Outcome disparities between children and young adults with cancer

For several cancer types, adolescents and young adults (AYAs, 18-39 years) have a worse prognosis compared to pediatric patients (0-17 years). The exact reasons for the inferior outcomes of AYAs with cancer are, however, still not clear.

Our current research program focuses on:

Reducing survival disparities between pediatric, adolescent, and young adult patients with acute myeloid leukemia

Adolescents and young adults (AYAs) with acute myeloid leukemia (AML) have a worse survival than pediatric patients. In a recent study, we have showed that this was also the case in the Netherlands between 1990 and 2015. Importantly, the survival gap was largest (almost 20 percent-points) in the most recent time period.

In this project, we examine factors contributing to the survival disparity between AYAs and children diagnosed with AML in the Netherlands by combining detailed information on disease biology and treatment from existing population-based and trial databases.

This project is performed in close collaboration with prof. Michel Zwaan and prof. Marc Raaijmakers (HOVON / ErasmusMC).

Survival disparities between children and young adults for the major subtypes of non-Hodgkin lymphoma

Non-Hodgkin lymphoma (NHL) is a relatively common type of cancer in children and young adults (AYAs). It has been shown that AYAs with NHL have poorer survival than children. However, the survival disparity may vary depending on subtype.

Using population-based data from the Netherlands Cancer Registry, we compared survival of children and AYAs diagnosed with NHL in the Netherlands between 1990 and 2015 for the major subtypes. AYAs with T-lymphoblastic lymphoma (T-LBL) and Burkitt lymphoma (BL) had a worse prognosis than children with these subtypes. For BL, the survival disparity decreased over time and only persisted for the oldest AYAs in recent years. Children and AYAs with diffuse large B-cell lymphoma (DLBCL) and anaplastic large cell lymphoma (ALCL) had similar survival. Interestingly, children with DLBCL are more dose-intensively treated than AYAs.

This study is performed in close collaboration with pediatric hemato-oncologists from the Princess Máxima Center for pediatric oncology and hemato-oncologists from adult wards.

Survival disparities between children and young adults with Ewing sarcoma

Ewing sarcoma is a tumor of the bone and soft tissues that typically affects children and young adults (AYAs). AYAs with Ewing sarcoma were reported to have a worse survival than children. However, findings specified by important clinical factors, that may vary with age, are limited.

In this project, we comprehensively evaluate population-based survival of children and AYAs diagnosed with Ewing sarcoma in the Netherlands over three decades considering tissue of origin, tumor site, and disease stage.

This project is being performed in close collaboration with prof. Hans Merks and other (pediatric and adult) oncologists and orthopedic surgeons.