ORLANDO, Fla., Dec. 11 /PRNewswire/ -- Cancer is the leading cause of
disease-related death among children in the U.S. The numbers of newly
diagnosed patients across the major childhood cancers, such as leukemia and
lymphoma, continue to escalate. But new research shows that mortality rates
are improving and long-term survival rates for childhood cancers are
steadily on the rise. Despite these successes in young children, we are
still faced with low survival rates and low clinical trial accrual in older
adolescents and young adults, particularly in blood disorders such as
leukemia and lymphoma. Two studies being presented today at the 48th Annual
Meeting of the American Society of Hematology (ASH(TM)) address the need
for more research in evaluating leukemia and lymphoma survivorship among
youths of varying ages and races.
"Even with the growing annual rates of new childhood cancer cases,
medical research offers a positive outlook on future survival rates," said
Kenneth Kaushansky, MD, Vice President of ASH and Helen M. Ranney Professor
and Chair of the Department of Medicine, University of California, San
Diego. "By focusing research on promising new targets and making
significant scientific advances to improve the survival rate among
adolescents and young adults afflicted by leukemia and lymphoma, we hope to
provide a paradigm for treating other cancers. Finally, by remaining
attentive to outcome disparities in subsets of patients, we should make
certain that all our patients can benefit from these medical advances."
The Racial Disparity Gap in Pediatric Leukemia and Lymphoma Survival
Has Been Eliminated in Children but Not in Older Adolescents and Young
Adults [Abstract #76]
*This abstract is being presented on Sunday, December 10, 5:15 p.m.
(EST) prior to Monday's press conference at 11:00 a.m. It is embargoed for
release until the time of initial presentation.
Racial disparities continue to be at the forefront of controversial
health issues, making it even more challenging to achieve and maintain
successful research and treatment of patients from socioeconomically
disadvantaged minority groups, and more studies are now being conducted to
investigate the factors associated with disparities in various races for a
number of specific diseases. Leukemia and lymphoma survival rates have
gradually improved among all age groups from 0-29. Disparities in success
rates between racial groups, however, although improved in the age range of
0-19, became more pronounced among young adults, ages 20-29. New research
into pediatric leukemia and lymphoma survival addresses the problem of
racial disparity among older adolescents and provides a platform for
physicians to overcome this longstanding barrier.
African Americans face a higher likelihood of developing and dying from
each of the four most common cancers in the United States (lung, colon,
breast, and prostate), and have also shown worse outcomes in pediatric
leukemia and lymphoma. Through scientific advancements, the Children's
Oncology Group (COG) has worked with U.S. physicians to fight racial
disparities among leukemia and lymphoma patients and, as a result, has
significantly reduced the deficit in pediatric patients. Researchers are
optimistic that they will be able to follow this model to reduce the racial
deficit in leukemia and lymphoma survivors among older adolescents and
young adults.
Aspiring to mirror the success of COG, cancer experts examined national
survey data from the U.S. Surveillance, Epidemiology, and End Results
(SEER) program for trends in survival differences between whites and blacks
with leukemia and lymphoma, related to their age at time of diagnosis. SEER
results provided the most comprehensive data of leukemia and lymphoma
incidence and survival over the past several decades.
Survey results detailed the annual five-year relative survival rate
trends between 1975 and 2000 for all leukemia and lymphoma cases. For
patients younger than 10 years of age, five-year survival rates among white
and black children were similar. Comparable trends were displayed for white
and black patients between the ages of 10 and 19. However, data revealed
that outcomes for black patients were progressively worse than those for
whites among patients between the ages of 20 and 29 years. As of 2000, the
projected survival deficit between blacks and whites in the 20- to 29-year
age group was 20-25 percent among acute myelogenous leukemia patients, and
5-10 percent for other leukemia and lymphoma cases.
