Outcome of adolescents and young adults with acute myeloid leukemia treated on COG trials compared to CALGB and SWOG trials
BACKGROUND A retrospective meta‐analysis of adolescents and young adults (AYAs) with acute myeloid leukemia (AML) was performed to determine if differences in outcome exist following treatment on pediatric versus adult oncology treatment regimens. METHODS Outcomes were compared of 517 AYAs with AML...
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| Veröffentlicht in: | Cancer 2013-12, Vol.119 (23), p.4170-4179 |
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| creator | Woods, William G. Franklin, Anna R. K. Alonzo, Todd A. Gerbing, Robert B. Donohue, Kathleen A. Othus, Megan Horan, John Appelbaum, Frederick R. Estey, Elihu H. Bloomfield, Clara D. Larson, Richard A. |
| description | BACKGROUND
A retrospective meta‐analysis of adolescents and young adults (AYAs) with acute myeloid leukemia (AML) was performed to determine if differences in outcome exist following treatment on pediatric versus adult oncology treatment regimens.
METHODS
Outcomes were compared of 517 AYAs with AML aged 16 to 21 years who were treated on Children's Oncology Group (COG), Cancer and Leukemia Group B (CALGB), and Southwest Oncology Group (SWOG) frontline AML trials from 1986 to 2008.
RESULTS
There was a significant age difference between AYA cohorts in the COG, CALGB, and SWOG trials (median, 17.2 versus 20.1 versus 19.8 years, P |
| doi_str_mv | 10.1002/cncr.28344 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3833872</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1459976592</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4504-80c9f7a83bce6f54cec99001c1422dc72203aad10f89935786f74cabb2a510ae3</originalsourceid><addsrcrecordid>eNp9kctuEzEUhi0EomlhwwNU3iChSlN8m9jeIMEIAlJFJC6CnXXi8bQunnGwZ6giXh6nCWnZsDo6x5__c_kRekbJOSWEvbSDTedMcSEeoBklWlaECvYQzQghqqoF_36EjnO-LqlkNX-MjpigRNRaztDv5TTa2DscOwxtDC5bN4wZw9DiTZyGy1KdQinc-PEKg51Gh_uNC9G3OLjph-s94DE5GF2L44Cb5aKkHkLGRXYNqZTHiJvXF4s3t6Kfvx2IJ-hRV4J7uo8n6Ou7t1-a99XFcvGh_KisqImoFLG6k6D4yrp5VwvrrNaEUFuWZK2VjBEO0FLSKa15LdW8k8LCasWgpgQcP0GvdrrradW7drtggmDWyfeQNiaCN_--DP7KXMZfhivOlWRF4MVeIMWfk8uj6X25UwgwuDhlQ8sttZzXeoue7VCbYs7JdYc2lJitW2brlrl1q8Cn9wc7oH_tKcDzPQDZQugSDNbnO05qrilRhaM77sYHt_lPS9N8bD7tmv8B3dauPg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1459976592</pqid></control><display><type>article</type><title>Outcome of adolescents and young adults with acute myeloid leukemia treated on COG trials compared to CALGB and SWOG trials</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Wiley Online Library Free Content</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Woods, William G. ; Franklin, Anna R. K. ; Alonzo, Todd A. ; Gerbing, Robert B. ; Donohue, Kathleen A. ; Othus, Megan ; Horan, John ; Appelbaum, Frederick R. ; Estey, Elihu H. ; Bloomfield, Clara D. ; Larson, Richard A.</creator><creatorcontrib>Woods, William G. ; Franklin, Anna R. K. ; Alonzo, Todd A. ; Gerbing, Robert B. ; Donohue, Kathleen A. ; Othus, Megan ; Horan, John ; Appelbaum, Frederick R. ; Estey, Elihu H. ; Bloomfield, Clara D. ; Larson, Richard A.</creatorcontrib><description>BACKGROUND
A retrospective meta‐analysis of adolescents and young adults (AYAs) with acute myeloid leukemia (AML) was performed to determine if differences in outcome exist following treatment on pediatric versus adult oncology treatment regimens.
