Cancer

BackgroundStudies show superior outcomes for adolescent and young adult (AYA) patients with acute lymphoblastic leukemia (ALL) treated following pediatric versus adult ALL therapeutic regimens. Whether adult oncologists in the United States have adopted this approach to AYA ALL is currently unknown. We sought to provide a population-based description of AYA ALL treatment patterns over the past decade.MethodsData on AYAs 15-39 years and diagnosed with ALL during 2004-2014 while living in the Greater Bay Area were obtained from the Greater Bay Area Cancer Registry (GBACR). Treating facilities were designated as pediatric or adult centers; induction treatment regimens were abstracted from registry text data fields.ResultsOf 304 patients diagnosed in the GBACR catchment region, complete treatment data was available for 229 (75%). Location of care was identified for 296 (97%) patients treated at 31 unique centers. 70% of AYAs received induction therapy at an adult center. All AYAs treated at pediatric centers received pediatric ALL regimens. Among AYAs treated by adult oncologists with complete treatment data, none received a pediatric regimen prior to 2008. From 2008-2012, while the adult intergroup C10403 pediatric-inspired ALL protocol was open to accrual, 31% of AYAs treated by adult oncologists received pediatric regimens. This fell to 21% in 2013-2014. Adult facilities treating 652 AYA ALL GBACR patients per year were more likely to administer pediatric regimens than lower volume centers (P= 0.03).ConclusionAs of 2014, only a minority of AYAs with ALL received pediatric ALL regimens at adult cancer centers.HHSN261201000035C/PC,CA/None/NoneHHSN261201000140C/CA/NCI NIH HHS/United StatesHHSN261201000036C/CA/NCI NIH HHS/United StatesHHSN261201000035I/CA/NCI NIH HHS/United StatesHHSN261201000034C/CA/NCI NIH HHS/United StatesU58 DP003862/DP/NCCDPHP CDC HHS/United StatesP30 CA124435/CA/NCI NIH HHS/United States2018-01-01T00:00:00Z27622953PMC5161602vault:2559