"Leukemia and lymphoma continue to attack America's youth, and as
survival rates slowly improve, the racial disparity gap between children
and young adults only seems to be more apparent," said Aaron Viny, BS,
Cleveland Clinic Lerner College of Medicine, Ohio, and lead author of the
study. "If COG is able to successfully reduce the racial disparity among
pediatric patients, there is a great opportunity to duplicate that success
with older adolescents and young adults. By examining clinical trials data
through COG or other relevant databases, researchers will be one step
closer to eliminating that gap."
Twenty Years of Follow-Up Among Survivors of Childhood and Young Adult
Acute Myeloid Leukemia (AML): A Report from the Childhood Cancer Survivor
Study (CCSS) [Abstract #560]
Leukemias are the most common cancer affecting children and young
adults, accounting for nearly one-third of all cancers in children under
age 15 and a quarter of cancers occurring before age 20. Acute myeloid
leukemia (AML, a cancer of the blood and bone marrow) accounts for
approximately 25 percent of childhood leukemias, with an increased
incidence in the adolescent and young adult age group.
AML remains a challenging disease to successfully treat; however,
national clinical trials have greatly advanced pediatric AML therapy,
increased remission rates, and improved survival among childhood and young
adult patients. Despite this improvement, little information exists
concerning the late medical and social effects experienced by these
aggressively treated patients. A comprehensive twenty-year analysis of
survival, medical late effects, marriage, education, and employment rates
among survivors of AML and a sibling control group provided a wealth of
data about the long-term quality of life for these individuals.
Experts in the field of pediatric cancer evaluated 272 survivors of AML
participating in the Childhood Cancer Survivor Study (CCSS), all of whom
had survived at least five years from the time of diagnosis, were less than
21 years old at diagnosis, were treated between 1970 and 1986, and were not
treated with a blood or marrow transplant. Comparisons were made to a
sibling control group. Among these five-year survivors, 97 percent were
still alive 10 years later and 94 percent were alive after 20 years (25
years post- diagnosis). Six patients reported disease recurrences, two died
from relapse, one from congestive heart failure, and one from a myocardial
infarction. The incidence of recurrent AML was 1.8 percent at 10 years and
3.7 percent at 20 years, suggesting treatment success in five-year AML
survivors.
Study results also showed that AML survivors were successful in their
lives:
* Among those 25 years or older, marriage rates were similar between AML
survivors and the general U.S. population at 59 percent, but lower
compared to the sibling comparison group at 69 percent.
* College graduation rates were lower among survivors (42 percent) when
compared to siblings (52 percent), but higher than the general
population (34 percent).
* All survivors and siblings were employed and most had health insurance
(93 percent vs. 90 percent).
"We are encouraged by the favorable survival rates among children and
young adults living more than five years from their diagnosis of AML.
However, late-occurring medical sequelae remain an area of concern, and it
is crucial that these patients continue to be evaluated in a long-term
follow-up clinic, where a physician familiar with the unique issues of
cancer survivors can review their prior treatment and screen for late
effects of cancer therapy," said Daniel A. Mulrooney, MD, University of
Minnesota Medical School in Minneapolis. "On social measures, AML survivors
may not be doing as well as their siblings or socioeconomic group.
Fortunately, however, they are doing just as well, or better, when compared
to the general U.S. population."
The American Society of Hematology (http://www.hematology.org) is the
world's largest professional society concerned with the causes and
treatment of blood disorders. Its mission is to further the understanding,
diagnosis, treatment, and prevention of disorders affecting blood, bone
marrow, and the immunologic, hemostatic, and vascular systems, by promoting
research, clinical care, education, training, and advocacy in hematology.
SOURCE American Society of Hematology
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Related links:
http://www.hematology.org
CONTACT:
Leslie Humbel of Spectrum Science
Communications, +1-202-955-6222, lhumbel@spectrumscience.com; or
Laura Stark of American Society of Hematology, +1-202-776-0544,
lstark@hematology.org; On-site (12/8-12/12): +1-407-685-5405
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