American Association for Cancer Research
10559965epi160722-sup-171365_1_supp_3728435_3g1493.docx (16.21 kB)

Supplementary Table 2 from Adolescents and Young Adults with Acute Lymphoblastic Leukemia and Acute Myeloid Leukemia: Impact of Care at Specialized Cancer Centers on Survival Outcome

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journal contribution
posted on 2023-03-31, 13:42 authored by Julie Wolfson, Can-Lan Sun, Laura Wyatt, Wendy Stock, Smita Bhatia

Overall Survival: CCC/COG vs. Non-CCC/COG Facilities in AYAs



St. Baldrick's Scholar Career Development Award

National Cancer Institute



Background: Adolescents and young adults (AYA; 15–39 years) with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) experience inferior survival when compared with children. Impact of care at NCI-designated Comprehensive Cancer Centers (CCC) or Children's Oncology Group sites (COG) on survival disparities remains unstudied.Methods: Using the Los Angeles cancer registry, we identified 1,870 ALL or AML patients between 1 and 39 years at diagnosis. Cox regression analyses assessed risk of mortality; younger age + CCC/COG served as the referent group. Logistic regression was used to determine odds of care at CCC/COG, adjusting for variables above.Results: ALL outcome: AYAs at non-CCC/COG experienced inferior survival (15–21 years: HR = 1.9, P = 0.005; 22–29 years: HR = 2.6, P < 0.001; 30–39 years: HR = 3.0, P < 0.001). Outcome at CCC/COG was comparable between children and young AYAs (15–21 years: HR = 1.3, P = 0.3; 22–29 years: HR = 1.2, P = 0.2) but was inferior for 30- to 39-year-olds (HR = 3.4, P < 0.001). AML outcome: AYAs at non-CCC/COG experienced inferior outcome (15–21 years: HR = 1.8, P = 0.02; 22–39 years: HR = 1.4, P = 0.06). Outcome at CCC/COG was comparable between children and 15- to 21-year-olds (HR = 1.3, P = 0.4) but was inferior for 22- to 39-year-olds (HR = 1.7, P = 0.05). Access: 15- to 21-year-olds were less likely to use CCC/COG than children (P < 0.001). In 22- to 39-year-olds, public/uninsured (ALL: P = 0.004; AML<0.001), African American/Hispanics (ALL: P = 0.03), and 30- to 39-year-olds (ALL: P = 0.03) were less likely to use CCC/COG.Conclusions: Poor survival in AYAs with ALL and AML is mitigated by care at CCC/COG. Barriers to CCC/COG care include public/uninsured, and African American/Hispanic race/ethnicity.Impact: Care at CCC/COG explains, in part, inferior outcomes in AYAs with ALL and AML. Key sociodemographic factors serve as barriers to care at specialized centers. Cancer Epidemiol Biomarkers Prev; 26(3); 312–20. ©2017 AACR.

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