Teens, young adults with leukemia living longer

(Agencies)
Updated: 2009-08-25 09:40

Adolescents and young adults with leukemia or lymphoma still fare worse than children with these blood cancers, but new research shows things are getting better.

"There's good news, there's not-so-good news," Dr. Dianne Pulte of the University of Medicine and Dentistry of New Jersey in Newark, the lead researcher on the study, told Reuters Health.

"We're starting to do better with treating this population, but I think we could still do better," she said.

Young patients may fall through the cracks for many reasons, Pulte noted in an interview. Oncologists may not know whether to treat them with pediatric or adult protocols, while teens and young adults also are less likely to have health insurance. "It's easy for any problem specific to this group to get lost in the noise," she said.

Another problem, she added, is that 15- to 24-year-olds diagnosed with leukemia or lymphoma have simply not been studied as much as younger or older patients have.

To better understand their situation, Pulte and her team analyzed data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) cancer registry.

They compared survival from Hodgkin's lymphoma (HL), non-Hodgkin lymphoma (NHL), acute lymphocytic leukemia (ALL), acute myelogenous leukemia (AML), and chronic myelogenous leukemia (CML) for patients diagnosed in 1981-1985 and in 2001-2005.

During that time, there were substantial improvements in 5- and 10-year relative survival for all five cancer types. For example, 10-year relative survival for HL rose from 80.4 percent to 93.4 percent, while NHL survival jumped from 55.6 percent to 76.2 percent.

Ten-year relative survival for CML went from 0 to 74.5 percent, probably due to the introduction of a new medicine for the disease, imatinib, and more widespread use of stem cell transplants for these patients, Pulte and her colleagues suggest.

But while 10-year relative survival for acute leukemias also improved (from 30.5 percent to 52.5 percent for ALL and from 15.2 percent to 45.1 percent for AML), survival increases stalled after the late 1990s.

The fact that survival for both ALL and AML has continued to improve into the 21st century in Western Europe, where the same treatment protocols are used as in the US, suggests that lack of health insurance coverage in this country could be a factor, Pulte said.

While a child with leukemia or lymphoma will almost always be referred to a major cancer center for treatment and participation in a clinical trial, the same isn't typically true for adolescents and young adults, Pulte said.

She also noted that while many people may be reluctant to enter clinical trials out of fear that they will be given a placebo or fake treatment, it's important to understand that all patients enrolled in these trials do get treated, either with an experimental approach or a standard, proven protocol, and receive very thorough follow-up.