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Author Notes:

John Horan, MD, MPH, Aflac Cancer and Blood Disorders Center, Emory University and Children's Healthcare of Atlanta, 1405 Clifton Road, Atlanta, GA 30322; Fax: (404) 785-1421; john.horan@choa.org.

Dr. Franklin is a current employee of Amgen, owns stock and stock options in Amgen, and has received grants and travel/meeting support from USC/Children's Hospital Los Angeles.

All other authors made no disclosure.


Research Funding:

Supported in part by the AYA Cancer Research Program of the Aflac Foundation/CureSearch for Children's Cancer; and by grants from the National Institutes of Health (U10 CA98543 and U10 CA98413).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • acute myeloid leukemia
  • adolescent and young adult
  • children
  • infection
  • cancer
  • AML
  • AGE

Differences in Outcomes of Newly Diagnosed Acute Myeloid Leukemia for Adolescent/Young Adult and Younger Patients A Report from the Children's Oncology Group

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Journal Title:



Volume 119, Number 23


, Pages 4162-4169

Type of Work:

Article | Post-print: After Peer Review


BACKGROUND Studies comparing survival of adolescent and young adult (AYA) patients to that of younger patients with newly diagnosed acute myeloid leukemia (AML) have yielded conflicting results. In order to more accurately characterize relative survival and other outcomes of AYA patients, a cross-study analysis was conducted using data from recent trials conducted by the Children's Cancer Group (CCG) and Children's Oncology Group (COG). METHODS Data were combined from the CCG-2891, CCG-2941, CCG-2961, and AAML03P1 trials. The data set included 1840 patients, comprising 238 AYA and 1602 younger patients. RESULTS Overall survival was not significantly different in the 2 groups (AYA, 49% ± 7% versus younger, 54% ± 3% (± 2 standard errors), P =.058). Relapse was lower in AYA patients (30% ± 7% versus 41% ± 3%, P =.002), but treatment-related mortality (TRM) was higher (25% ± 6% versus 12% ± 2%, P <.001). After adjustment for other factors, older age remained strongly associated with TRM (hazard ratio = 2.30, 95% CI = 1.59-3.33, P <.001). Infection accounted for the excess TRM in AYA patients. CONCLUSIONS Survival in AYA and younger patients with newly diagnosed AML is similar; however, older patients are at higher risk for TRM. More effective strategies for preventing mortality from infection in AYA patients are needed.

Copyright information:

© 2013 American Cancer Society.

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