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      Survival among children diagnosed with acute lymphoblastic leukemia in the United States, by race and age, 2001 to 2009: Findings from the CONCORD-2 study : ALL Survival Among Children in the US

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          Abstract

          <div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d7967974e176">BACKGROUND:</h5> <p id="P3">Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. This report describes the survival of children with ALL in the United States using the most comprehensive and up-to-date cancer registry data. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d7967974e181">METHODS:</h5> <p id="P4">Data from 37 state cancer registries that cover approximately 80% of the US population were used. Age-standardized survival up to 5 years was estimated for children aged 0–14 years who were diagnosed with ALL during 2 periods (2001–2003 and 2004–2009). </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d7967974e186">RESULTS:</h5> <p id="P5">In total, 17,500 children with ALL were included. The pooled age-standardized net survival estimates for all US registries combined were 95% at 1 year, 90% at 3 years, and 86% at 5 years for children diagnosed during 2001–2003, and 96%, 91%, and 88%, respectively, for those diagnosed during 2004–2009. Black children who were diagnosed during 2001–2003 had lower 5-year survival (84%) than white children (87%) and had less improvement in survival by 2004–2009. For those diagnosed during 2004–2009, the 1-year and 5- year survival estimates were 96% and 89%, respectively, for white children and 96% and 84%, respectively, for black children. During 2004–2009, survival was highest among children aged 1 to 4 years (95%) and lowest among children aged &lt;1 year (60%). </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d7967974e191">CONCLUSIONS:</h5> <p id="P6">The current results indicate that overall net survival from childhood ALL in the United States is high, but disparities by race still exist, especially beyond the first year after diagnosis. Clinical and public health strategies are needed to improve health care access, clinical trial enrollment, treatment, and survivorship care for children with ALL. </p> </div>

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          Most cited references28

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          Childhood Acute Lymphoblastic Leukemia: Progress Through Collaboration.

          To review the impact of collaborative studies on advances in the biology and treatment of acute lymphoblastic leukemia (ALL) in children and adolescents.
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            Geographical patterns and time trends of cancer incidence and survival among children and adolescents in Europe since the 1970s (the ACCISproject): an epidemiological study.

            Cancer is rare before age 20 years. We aimed to use the European database of childhood and adolescent cancer cases, within the Automated Childhood Cancer Information System project, to estimate patterns and trends of incidence and survival within Europe. Comparable, high-quality data from 63 European population-based cancer registries consisted of 113000 tumours in children and 18243 in adolescents diagnosed in 1970-99. Incidence rates and survival were compared by region (east vs west), period, and malignant disease. In the 1990s, age-standardised incidence rates were 140 per million for children (0-14 years) and 157 per million for ages 0-19 years. Over the three decades, overall incidence increased by 1.0% per year (p<0.0001) in children (increases for most tumour types), and by 1.5% (p<0.0001) in adolescents (15-19 years; notable increases were recorded for carcinomas, lymphomas, and germ-cell tumours). Overall 5-year survival for children in the 1990s was 64% in the east and 75% in the west, with differences between regions for virtually all tumour groups; 5-year survival was much the same in adolescents. Survival has improved dramatically since the 1970s in children and adolescents, more so in the west than in the east. Our results are clear evidence of an increase of cancer incidence in childhood and adolescence during the past decades, and of an acceleration of this trend. Geographical and temporal patterns suggest areas for further study into causes of these neoplasms, as well as providing an indicator of progress of public-health policy in Europe.
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              A 50-year journey to cure childhood acute lymphoblastic leukemia.

              The 50th anniversary of Seminars in Hematology coincides with the 50th anniversary of St. Jude Children's Research Hospital, and both milestones are inexorably linked to studies contributing to the cure of childhood acute lymphoblastic leukemia (ALL). We thought it fitting, therefore, to mark these events by traveling back in time to point out some of the achievements, institutions, study groups, and individuals that have made cure of childhood ALL a reality. In many instances, progress was driven by new ideas, while in others it was driven by new experimental tools that allowed more precise assessment of the biology of leukemic blasts and their utility in selecting therapy. We also discuss a number of contemporary advances that point the way to exciting future directions. Whatever pathways are taken, a clear challenge will be to use emerging genome-based or immunologic-based treatment options in ways that will enhance, rather than duplicate or compromise, recent gains in outcome with classic cytotoxic chemotherapy. The theme of this journey serves as a reminder of the chief ingredient of any research directed to a catastrophic disease such as ALL. It is the audacity of a small group of investigators who confronted a childhood cancer with the goal of cure, not palliation, as their mindset. Copyright © 2013 Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Cancer
                Cancer
                Wiley
                0008543X
                December 15 2017
                December 15 2017
                December 05 2017
                : 123
                : 5178-5189
                Affiliations
                [1 ]Division of Cancer Prevention and Control; Centers for Disease Control and Prevention; Atlanta Georgia
                [2 ]Georgia Center for Cancer Statistics; Emory University; Atlanta Georgia
                [3 ]Cancer Survival Group, Department of Epidemiology and Population Health; London School of Hygiene and Tropical Medicine; London United Kingdom
                [4 ]Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta; Emory University School of Medicine; Atlanta Georgia
                Article
                10.1002/cncr.30899
                6075705
                29205314
                b8985fe7-2d4c-4637-a3f4-31aaffb4ed93
                © 2017

                http://doi.wiley.com/10.1002/tdm_license_1.1

                http://onlinelibrary.wiley.com/termsAndConditions#vor

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