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Acute lymphoblastic leukemia

Improved survival in adult patients with acute lymphoblastic leukemia in the Netherlands: a population-based study on treatment, trial participation and survival

Leukemia volume 30, pages 310–317 (2016)Cite this article

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Abstract

This nationwide population-based study assessed trends in treatment, trial participation and survival among 1833 adult patients diagnosed with acute lymphoblastic leukemia (ALL) in the Netherlands between 1989 and 2012 reported to the Netherlands Cancer Registry. Patients were categorized into four periods and five age groups (18–24, 25–39, 40–59, 60–69 and ⩾70 years). The application of allogeneic stem cell transplantation (alloSCT), particularly reduced-intensity conditioning (RIC) alloSCT, increased over time up to age 70 years. The inclusion rate in the trials was 67, 66, 55, 58 and 0% for the five age groups. Survival improved over time for patients below 70 years. Five-year relative survival in the period 2007–2012 was 75, 57, 37, 22 and 5% for the five age groups. In that same period, 5-year overall survival among patients aged 18–39 years was 68% for the chemotherapy-alone group and 66% for the alloSCT group. For patients aged 40–69 years, the corresponding estimates were 24 and 41%. Pronounced survival improvement observed among patients aged 18–39 years might mainly be explained by implementation of pediatric-based regimens since 2005, whereas among patients aged 40–69 years, increased application of RIC-alloSCT has contributed significantly to the observed improvement. Outcome of patients aged ⩾70 remains unsatisfactory, indicating a need for specific trials for the elderly.

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Acknowledgements

We thank the Dutch-Belgian Cooperative Trial Group for Hemato-Oncology (HOVON) and the European Organization for Research and Treatment of Cancer (EORTC) for permission to use the data on trial participation from their clinical ALL trials for this research. We also thank the HOVON stem cell transplantation (SCT) Working Party for permission to use data on SCTs for this study. The contents of this publication and methods used are solely the responsibility of the authors and do not necessarily represent the official views of the EORTC. This work was supported by grants from The Netherlands Organization for Health Research and Development (ZonMw; Grant No.152001007).

Author contributions

AGD, AS, MJ-L and AWR: designed the study; MvdM: analyzed the data; OV, AGD and JJC: collected the data; AGD and AS: wrote the manuscript with contributions from MvdM, OV, PS, JJC, MJ-L and AWR; and all authors read, commented on and approved the final version of the manuscript.

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  1. A G Dinmohamed and A Szabó: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands

    A G Dinmohamed, A Szabó, P Sonneveld, J J Cornelissen, M Jongen-Lavrencic & A W Rijneveld

  2. Department of Registration, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands

    M van der Mark & O Visser

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  1. A G Dinmohamed
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Dinmohamed, A., Szabó, A., van der Mark, M. et al. Improved survival in adult patients with acute lymphoblastic leukemia in the Netherlands: a population-based study on treatment, trial participation and survival. Leukemia 30, 310–317 (2016). https://doi.org/10.1038/leu.2015.230

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