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Burke MJ, Devidas M, Chen Z, et al. Outcomes in adolescent and young adult patients (16 to 30 years) compared to younger patients treated for high-risk B-lymphoblastic leukemia: report from Children's Oncology Group Study AALL0232. Leukemia. 2021;doi: 10.1038/s41375-021-01460-6.
Burke, M. J., Devidas, M., Chen, Z., Salzer, W. L., Raetz, E. A., Rabin, K. R., Heerema, N. A., Carroll, A. J., Gastier-Foster, J. M., Borowitz, M. J., Wood, B. L., Winick, N. J., Carroll, W. L., Hunger, S. P., Loh, M. L., & Larsen, E. C. (2021). Outcomes in adolescent and young adult patients (16 to 30 years) compared to younger patients treated for high-risk B-lymphoblastic leukemia: report from Children's Oncology Group Study AALL0232. Leukemia, . https://doi.org/10.1038/s41375-021-01460-6
Burke, Michael J, et al. "Outcomes in adolescent and young adult patients (16 to 30 years) compared to younger patients treated for high-risk B-lymphoblastic leukemia: report from Children's Oncology Group Study AALL0232." Leukemia vol. (2021). doi: https://doi.org/10.1038/s41375-021-01460-6
Burke MJ, Devidas M, Chen Z, Salzer WL, Raetz EA, Rabin KR, Heerema NA, Carroll AJ, Gastier-Foster JM, Borowitz MJ, Wood BL, Winick NJ, Carroll WL, Hunger SP, Loh ML, Larsen EC. Outcomes in adolescent and young adult patients (16 to 30 years) compared to younger patients treated for high-risk B-lymphoblastic leukemia: report from Children's Oncology Group Study AALL0232. Leukemia. 2021 Nov 01; doi: 10.1038/s41375-021-01460-6. Epub 2021 Nov 01. PMID: 34725453.
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Leukemia. 2021 Nov 01; doi: 10.1038/s41375-021-01460-6. Epub 2021 Nov 01.

Outcomes in adolescent and young adult patients (16 to 30 years) compared to younger patients treated for high-risk B-lymphoblastic leukemia: report from Children's Oncology Group Study AALL0232.

Leukemia

Michael J Burke, Meenakshi Devidas, Zhiguo Chen, Wanda L Salzer, Elizabeth A Raetz, Karen R Rabin, Nyla A Heerema, Andrew J Carroll, Julie M Gastier-Foster, Michael J Borowitz, Brent L Wood, Naomi J Winick, William L Carroll, Stephen P Hunger, Mignon L Loh, Eric C Larsen

Affiliations

  1. Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, WI, USA. [email protected].
  2. Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA.
  3. Biostatistics, Colleges of Medicine and Public Health & Health Professions, University of Florida, Gainesville, FL, USA.
  4. U.S. Army Medical Research and Materiel Command, Fort Detrick, MD, USA.
  5. Department of Pediatrics, Perlmutter Cancer Center, New York University Langone Medical Center, New York, NY, USA.
  6. Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
  7. Department of Pathology, The Ohio State University School of Medicine, Columbus, OH, USA.
  8. Department of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA.
  9. Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
  10. Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.
  11. Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
  12. Department of Pediatrics, Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
  13. Department of Pediatrics, Benioff Children's Hospital and the Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco, CA, USA.
  14. Department of Pediatrics, Maine Children's Cancer Program, Scarborough, ME, USA.

PMID: 34725453 DOI: 10.1038/s41375-021-01460-6

Abstract

Adolescent and young adult (AYA) patients 16-30 years old with high-risk acute lymphoblastic leukemia (HR-ALL) have inferior outcomes compared to younger HR-ALL patients. AALL0232 was a Phase 3 randomized Children's Oncology Group trial for newly diagnosed HR B-ALL (1-30 years). Between 2004 and 2011, 3154 patients enrolled with 3040 eligible and evaluable for induction. AYA patients comprised 20% of patients (16-21 years, n = 551; 22-30 years, n = 46). 5-year event-free survival and overall survival was 65.4 ± 2.2% and 77.4 ± 2.0% for AYA patients compared to 78.1 ± 0.9% and 87.3 ± 0.7% for younger patients (p < 0.0001). Five-year cumulative incidence of relapse was 18.5 ± 1.7% for AYA patients and 13.5 ± 0.7% for younger patients (p = 0.006), largely due to increased marrow relapses (14.0 ± 1.5% versus 9.1 ± 0.6%; p < 0.0001). Additionally, induction failure rate was higher in AYA (7.2 ± 1.1% versus 3.5 ± 0.4%; p < 0.001) and post-induction remission deaths were significantly higher in AYA (5.7 ± 1.0% versus 2.4 ± 0.3%; p < 0.0001). AALL0232 enrolled the largest number of AYA B-ALL patients to date, demonstrating significantly inferior survival and greater rates of treatment-related toxicities compared to younger patients. Although treatment intensification has improved outcomes in younger patients, they have not been associated with the same degree of improvement for older patients.

© 2021. The Author(s), under exclusive licence to Springer Nature Limited.

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