Outcomes of adolescents with acute lymphoblastic leukaemia.

Autor:	Feng J; Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong.; Department of Paediatrics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, PR China., Cheng FWT; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong., Chiang AKS; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong.; Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong.; Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong., Lam GKS; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong., Chow TTW; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong., Ha SY; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong.; Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong., Luk CW; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong.; Department of Paediatrics and Adolescent Medicine, Queen Elizabeth Hospital, Hong Kong., Li CH; Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong., Ling SC; Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong., Yau PW; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong.; Department of Paediatrics and Adolescent Medicine, Queen Elizabeth Hospital, Hong Kong., Ho KKH; Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong., Leung AWK; Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong.; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong.; Department of Paediatrics, Prince of Wales Hospital, Hong Kong., Chan NPH; Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong., Ng MHL; Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong., Li CK; Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong.; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong.; Hong Kong Hub of Paediatrics Excellence, The Chinese University of Hong Kong, Hong Kong.
Jazyk:	angličtina
Zdroj:	Hong Kong medical journal = Xianggang yi xue za zhi [Hong Kong Med J] 2022 Jun; Vol. 28 (3), pp. 204-214. Date of Electronic Publication: 2022 Jun 14.
DOI:	10.12809/hkmj208914
Abstrakt:	Introduction: Compared with young children who have acute lymphoblastic leukaemia (ALL), adolescents with ALL have unfavourable disease profiles and worse survival. However, limited data are available regarding the characteristics and outcomes of adolescents with ALL who underwent treatment in clinical trials. The aim of this study was to investigate the causes of treatment failure in adolescents with ALL. Methods: We retrospectively analysed the outcomes of 711 children with ALL, aged 1-18 years, who were enrolled in five clinical trials of paediatric ALL treatment between 1993 and 2015. Results: Among the 711 children with ALL, 530 were young children (1-9 years at diagnosis) and 181 were adolescents (including 136 younger adolescents [10-14 years] and 45 older adolescents [15-18 years]). Compared with young children who had ALL, adolescents with ALL were less likely to have favourable genetic features and more likely to demonstrate poor early response to treatment. The 10-year overall survival and event-free survival rates were significantly lower among adolescents than among young children (77.9% vs 87.6%, P=0.0003; 69.7% vs 76.5%, P=0.0117). There were no significant differences in the 10-year cumulative incidence of relapse, but the 10-year cumulative incidence of treatment-related death (TRD) was significantly greater among adolescents (7.2%) than among young children (2.3%; P=0.002). Multivariable analysis showed that both younger and older adolescents (vs young children) had worse survival and greater incidence of TRD. Conclusion: Adolescents with ALL had worse survival because they experienced a greater incidence of TRD. There is a need to investigate optimal treatment adjustments and novel targeted agents to achieve better survival rates (without excessive toxicity) among adolescents with ALL. Competing Interests: All authors have disclosed no conflicts of interest.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu