Patterns of care and survival for adolescents and young adults with acute leukaemia - a population-based study

We report a population-based study of patterns of care and survival for peo ple with acute leukaemia diagnosed at age 15-29 years during 1984-94 in reg ions of England and Wales covered by specialist leukaemia registries. There were 879 patients: 417 with acute lymphoblastic leukaemia (ALL) and 462 wi th acute myeloid leukaemia (AML). For ALL, actuarial survival rates were 43 % at 5 years after diagnosis and 37% at 10 years. Survival improved signifi cantly between 1984-88 and 1989-94 for those aged 15-19 at diagnosis. Patie nts entered in national clinical trials and those not entered had similar s urvival rates. Survival Fates were similar at teaching and non-teaching hos pitals and at hospitals treating different numbers of study patients per ye ar. For AML, survival rates were 42% at 5 years after diagnosis and 39% at 10 years. Survival improved significantly between 1984-88 and 1989-94. Pati ents entered in the Medical Research Council AML10 trial had a higher survi val rate than those who were in the earlier AML9 trial. Survival did not va ry with category of hospital. We conclude that survival has improved for ad olescents and young adults with acute leukaemia but that there is at presen t no evidence that centralized treatment results in a survival benefit for patients in this age group.