Patient Characteristics and Outcomes in Adolescents and Young Adults (AYA) with Acute Myeloid Leukemia (AML)

Naveen Pemmaraju, Hagop Kantarjian, Farhad Ravandi, Graciela M. Nogueras-Gonzalez, Xuelin Huang, Susan O'Brien, William Wierda, Guillermo Garcia-Manero, Deborah Thomas, Sherry Pierce, Srdan Verstovsek, Gautam Borthakur, Jorge Cortes

Research output: Contribution to journalArticle

Abstract

Background Little is known about outcomes of acute myeloid leukemia (AML) in adolescents and young adults (AYA). The purpose of this study is to determine the characteristics and outcomes of AYA AML patients in comparison to older adult patients with AML. Patients and Methods We retrospectively analyzed all AML patients treated at our institution from 1965 to 2009 who were aged 16 to 29 years. Results Among 3922 adult AML patients treated during this period, 432 (11%) were identified as AYA. Median age was 23 years (range, 16-29 years); 73 (17%) patients had core binding factor (CBF)-AML [inversion (16), translocation (8:21)], and 51 (12%) had acute promyelocytic leukemia. Complete remission (CR) rates were 93% for CBF AML, 78% for APL, 77% with diploid karyotype, and 68% for other AML. Univariate analysis demonstrated higher rates of CR, CR duration, and overall survival (OS) in the AYA group compared with older patients. On multivariate analysis, AYA age group was independently associated with improved CR rate and CR duration, with a trend for longer OS (P =.085). Conclusion Outcome of AYA AML patients is overall better than for older adults with AML. Despite improvements in treatments and outcomes over time, there is still need for improvement in AYA with AML particularly for those with AML other than CBF and APL.

Original languageEnglish (US)
Pages (from-to)213-222.e2
JournalClinical Lymphoma, Myeloma and Leukemia
Volume16
Issue number4
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

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Acute Myeloid Leukemia
Young Adult
Core Binding Factors
Acute Promyelocytic Leukemia
Survival
Diploidy
Karyotype
Multivariate Analysis
Age Groups

Keywords

  • Adherence
  • Diploid cytogenetics
  • FLT3 mutation
  • Older adult
  • Pediatric

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Patient Characteristics and Outcomes in Adolescents and Young Adults (AYA) with Acute Myeloid Leukemia (AML). / Pemmaraju, Naveen; Kantarjian, Hagop; Ravandi, Farhad; Nogueras-Gonzalez, Graciela M.; Huang, Xuelin; O'Brien, Susan; Wierda, William; Garcia-Manero, Guillermo; Thomas, Deborah; Pierce, Sherry; Verstovsek, Srdan; Borthakur, Gautam; Cortes, Jorge.

In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 16, No. 4, 01.04.2016, p. 213-222.e2.

