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Prinses Máxima Centrum

Survival rate of children with Acute Lymphatic Leukemia significantly improved over the past 30 years

The survival rate of children (0 to 17 years) with ALL (acute lymphatic leukemia) was already reasonably good in the nineties in the Netherlands and has increased further in recent decades to 91%. This was found in an epidemiologically descriptive study by researchers of the Princess Máxima Center and the Netherlands Comprehensive Cancer Organisation (IKNL).

The study, which was published in the scientific journal Leukemia, showed that the chance of survival of ALL five years after diagnosis increased from 80% in the early nineties to 91% in the last measured period from 2010 to 2015. Researcher Ardine Reedijk used data from the Dutch Cancer Registry (NKR) for this purpose. Additional externally collected mortality figures came from the Central Bureau of Statistics (CBS).

The occurrence of Acute Lymphatic Leukemia 
The incidence (number of new cases) of ALL has not increased over time, although the number of children with this disease does vary from year to year. On average 115 children are diagnosed with ALL each year. For subtypes B precursor ALL in the age group 10-14 and T-cell ALL in 15-17 year-olds there was a slight increase in incidence. Although the researchers have no clear explanation for the slight increase in incidence, there are no clear factors to indicate that the risk of developing ALL at childhood age in the Netherlands is increasing.

 

Treatment of adolescents with ALL
There was a clear rise in the percentage of adolescents (15-17 year-olds) with ALL treated in a pediatric oncology center. In the years 1990-1994, 35% of 15-17 year-olds were treated in such a center, in 2010-2015 this was 87%. The risk of death in 15-17 year-olds was 70% lower when treated in a pediatric oncology center, compared to an adult oncology department in a university hospital or a general hospital. The treatment of ALL patients up to the age of 40 in adult hemato-oncology departments in the Netherlands has been adapted to more pediatric oncology treatment schedules since 2004. However, there may still be differences in treatment between the pediatric and adult oncology departments in terms of treatment schedules and side effects.

 

Long-term research
The higher survival rates and results of this research indicate a long-term development of small improvements. In the Princess Máxima Center, where since a few years all child oncology research has been brought together, we will continue to monitor future improvements. The information on cancer prevention and survival is not only important to evaluate new treatments, but can also be used by doctors to inform and advise children and their parents on up-to-date prognoses.

From the Princess Máxima Center, this research was carried out by Dr. Ardine Reedijk, researcher, and pediatric oncologist Prof. Rob Pieters, epidemiologist Dr. Henrike Karim-Kos, pediatric oncologist Dr. Inge van der Sluis, and pediatrician-epidemiologist Prof. Leontien Kremer.

Read the article in Leukemia: https://rdcu.be/b6nLt