Adolescents and young adults (AYAs) vs pediatric patients: survival, risks, and barriers to enrollment

• Type of Material: Article
• Authors: Sanyukta K. Janardan, Emory University; Tamara Miller, Emory University
• Language: English
• Date: 2023-12-08
• Publisher: The American Society of Hematology
• Publication Version: Final Published Version
• Copyright Statement: © 2023 by The American Society of Hematology
• Final Published Version (URL): https://doi.org/10.1182/hematology.2023000507
• Title of Journal or Parent Work: Hematology
• Volume: 2023
• Issue: 1
• Start Page: 581
• End Page: 586
• Keywords: acute lymphoblastic leukemia; pediatric patients; Adolescents
• Research Categories: Health Sciences, Public Health; Health Sciences, Oncology

Abstract

Adolescents and young adults (AYAs; ages 15-39 years) with acute lymphoblastic leukemia (ALL) have worse outcomes than pediatric patients with ALL. Multiple factors contribute to this differential survival. AYAs are more likely to have higher-risk leukemia biology than children with ALL. AYA patients have more choices for treatment facility and treatment protocol, as well as barriers to clinical trial enrollment, both of which can affect survival. AYAs must also navigate psychosocial factors inherent to their unique developmental stage. Furthermore, AYAs typically sustain more treatment-related toxicities than pediatric patients. Treatment on pediatric or pediatric-inspired ALL protocols at pediatric cancer centers has been associated with improved outcomes for AYAs with ALL, but there is still variation in the treatment that AYAs with ALL receive. Clinical trials focused on AYAs with ALL and individualized decision-making regarding choice of treatment facility and treatment protocol are needed to optimize the survival and long-term outcomes of this patient population.