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Patterns of care and outcomes in adolescent and young adult acute lymphoblastic leukemia: a population-based study

Lori Muffly, Elysia Alvarez, Daphne Lichtensztajn, Renata Abrahão, Scarlett Lin Gomez and Theresa Keegan

Data supplements

Article Figures & Data

Tables

  • Table 1.

    Baseline patient and treating facility characteristics according to adult or pediatric treatment setting among AYA with ALL, ages 15-39 y, 2004-2014, California

    All settings (N = 1473)Adult setting (N = 998)Pediatric setting (N = 475)
    N%N%N%
    Age at diagnosis, y
     15-1847632.3626.241487.1
     19-2436224.530430.45812.2
     25-2921214.321021.0<50.4
     30-3420814.120820.800
     35-3921514.521421.4<50.2
    Year of diagnosis
     2004-200746931.834134.112826.9
     2008-201154837.236036.018839.5
     2012-201445630.929729.715933.4
    Sex
     Male94364.061361.433069.4
     Female53035.938538.514530.5
    Race/ethnicity
     NH white34023.025025.09018.9
     NH African American453.0333.3122.5
     Hispanic93963.762262.331766.7
     Asian/PI1419.5868.65511.5
     Other/unknown80.570.7<50.2
    Neighborhood SES quintile
     1 Lowest47232.032432.414831.1
     233422.622522.510922.9
     326217.717517.58718.3
     421514.514714.76814.3
     5 Highest19012.812712.76313.2
    Health insurance
     Uninsured/self-pay382.5323.261.2
     Insured NOS785.2535.3255.2
     Private/military63643.141741.721946.1
     Public/Medicaid/Medicare69647.247247.222447.1
     Unknown251.6242.4<50.2
    Induction facility is COG center or NCI CC
     No64543.759259.35311.1
     Yes82856.240640.642288.8
    • NH, non-Hispanic; NOS, not otherwise specified; PI, Pacific Islander; SES, socioeconomic status.

  • Table 2.

    Chemotherapy regimens administered to AYA with ALL, ages 15-39 y, 2004-2014, California

    SettingAll years2004-20072008-20112012-2014
    N%N%N%N%
    Adult treatment
     Adult ALL regimen54375.618189.621373.414965.9
     Hyper-CVAD30642.67436.612342.410948.2
     Adult cooperative group regimens*12517.46130.14013.72410.6
     Linker regimen8411.62813.84314.8135.7
     Other283.8188.972.4<51.3
     Pediatric ALL regimen17524.32110.37726.57734.0
     C10403679.3003612.43113.7
      BFM456.2125.9206.8135.7
      Pediatric cooperative group regimens385.252.4165.5177.5
      Other pediatric regimen253.4<51.951.7167.0
    Pediatric treatment
     Pediatric ALL regimen472100.0126100.0187100.0159100.0
     Pediatric cooperative group regimens^32869.47962.612365.712679.2
     Other pediatric regimen14430.54737.36434.23320.7
    • BFM, Berlin-Frankfurt-Münster; CVAD, cyclophosphamide, vincristine sulfate, Adriamycin, and dexamethasone.

    • * Adult cooperative group regimens with the exception of C10403.

  • Table 3.

    Multivariable associations of patient and treatment characteristics with OS and LSS among AYA with ALL, ages 15-39 y, 2004-2014, California

    OSLSS
    HR (95% CI)PHR (95% CI)P
    Sex.27.64
     Female0.91 (0.76-1.08)0.96 (0.79-1.16)
     MaleRef.Ref.
    Age at diagnosis, y.07.38
     15-180.75 (0.51-1.10)0.86 (0.58-1.29)
     19-240.83 (0.63-1.08)0.85 (0.64-1.14)
     25-291.13 (0.84-1.51)1.08 (0.79-1.49)
     30-341.08 (0.81-1.44)1.09 (0.80-1.48)
     35-39Ref.Ref.
    Race/ethnicity<.001<.001
     Asian/PI1.1 (0.79-1.08)1.14 (0.76-1.71)
     Hispanic1.64 (1.30-2.06)1.76 (1.39-2.24)
     NH African American2.07 (1.28-3.35)2.01 (1.19-3.39)
     Other/ unknown1.97 (0.72-5.40)2.41 (0.88-6.61)
     NH whiteRef.Ref.
    Treatment setting.001<.001
     Pediatric0.53 (0.37-0.76)0.51 (0.35-0.74)
     AdultRef.Ref.
    Induction facility is COG center or NCI CC.019.026
     Yes0.80 (0.66-0.96)0.80 (0.65-0.97)
     NoRef.Ref.
    • Final model includes age, sex, and all variables significant at the P < .10 level.

    • Ref, reference.

  • Table 4.

    Multivariable associations of patient and treatment characteristics with OS and LSS among AYA with ALL, ages 15-24 y, 2004-2014, California

    OSLSS
    HR (95% CI)PHR (95% CI)P
    Sex.26.53
     Female0.86 (0.66-1.12)0.92 (0.70-1.21)
     MaleRef.Ref.
    Age at diagnosis, y.51.94
     15-180.89 (0.64-1.25)1.01 (0.71-1.44)
     19-24Ref.Ref.
    Race/ethnicity<.001<.001
     Asian/PI1.30 (0.72-2.37)1.45 (0.78-2.76)
     Hispanic2.30 (1.59-3.31)2.48 (1.66-3.94)
     NH African American3.10 (1.63-5.88)3.13 (1.56-6.32)
     Other/ unknown0.86 (0.12-6.28)1.09 (0.15-7.99)
     NH whiteRef.Ref.
    Treatment setting.001.001
     Pediatric0.51 (0.35-0.74)0.51 (0.34-0.76)
     AdultRef.Ref.
    Induction facility is COG center or NCI CC.07.029
     Yes0.77 (0.58-1.02)0.72 (0.53-0.97)
     NoRef.Ref.
    • Final model includes age, sex, and all variables significant at the P < .10 level.

  • Table 5.

    Multivariable associations of patient and treatment characteristics with OS and LSS among AYA with ALL treated in an adult setting, ages 15-39 y, 2009-2014, California

    OSLSS
    HR (95% CI)PHR (95% CI)P
    Sex.27.59
     Female0.82 (0.58-1.16)0.90 (0.62-1.31)
     MaleRef.Ref.
    Race/ethnicity.60.04
     Asian/PI1.39 (0.73-2.62)1.73 (0.85-3.51)
     Hispanic1.82 (1.22-2.74)2.10 (1.31-3.35)
     NH African American2.04 (0.78-5.36)2.19 (0.74-6.51)
     Other/ unknown2.02 (0.48-8.56)2.80 (0.64-12.17)
     NH whiteRef.Ref.
    Front-line ALL regimen.83.21
     Pediatric1.05 (0.70-1.57)1.33 (0.85-2.08)
     AdultRef.Ref.
    Induction facility is COG center or NCI CC0.280.10
     Yes0.81 (0.56-1.19)0.70 (0.46-1.07)
     NoRef.Ref.
    • Final model is stratified on age and includes sex, type of induction, NCI/COG CC status, and all variables significant at the P < .10 level.