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5- and 10-year survival continues to improve for US children with hematologic malignancies

5- and 10-year survival rates continue to improve for children under the age of 15 who are diagnosed with acute lymphoblastic leukemia (ALL), acute non-lymphoblastic leukemia, or non-Hodgkin lymphoma (NHL) in the United States, researchers report in the September 9 online issue of the Journal of the National Cancer Institute.

Advances in treatment for childhood hematologic malignancies have led to increased long-term survival in these patients. However, most population-based studies include survival data from patients who were diagnosed in the mid-1990s or before and, therefore, may not reflect current outcomes.

To improve on those data, Hermann Brenner, M.D., of the German Cancer Research Center in Heidelberg and colleagues used period analysis to assess current trends. The method has been validated in adult cancers and accurately reflects long-term outcomes but has not been used in pediatric cancers. Using period analysis, the researchers compared 5- and 10-year survival estimates for patients included in the 1990-1994, 1995-41999, and 2000-2004 periods. They also developed methods to predict survival in patients diagnosed in 2005-2009.

Between 1990-1994 and 2000-2004, 5- and 10-year survival increased from 80.2 percent to 87.5 percent and from 73.4 percent to 83.8 percent, respectively, for patients with ALL; from 41.9 percent to 59.9 percent and from 38.7 percent to 59.1 percent, respectively, for patients with acute non-lymphoblastic leukemia; and from 76.6 percent to 87.7 percent and from 73.0 percent to 86.9 percent, respectively, for patients with NHL. The 5- and 10-year survival rates for the 1990჻� period were 96.1 percent and 94.4 percent, respectively, for patients with Hodgkin lymphoma and did not substantially change over the study period. The estimated 10-year survival for patients diagnosed in 2005჻� with ALL was 88.0 percent, with acute non-lymphoblastic leukemia was 63.9 percent, with NHL was 90.6 percent, and with Hodgkin lymphoma was 94.3 percent.

"Our period analysis revealed that survival after diagnosis with childhood hematologic malignancies has improved greatly over the past decade," the authors conclude. "Improvements in survival in childhood hematologic malignancies are most likely attributable to changes in how these diseases are treated."

In an accompanying editorial, Alan Wayne, M.D., of the National Cancer Institute in Bethesda, Md., and colleagues review the progress that has been made in improving survival in children diagnosed with a hematologic malignancy. They note, however, that intensifying existing therapies is unlikely to bring further gains and incorporation of molecularly targeted therapies will be essential for continued progress.

With that in mind, the period analysis used by Brenner and colleagues, including their projections for future benefits, could speed drug development. "If their projections prove to be valid, this approach may facilitate earlier evaluation of molecularly targeted agents and more rapid advances in therapy," the editorialists write.


Contact: Liz Savage
Journal of the National Cancer Institute

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