Blood Cancer Survival Worse in Young Adults vs Children

TOPLINE:

European adolescents and young adults (AYAs) aged 15-39 years had lower 5-year relative survival (RS) rates than children for most types of leukaemia and lymphoma, despite overall survival improvements from 2000 to 2013.

METHODOLOGY:

• This study analysed approximately 34,000 AYAs and 10,000 children with haematologic tumours diagnosed between 2006 and 2013 using the EUROCARE-6 database with population-based cancer registry data from 29 European countries.
• Researchers calculated the 5-year RS for children (age, 0-14 years) and AYAs (age, 15-39 years) for the follow-up period 2010-2014 and estimated the 5-year RS trends between 2000 and 2013.
• RS was defined as the ratio of the observed survival in patients to the expected survival in the general population with the same age, calendar year, place of residence, and sex.

TAKEAWAY:

• Compared with children, AYAs showed lower 5-year RS for acute lymphoblastic leukaemia (ALL; 90.1% vs 61.3%), acute myeloid leukaemia (AML; 70.5% vs 58.1%), and non-Hodgkin lymphoma (NHL; 90.1% vs 83.8%).
• Survival rates improved between 2004-2006 and 2010-2014 for AYAs with leukaemia overall (by 9%), ALL (by 11%), AML (by 8%), and chronic myeloid leukaemia (CML; by 11%).
• Considering lymphomas, the RS increased by 4% for lymphomas overall, by 6% for NHL, and by 2% for HL between the follow-up periods 2004-2006 and 2010-2014.
• Female AYAs had better RS than male AYAs for leukaemia overall, AML, lymphomas overall, NHL, and Natural Killer/T-cell lymphoma.
• No differences in survival were observed between children and AYAs diagnosed with acute promyelocytic leukaemia; however, AYAs had better survival than children for CML.

IN PRACTICE:

The authors wrote, “Despite improvements in survival for children and AYAs with haematological cancers between 2000 and 2013, differences between children and AYAs persist, which highlights the importance of close collaboration between paediatric and adult oncology teams.” They added, “Dedicated AYA services should have environments suited to the age and psychology of AYA patients who should be supported by a multidisciplinary team (MDT) familiar with their needs and with paediatric and adult practices,” the authors wrote.

SOURCE:

The study was led by Annalisa Trama, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, and Elena Demuru, Istituto Superiore di Sanita, Rome, Italy. It was published online on March 1, 2025, in the European Journal of Cancer.

LIMITATIONS:

Information on molecular characterisation and treatments received was unavailable in the study, as European cancer registries do not systematically collect it. Additionally, a high proportion of ALL cases lacked information on whether the leukaemia was of B-cell or T-cell phenotype, primarily because registries did not use more specific codes. The relatively old diagnostic period and use of end-of-follow-up data for analyses were also noted as limitations.

DISCLOSURES:

This research did not receive a specific grant from any public, commercial, or not-for-profit funding agency. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.