METHODS
Outcomes were compared of 517 AYAs with AML aged 16 to 21 years who were treated on Children's Oncology Group (COG), Cancer and Leukemia Group B (CALGB), and Southwest Oncology Group (SWOG) frontline AML trials from 1986 to 2008.
RESULTS
There was a significant age difference between AYA cohorts in the COG, CALGB, and SWOG trials (median, 17.2 versus 20.1 versus 19.8 years, P < .001). The 10‐year event‐free survival of the COG cohort was superior to the combined adult cohorts (38% ± 6% versus 23% ± 6%, log‐rank P = .006) as was overall survival (45% ± 6% versus 34% ± 7%), with a 10‐year estimate comparison of P = .026. However, the younger age of the COG cohort is confounding, with all patients aged 16 to 18 years doing better than those aged 19 to 21 years. Although the 10‐year relapse rate was lower for the COG patients (29% ± 6% versus 57% ± 8%, Gray's P < .001), this was offset by a higher postremission treatment‐related mortality of 26% ± 6% versus 12% ± 6% (Gray's P < .001). Significant improvements in 10‐year event‐free survival and overall survival were observed for the entire cohort in later studies.
CONCLUSIONS
Patients treated on pediatric trials had better outcomes than those treated on adult trials, but age is a major confounding variable, making it difficult to compare outcomes by cooperative group. Cancer 2013;119:4170–4179. © 2013 American Cancer Society.
Adolescent and young adults with acute myeloid leukemia had equivalent outcomes whether treated on pediatric or adult trials when factoring in age. Pediatric trials led to significantly lower relapse rates as well as higher treatment‐related mortality.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.28344</identifier><identifier>PMID: 24104597</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>Hoboken, NJ: Wiley-Blackwell</publisher><subject>acute myeloid leukemia ; Adolescent ; adolescents ; Adult ; Age Factors ; antineoplastic combined chemotherapy protocols ; Biological and medical sciences ; Disease-Free Survival ; Female ; Hematologic and hematopoietic diseases ; Humans ; Leukemia, Myeloid, Acute - drug therapy ; Leukemia, Myeloid, Acute - mortality ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Male ; Medical sciences ; Proportional Hazards Models ; Retrospective Studies ; Tumors ; Young Adult ; young adults</subject><ispartof>Cancer, 2013-12, Vol.119 (23), p.4170-4179</ispartof><rights>2013 American Cancer Society</rights><rights>2014 INIST-CNRS</rights><rights>2013 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4504-80c9f7a83bce6f54cec99001c1422dc72203aad10f89935786f74cabb2a510ae3</citedby><cites>FETCH-LOGICAL-c4504-80c9f7a83bce6f54cec99001c1422dc72203aad10f89935786f74cabb2a510ae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.28344$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.28344$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27939108$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24104597$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Woods, William G.</creatorcontrib><creatorcontrib>Franklin, Anna R. K.</creatorcontrib><creatorcontrib>Alonzo, Todd A.</creatorcontrib><creatorcontrib>Gerbing, Robert B.</creatorcontrib><creatorcontrib>Donohue, Kathleen A.</creatorcontrib><creatorcontrib>Othus, Megan</creatorcontrib><creatorcontrib>Horan, John</creatorcontrib><creatorcontrib>Appelbaum, Frederick R.</creatorcontrib><creatorcontrib>Estey, Elihu H.</creatorcontrib><creatorcontrib>Bloomfield, Clara D.</creatorcontrib><creatorcontrib>Larson, Richard A.</creatorcontrib><title>Outcome of adolescents and young adults with acute myeloid leukemia treated on COG trials compared to CALGB and SWOG trials</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND
A retrospective meta‐analysis of adolescents and young adults (AYAs) with acute myeloid leukemia (AML) was performed to determine if differences in outcome exist following treatment on pediatric versus adult oncology treatment regimens.
METHODS
Outcomes were compared of 517 AYAs with AML aged 16 to 21 years who were treated on Children's Oncology Group (COG), Cancer and Leukemia Group B (CALGB), and Southwest Oncology Group (SWOG) frontline AML trials from 1986 to 2008.
