Age Acts as an Adverse Independent Variable for Survival in Acute Lymphoblastic Leukemia: Data From a Cohort in Northeast Mexico

Clin Lymphoma Myeloma Leuk. 2017 Sep;17(9):590-594. doi: 10.1016/j.clml.2017.06.016. Epub 2017 Jun 17.

Abstract

Background: Survival for acute lymphoblastic leukemia (ALL) decreases with age. Patients across all age groups from a homogeneous ethnic and socioeconomic background were studied to document age effect.

Material and methods: Patients diagnosed from 2005 to 2015 at a university hospital in Northeast Mexico were divided into 4 age groups: infants (< 1), children (≥ 1 to < 16), adolescents (≥ 16 to ≤ 20), and adults (> 20 years). Correlation between age at diagnosis and relapse-free (RFS) and overall survival (OS) was investigated.

Results: A total of 377 patients were included. Five-year RFS and OS for children were 55.6% and 66.9%; for adolescents, 36.0% and 48.3%; for adults, 19.5% and 24.1%, respectively. Differences in RFS and OS between age groups were significant (P < .001, P < .001). In the Cox regression model, all age groups reached statistical significance in univariate analysis of mortality.

Conclusion: Age plays a decisive role in clinical evolution of ALL and strongly influences outcome. Age older than 20 represents a progressive high-risk factor for death.

Keywords: Adolescent ALL; Adult ALL; Gender; Infant leukemia; Organomegaly.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Mexico / epidemiology
  • Mexico / ethnology
  • Middle Aged
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / epidemiology*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Recurrence
  • Retrospective Studies
  • Socioeconomic Factors
  • Survival Rate
  • Symptom Assessment
  • Treatment Outcome
  • Young Adult

Substances

  • Biomarkers