

Survival improvements in adolescents and young adults after myeloablative allogeneic transplantation for acute lymphoblastic leukemia

William A Wood  1 , Stephanie J Lee  2 , Ruta Brazauskas  3 , Zhiwei Wang  4 , Mahmoud D Aljurf  5 , Karen K Ballen  6 , David K Buchbinder  7 , Jason Dehn  8 , Cesar O Freytes  9 , Hillard M Lazarus  10 , Charles F Lemaistre  11 , Paulette Mehta  12 , David Szwajcer  13 , Steven Joffe  14 , Navneet S Majhail  15
Affiliations

Survival improvements in adolescents and young adults after myeloablative allogeneic transplantation for acute lymphoblastic leukemia

William A Wood et al. Biol Blood Marrow Transplant. 2014 Jun.

Abstract

Adolescents and young adults (AYAs, ages 15 to 40 years) with cancer have not experienced survival improvements to the same extent as younger and older patients. We compared changes in survival after myeloablative allogeneic hematopoietic cell transplantation (HCT) for acute lymphoblastic leukemia (ALL) among children (n = 981), AYAs (n = 1218), and older adults (n = 469) who underwent transplantation over 3 time periods: 1990 to 1995, 1996 to 2001, and 2002 to 2007. Five-year survival varied inversely with age group. Survival improved over time in AYAs and paralleled that seen in children; however, overall survival did not change over time for older adults. Survival improvements were primarily related to lower rates of early treatment-related mortality in the most recent era. For all cohorts, relapse rates did not change over time. A subset of 222 AYAs between the ages of 15 and 25 at 46 pediatric or 49 adult centers were also analyzed to describe differences by center type. In this subgroup, there were differences in transplantation practices among pediatric and adult centers, although HCT outcomes did not differ by center type. Survival for AYAs undergoing myeloablative allogeneic HCT for ALL improved at a similar rate as survival for children.

Keywords: Adolescent and young adults; Allogeneic; Hematopoietic cell transplantation; Survival.

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Conflict of interest statement

Conflict-of-interest disclosure: The authors have no interests to disclose.

Figures

Figure 1
Figure 1
5-year adjusted overall survival probabilities for each age group over time (the lines in the box represent survival probability and the ends of the box represent 95% confidence intervals)
Figure 2
Figure 2
Outcomes for AYAs 15–25 years of age transplanted between 2002 and 2007 (A) overall survival (B) leukemia-free survival (C) treatment related mortality (D) relapse
Figure 2
Figure 2
Outcomes for AYAs 15–25 years of age transplanted between 2002 and 2007 (A) overall survival (B) leukemia-free survival (C) treatment related mortality (D) relapse
Figure 2
Figure 2
Outcomes for AYAs 15–25 years of age transplanted between 2002 and 2007 (A) overall survival (B) leukemia-free survival (C) treatment related mortality (D) relapse
Figure 2
Figure 2
Outcomes for AYAs 15–25 years of age transplanted between 2002 and 2007 (A) overall survival (B) leukemia-free survival (C) treatment related mortality (D) relapse
See this image and copyright information in PMC

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