RESULTS
There was a significant age difference between AYA cohorts in the COG, CALGB, and SWOG trials (median, 17.2 versus 20.1 versus 19.8 years, P < .001). The 10‐year event‐free survival of the COG cohort was superior to the combined adult cohorts (38% ± 6% versus 23% ± 6%, log‐rank P = .006) as was overall survival (45% ± 6% versus 34% ± 7%), with a 10‐year estimate comparison of P = .026. However, the younger age of the COG cohort is confounding, with all patients aged 16 to 18 years doing better than those aged 19 to 21 years. Although the 10‐year relapse rate was lower for the COG patients (29% ± 6% versus 57% ± 8%, Gray's P < .001), this was offset by a higher postremission treatment‐related mortality of 26% ± 6% versus 12% ± 6% (Gray's P < .001). Significant improvements in 10‐year event‐free survival and overall survival were observed for the entire cohort in later studies.
CONCLUSIONS
Patients treated on pediatric trials had better outcomes than those treated on adult trials, but age is a major confounding variable, making it difficult to compare outcomes by cooperative group. Cancer 2013;119:4170–4179. © 2013 American Cancer Society.
Adolescent and young adults with acute myeloid leukemia had equivalent outcomes whether treated on pediatric or adult trials when factoring in age. Pediatric trials led to significantly lower relapse rates as well as higher treatment‐related mortality.</description><subject>acute myeloid leukemia</subject><subject>Adolescent</subject><subject>adolescents</subject><subject>Adult</subject><subject>Age Factors</subject><subject>antineoplastic combined chemotherapy protocols</subject><subject>Biological and medical sciences</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Humans</subject><subject>Leukemia, Myeloid, Acute - drug therapy</subject><subject>Leukemia, Myeloid, Acute - mortality</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Tumors</subject><subject>Young Adult</subject><subject>young adults</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctuEzEUhi0EomlhwwNU3iChSlN8m9jeIMEIAlJFJC6CnXXi8bQunnGwZ6giXh6nCWnZsDo6x5__c_kRekbJOSWEvbSDTedMcSEeoBklWlaECvYQzQghqqoF_36EjnO-LqlkNX-MjpigRNRaztDv5TTa2DscOwxtDC5bN4wZw9DiTZyGy1KdQinc-PEKg51Gh_uNC9G3OLjph-s94DE5GF2L44Cb5aKkHkLGRXYNqZTHiJvXF4s3t6Kfvx2IJ-hRV4J7uo8n6Ou7t1-a99XFcvGh_KisqImoFLG6k6D4yrp5VwvrrNaEUFuWZK2VjBEO0FLSKa15LdW8k8LCasWgpgQcP0GvdrrradW7drtggmDWyfeQNiaCN_--DP7KXMZfhivOlWRF4MVeIMWfk8uj6X25UwgwuDhlQ8sttZzXeoue7VCbYs7JdYc2lJitW2brlrl1q8Cn9wc7oH_tKcDzPQDZQugSDNbnO05qrilRhaM77sYHt_lPS9N8bD7tmv8B3dauPg</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Woods, William G.</creator><creator>Franklin, Anna R. K.</creator><creator>Alonzo, Todd A.</creator><creator>Gerbing, Robert B.</creator><creator>Donohue, Kathleen A.</creator><creator>Othus, Megan</creator><creator>Horan, John</creator><creator>Appelbaum, Frederick R.</creator><creator>Estey, Elihu H.</creator><creator>Bloomfield, Clara D.</creator><creator>Larson, Richard A.</creator><general>Wiley-Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20131201</creationdate><title>Outcome of adolescents and young adults with acute myeloid leukemia treated on COG trials compared to CALGB and SWOG trials</title><author>Woods, William G. ; Franklin, Anna R. K. ; Alonzo, Todd A. ; Gerbing, Robert B. ; Donohue, Kathleen A. ; Othus, Megan ; Horan, John ; Appelbaum, Frederick R. ; Estey, Elihu H. ; Bloomfield, Clara D. ; Larson, Richard A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4504-80c9f7a83bce6f54cec99001c1422dc72203aad10f89935786f74cabb2a510ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>acute myeloid leukemia</topic><topic>Adolescent</topic><topic>adolescents</topic><topic>Adult</topic><topic>Age Factors</topic><topic>antineoplastic combined chemotherapy protocols</topic><topic>Biological and medical sciences</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Humans</topic><topic>Leukemia, Myeloid, Acute - drug therapy</topic><topic>Leukemia, Myeloid, Acute - mortality</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Tumors</topic><topic>Young Adult</topic><topic>young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Woods, William G.