Research output: Contribution to journalArticle

Pemmaraju, N, Kantarjian, H, Ravandi, F, Nogueras-Gonzalez, GM, Huang, X, O'Brien, S, Wierda, W, Garcia-Manero, G, Thomas, D, Pierce, S, Verstovsek, S, Borthakur, G & Cortes, J 2016, 'Patient Characteristics and Outcomes in Adolescents and Young Adults (AYA) with Acute Myeloid Leukemia (AML)', Clinical Lymphoma, Myeloma and Leukemia, vol. 16, no. 4, pp. 213-222.e2. https://doi.org/10.1016/j.clml.2015.12.010
Pemmaraju, Naveen ; Kantarjian, Hagop ; Ravandi, Farhad ; Nogueras-Gonzalez, Graciela M. ; Huang, Xuelin ; O'Brien, Susan ; Wierda, William ; Garcia-Manero, Guillermo ; Thomas, Deborah ; Pierce, Sherry ; Verstovsek, Srdan ; Borthakur, Gautam ; Cortes, Jorge. / Patient Characteristics and Outcomes in Adolescents and Young Adults (AYA) with Acute Myeloid Leukemia (AML). In: Clinical Lymphoma, Myeloma and Leukemia. 2016 ; Vol. 16, No. 4. pp. 213-222.e2.
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abstract = "Background Little is known about outcomes of acute myeloid leukemia (AML) in adolescents and young adults (AYA). The purpose of this study is to determine the characteristics and outcomes of AYA AML patients in comparison to older adult patients with AML. Patients and Methods We retrospectively analyzed all AML patients treated at our institution from 1965 to 2009 who were aged 16 to 29 years. Results Among 3922 adult AML patients treated during this period, 432 (11{\%}) were identified as AYA. Median age was 23 years (range, 16-29 years); 73 (17{\%}) patients had core binding factor (CBF)-AML [inversion (16), translocation (8:21)], and 51 (12{\%}) had acute promyelocytic leukemia. Complete remission (CR) rates were 93{\%} for CBF AML, 78{\%} for APL, 77{\%} with diploid karyotype, and 68{\%} for other AML. Univariate analysis demonstrated higher rates of CR, CR duration, and overall survival (OS) in the AYA group compared with older patients. On multivariate analysis, AYA age group was independently associated with improved CR rate and CR duration, with a trend for longer OS (P =.085). Conclusion Outcome of AYA AML patients is overall better than for older adults with AML. Despite improvements in treatments and outcomes over time, there is still need for improvement in AYA with AML particularly for those with AML other than CBF and APL.",
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AU - Kantarjian, Hagop

AU - Ravandi, Farhad

AU - Nogueras-Gonzalez, Graciela M.

AU - Huang, Xuelin

AU - O'Brien, Susan

AU - Wierda, William

AU - Garcia-Manero, Guillermo

AU - Thomas, Deborah

AU - Pierce, Sherry

AU - Verstovsek, Srdan

AU - Borthakur, Gautam

AU - Cortes, Jorge

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N2 - Background Little is known about outcomes of acute myeloid leukemia (AML) in adolescents and young adults (AYA). The purpose of this study is to determine the characteristics and outcomes of AYA AML patients in comparison to older adult patients with AML. Patients and Methods We retrospectively analyzed all AML patients treated at our institution from 1965 to 2009 who were aged 16 to 29 years. Results Among 3922 adult AML patients treated during this period, 432 (11%) were identified as AYA. Median age was 23 years (range, 16-29 years); 73 (17%) patients had core binding factor (CBF)-AML [inversion (16), translocation (8:21)], and 51 (12%) had acute promyelocytic leukemia. Complete remission (CR) rates were 93% for CBF AML, 78% for APL, 77% with diploid karyotype, and 68% for other AML. Univariate analysis demonstrated higher rates of CR, CR duration, and overall survival (OS) in the AYA group compared with older patients. On multivariate analysis, AYA age group was independently associated with improved CR rate and CR duration, with a trend for longer OS (P =.085). Conclusion Outcome of AYA AML patients is overall better than for older adults with AML. Despite improvements in treatments and outcomes over time, there is still need for improvement in AYA with AML particularly for those with AML other than CBF and APL.

AB - Background Little is known about outcomes of acute myeloid leukemia (AML) in adolescents and young adults (AYA). The purpose of this study is to determine the characteristics and outcomes of AYA AML patients in comparison to older adult patients with AML. Patients and Methods We retrospectively analyzed all AML patients treated at our institution from 1965 to 2009 who were aged 16 to 29 years. Results Among 3922 adult AML patients treated during this period, 432 (11%) were identified as AYA. Median age was 23 years (range, 16-29 years); 73 (17%) patients had core binding factor (CBF)-AML [inversion (16), translocation (8:21)], and 51 (12%) had acute promyelocytic leukemia. Complete remission (CR) rates were 93% for CBF AML, 78% for APL, 77% with diploid karyotype, and 68% for other AML. Univariate analysis demonstrated higher rates of CR, CR duration, and overall survival (OS) in the AYA group compared with older patients. On multivariate analysis, AYA age group was independently associated with improved CR rate and CR duration, with a trend for longer OS (P =.085). Conclusion Outcome of AYA AML patients is overall better than for older adults with AML. Despite improvements in treatments and outcomes over time, there is still need for improvement in AYA with AML particularly for those with AML other than CBF and APL.

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