The inferior prognosis of adolescents with acute lymphoblastic leukaemia (ALL) is caused by a higher rate of treatment‐related mortality and not an increased relapse rate – a population‐based analysis of 25 years of the Austrian ALL‐BFM (Berlin‐Frankfurt‐Münster) Study Group. (11th March 2013)

• Record Type: Journal Article
• Authors: Pichler, Herbert; Reismüller, Bettina; Steiner, Manuel; Dworzak, Michael N.; Pötschger, Ulrike; Urban, Christian; Meister, Bernhard; Schmitt, Klaus; Panzer‐Grümayer, Renate; Haas, Oskar A.; Attarbaschi, Andishe; Mann, Georg
• Is Part Of: British journal of haematology. Volume 161:Number 4(2013:May)
• Page Start: 556
• Page End: 565
• Publication Date: 2013-03-11
• Subjects: Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.12292
• Languages: English
• ISSNs: 0007-1048

Abstract

<abstract abstract-type="main" xml:lang="en" id="bjh12292-abs-0001"> <title>Summary</title> <p>Adolescents aged 15–18 years with acute lymphoblastic leukaemia (ALL) have been historically reported to have a poorer prognosis than younger children. We retrospectively analysed the characteristics and outcome of 67 adolescents included in a population‐based series of 1125 non‐infant cases that were enrolled into four Austrian ALL‐BFM (Berlin‐Frankfurt‐Münster) multicentre trials at paediatric institutions within a 25‐year period. Five‐year event‐free survival (EFS) and overall survival (OS) were 66 ± 6% and 76 ± 5% respectively, and thus lower than in younger children (83 ± 1%, 91 ± 1%; <italic>P</italic> < 0·001). This was not due to an increased cumulative incidence of relapse (CIR) (5‐year CIR: 19 ± 5% vs. 13 ± 1%; <italic>P</italic> = 0·284), but due to an increased incidence of treatment‐related death [5‐year cumulative incidence of death (CID): 15 ± 4% vs. 3 ± 0%; <italic>P</italic> < 0·001] as a first event. Furthermore, while 44/67 (66%) non‐high‐risk adolescents had favourable 5‐year EFS and OS rates (76 ± 7%, 89 ± 5%), 18/67 (27%) high‐risk adolescents had an inferior outcome (5‐year EFS: 56 ± 12%, OS 61 ± 11%, <italic>P</italic> < 0·05). Among the latter patients the CID was significantly higher than in younger high‐risk children (22 ± 10% vs. 6 ± 2%; <italic>P</italic> = 0·020). Given that adolescent age is an independent risk factor for death as a first event, this specific age group may need particular vigilance when receiving intense BFM‐type chemotherapy, as relapse‐free survival is similar to younger children.</p> </abstract>