</creatorcontrib><creatorcontrib>Franklin, Anna R. K.</creatorcontrib><creatorcontrib>Alonzo, Todd A.</creatorcontrib><creatorcontrib>Gerbing, Robert B.</creatorcontrib><creatorcontrib>Donohue, Kathleen A.</creatorcontrib><creatorcontrib>Othus, Megan</creatorcontrib><creatorcontrib>Horan, John</creatorcontrib><creatorcontrib>Appelbaum, Frederick R.</creatorcontrib><creatorcontrib>Estey, Elihu H.</creatorcontrib><creatorcontrib>Bloomfield, Clara D.</creatorcontrib><creatorcontrib>Larson, Richard A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Woods, William G.</au><au>Franklin, Anna R. K.</au><au>Alonzo, Todd A.</au><au>Gerbing, Robert B.</au><au>Donohue, Kathleen A.</au><au>Othus, Megan</au><au>Horan, John</au><au>Appelbaum, Frederick R.</au><au>Estey, Elihu H.</au><au>Bloomfield, Clara D.</au><au>Larson, Richard A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcome of adolescents and young adults with acute myeloid leukemia treated on COG trials compared to CALGB and SWOG trials</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>119</volume><issue>23</issue><spage>4170</spage><epage>4179</epage><pages>4170-4179</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>BACKGROUND
A retrospective meta‐analysis of adolescents and young adults (AYAs) with acute myeloid leukemia (AML) was performed to determine if differences in outcome exist following treatment on pediatric versus adult oncology treatment regimens.
METHODS
Outcomes were compared of 517 AYAs with AML aged 16 to 21 years who were treated on Children's Oncology Group (COG), Cancer and Leukemia Group B (CALGB), and Southwest Oncology Group (SWOG) frontline AML trials from 1986 to 2008.
RESULTS
There was a significant age difference between AYA cohorts in the COG, CALGB, and SWOG trials (median, 17.2 versus 20.1 versus 19.8 years, P < .001). The 10‐year event‐free survival of the COG cohort was superior to the combined adult cohorts (38% ± 6% versus 23% ± 6%, log‐rank P = .006) as was overall survival (45% ± 6% versus 34% ± 7%), with a 10‐year estimate comparison of P = .026. However, the younger age of the COG cohort is confounding, with all patients aged 16 to 18 years doing better than those aged 19 to 21 years. Although the 10‐year relapse rate was lower for the COG patients (29% ± 6% versus 57% ± 8%, Gray's P < .001), this was offset by a higher postremission treatment‐related mortality of 26% ± 6% versus 12% ± 6% (Gray's P < .001). Significant improvements in 10‐year event‐free survival and overall survival were observed for the entire cohort in later studies.
CONCLUSIONS
Patients treated on pediatric trials had better outcomes than those treated on adult trials, but age is a major confounding variable, making it difficult to compare outcomes by cooperative group. Cancer 2013;119:4170–4179. © 2013 American Cancer Society.
Adolescent and young adults with acute myeloid leukemia had equivalent outcomes whether treated on pediatric or adult trials when factoring in age. Pediatric trials led to significantly lower relapse rates as well as higher treatment‐related mortality.</abstract><cop>Hoboken, NJ</cop><pub>Wiley-Blackwell</pub><pmid>24104597</pmid><doi>10.1002/cncr.28344</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Wiley Online Library Free Content; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | acute myeloid leukemia Adolescent adolescents Adult Age Factors antineoplastic combined chemotherapy protocols Biological and medical sciences Disease-Free Survival Female Hematologic and hematopoietic diseases Humans Leukemia, Myeloid, Acute - drug therapy Leukemia, Myeloid, Acute - mortality Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Male Medical sciences Proportional Hazards Models Retrospective Studies Tumors Young Adult young adults |
| title | Outcome of adolescents and young adults with acute myeloid leukemia treated on COG trials compared to CALGB and SWOG trials |
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