Haematologists' approaches to the management of adolescents and young adults with acute leukaemia

Abstract

Summary. Approaches to the management of adolescents and young adults with acute leukaemia were investigated by sending a questionnaire to hospitals identified as having diagnosed or treated patients aged 15±29 years. The responses demonstrated the types of hospital treating these patients, the haematologists' perceived practice for entry of patients to Medical Research Council (MRC) leukaemia trials and reasons for non-entry. Data were linked to MRC trials data to determine the proportion of patients aged 15± 29 years at diagnosis in responding hospitals actually treated in MRC leukaemia trials in the 5 years preceding the questionnaire. Eighty-two per cent of haematologists stated that they entered patients`always' or`whenever possible' for acute myeloid leukaemia (AML) and 76% for acute lymphoblastic leukaemia (ALL), but actual entry rates from the study hospitals were 46% of 239 AML patients and 36% of 182 ALL patients. The reasons most commonly reported for not entering eligible patients to national leukaemia trials were clinician preference for one arm of an MRC trial, a regional study or non-trial protocol, and concern about workload and ethical approval.

A participatory study of teenagers and young adults views on access and participation in cancer research

“…What healthcare professionals say they do or intend to do, and what happens in practice is not always synonymous. An example of this was shown by Benjamin et al (2000) who cited that 76-82% of haematologists said they entered patients into leukaemia clinical trials; however examination of entry rates showed only 36-46% did so. Similarly, the BRIGHTLIGHT feasibility work with healthcare professionals and the cancer research network uncovered a great deal of enthusiasm for the study yet recruitment rates remain below target.…”

Clinical characteristics, biologic features and outcome for young adult patients with acute lymphoblastic leukaemia

“…The vast majority of YA patients with ALL treated on paediatric trials are treated by university-based paediatric oncologists while 25-40% of patients treated on adult trials are treated by community-based adult oncologists. However, a UK study suggested no difference in outcome for adults with ALL treated by university or community based adult oncologists (Benjamin et al, 2000), but this issue has not been examined in the USA adult ALL trials.…”

Significance of age in acute myeloid leukemia patients younger than 30 years

“…25 There is also a big difference for children and adolescents to access treatment in clinical trials, which might influence prognosis. 36,37 In the Nordic countries and in Germany more than 90% of children <15 years with AML are treated within clinical trials 38,39 ; in the UK this applies to 67% 40 and in the US to >60%. However, regarding the 15-20-year-olds or older with cancer, the number of patients enrolled in clinical trials is much lower.…”