Survival of European children, adolescents and young adults diagnosed with haematological malignancies in the period 2000-2013: Results from EUROCARE-6, a population-based study.

in European journal of cancer (Oxford, England : 1990) by A Trama, E E Geerdes, E Demuru, R De Angelis, H E Karim-Kos, X Troussard, D Bennett, R Marcos-Gragera, C E Kuehni, H Liu, A Bernasconi, C Vener, M Guevara, C M Zwaan, A Mayer-da-Silva, K Paapsi, R Ragusa, O P Smith,

TLDR

  • Despite improvement in overall survival, adolescents and young adults (AYAs) with haematologic malignancies have poorer survival compared to children for most types of leukaemia and lymphomas, highlighting the need for further efforts to improve their outcomes.

Abstract

While cancer survival has steadily improved over time for adolescents and young adults (AYAs), previous studies have shown poorer survival in AYAs compared to children with leukaemia and lymphomas. In this study, we provided updated European 5-year relative survival (RS) estimates for AYAs with haematologic malignancies compared to children and assessed improvements in survival over time. We used the EUROCARE-6 database, with population-based cancer registries data from 29 European countries. Using the period approach, we calculated 5-year RS for European children (0-14 years) and AYAs (15-39 years) in the follow-up period 2010- 2014 separately for leukaemia, lymphomas, relevant morphological subgroups, age- subgroups, and sex. We estimated 5-year RS time trends between 2000 and 2013. Compared to children, AYAs had a worse RS for all acute lymphoblastic leukaemias (ALL) and acute myeloid leukaemia (AML), but a better survival for chronic myeloid leukaemia (CML). No differences in RS were observed between children and AYAs with acute promyelocytic leukaemia (APL). Compared to children, AYAs had a worse RS for HL and NHL in general, and specifically for lymphoblastic, Burkitt, follicular and NK/T cell lymphomas. In AYAs, RS increased between 2000-2013 for leukaemia overall (by 9% points), ALL (by 11% points), AML (by 8% points) and CML (by 11% points). Despite increasing European survival for AYAs with haematological malignancies, we showed poorer survival in AYAs than in children for most types of leukaemia and lymphomas. These results reflect that further efforts are needed to improve the survival for this distinctive patient group.

Overview

  • The study aimed to provide updated European 5-year relative survival (RS) estimates for adolescents and young adults (AYAs) with haematologic malignancies compared to children and assess improvements in survival over time.
  • The study used the EUROCARE-6 database, which includes population-based cancer registry data from 29 European countries, to calculate 5-year RS for European children (0-14 years) and AYAs (15-39 years) in the follow-up period 2010-2014.
  • The study aimed to identify differences in 5-year RS between children and AYAs for various haematologic malignancies and to examine improvements in RS over time

Comparative Analysis & Findings

  • AYAs had a worse 5-year RS for all acute lymphoblastic leukaemias (ALL) and acute myeloid leukaemia (AML) compared to children, but a better survival for chronic myeloid leukaemia (CML).
  • No differences in RS were observed between children and AYAs with acute promyelocytic leukaemia (APL).
  • AYAs had a worse 5-year RS for Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) in general, and specifically for lymphoblastic, Burkitt, follicular, and NK/T cell lymphomas, compared to children.

Implications and Future Directions

  • The study highlights the need for further efforts to improve the survival for AYAs with haematologic malignancies, given their poorer survival compared to children for most types of leukaemia and lymphomas.
  • Future research should aim to identify factors contributing to the poorer survival of AYAs and develop effective strategies to improve their outcomes.
  • Public health initiatives and cancer control programs should prioritize the needs of AYAs with haematologic malignancies to ensure they receive optimal care and support.
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