Blood cancers

Paediatric leukaemia survival is high and improving but young adults left behind

Australian children, adolescents and young adults with leukaemias have amongst the highest 5-year survival rates in the world.

The Australian success rate of 87.7% 5-year net survival for all leukaemias combined is shared with other high income countries of Belgium (85.1%), Denmark (87.3%), Finland (86.5%), Iceland (92.0%) and Switzerland (85.2%).

However the staggering global health inequity is evidenced by low survival rates in Central and South American countries such as Mexico (45.5%) and Asian countries such as India (50.0%).

The study, published in The Lancet Child and Adolescent Health, analysed data from 164,563 patients (0-20 years) from 258 cancer registries across 61 countries.

It found Australian patients also did comparatively well in 5-year net survival for lymphoid leukaemia (89.2%), AML (77.7%), chronic myeloproliferative diseases (93.5%) and unspecified leukaemias (87.0%).

The study said Australia, along with the US, UK, France, Switzerland and New Zealand had enjoyed a steady increase of about 5% in 5-­year survival during the 15 ­year period from 2000 to 2014.

“The gains in survival were largely driven by improvements in 5-­year survival in children,” it said.

“In countries such as the UK, Canada, the USA, Australia, and New Zealand, most children with leukaemia have been enrolled in long-­running series of clinical trials for many years.”

The study said adolescents and young adults were less likely to be enrolled in clinical trials than children because of the small number of clinical trials available to them.

“Over the past few years, in some parts of the world, adolescents and young adults with leukaemia have increasingly been treated under paediatric protocols, which has led to improved outcomes,” it said.

“However, this approach has not been adopted worldwide, and survival for adolescents and young adults with leukaemia is often lower than that of children.”

“The gap in survival between high-­income countries and low-­income and middle-­income countries for children with leukaemia persists, and adolescents and young adults with leukaemia continue to have lower survival than children worldwide.”

The study is part of the CONCORD program for worldwide surveillance of trends in cancer survival.

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