Chronic Myeloid Leukemia in Adolescents and Young Adults: Patient Characteristics, Outcomes and Review of the LiteraturePemmaraju N. · Cortes J.
Department of Leukemia, M.D. Anderson Cancer Center, University of Texas, Houston, Tex., USA
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Over the past two decades, many improvements have been made in the management of patients with leukemia. Research in this field most often focuses on the youngest and oldest patient age groups. However, the population of patients in between those age groups has received relatively little attention with few studies specifically focusing on them. This important ‘age gap' has demonstrated a unique, difficult-to-treat group of patients known as adolescents and young adults, or AYAs. Variably defined in the literature as patients from late teenage years to the age of up to 40 years, the AYA group of patients represents a vulnerable subset of patients now identified to require its own focus, development of therapeutic strategies and parallel emphasis on special support systems involving multidisciplinary psychosocial care. Despite the great advancements that have been realized for patients with chronic myeloid leukemia (CML), the AYA group has seldom been the focus of specific reports and studies, and the outcome appears to lag behind the general population. This review focuses on this subset of AYA patients with CML and summarizes the available data and recent developments, challenges and treatment options for this group of patients.
© 2014 S. Karger AG, Basel
- Pui CH, Evans WE: A 50-year journey to cure childhood acute lymphoblastic leukemia. Semin Hematol 2013;50:185-196.
- Wood WA, Lee SJ: Malignant hematologic diseases in adolescents and young adults. Blood 2011;117:5803-5815.
- Cortes J, Kantarjian H: How I treat newly diagnosed chronic phase CML. Blood 2012;120:1390-1397.
- Siegel R, Naishadham D, Jemal A: Cancer statistics, 2013. CA Cancer J Clin 2013;63:11-30.
- Pemmaraju N, Kantarjian H, Shan J, Jabbour E, Quintas-Cardama A, Verstovsek S, Ravandi F, Wierda W, OʼBrien S, Cortes J: Analysis of outcomes in adolescents and young adults with chronic myelogenous leukemia treated with upfront tyrosine kinase inhibitor therapy. Haematologica 2012;97:1029-1035.
- Thomas DM, Albritton KH, Ferrari A: Adolescent and young adult oncology: an emerging field. J Clin Oncol 2010;28:4781-4782.
- Pollock BH, Birch JM: Registration and classification of adolescent and young adult cancer cases. Pediatr Blood Cancer 2008;50:1090-1093.
- Stock W: Adolescents and young adults with acute lymphoblastic leukemia. Hematology Am Soc Hematol Educ Program 2010;2010:21-29.
- Bleyer A, Budd T, Montello M: Adolescents and young adults with cancer: the scope of the problem and criticality of clinical trials. Cancer 2006;107:1645-1655.
- Bleyer A, Morgan S, Barr R: Proceedings of a workshop: bridging the gap in care and addressing participation in clinical trials. Cancer 2006;107:1656-1658.
- Butow P, Palmer S, Pai A, Goodenough B, Luckett T, King M: Review of adherence-related issues in adolescents and young adults with cancer. J Clin Oncol 2010;28:4800-4809.
- Bleyer A, Viny A, Barr R: Cancer in 15- to 29-year-olds by primary site. Oncologist 2006;11:590-601.
- Brunner AM, Campigotto F, Sadrzadeh H, Drapkin BJ, Chen YB, Neuberg DS, Fathi AT: Trends in all-cause mortality among patients with chronic myeloid leukemia: a Surveillance, Epidemiology, and End Results database analysis. Cancer 2013;119:2620-2629.
- Chen Y, Wang H, Kantarjian H, Cortes J: Trends in chronic myeloid leukemia incidence and survival in the United States from 1975 to 2009. Leuk Lymphoma 2013;54:1411-1417.
- Lakshmaiah KC, Bhise R, Purohit S, Abraham LJ, Lokanatha D, Suresh TM, Appaji L, Arunakumari BS, Govindbabu K: Chronic myeloid leukemia in children and adolescents: results of treatment with imatinib mesylate. Leuk Lymphoma 2012;53:2430-2433.
- Kalmanti L, Saussele S, Lauseker M, Proetel U, Müller MC, Hanfstein B, Schreiber A, Fabarius A, Pfirrmann M, Schnittger S, Dengler J, Falge C, Kanz L, Neubauer A, Stegelmann F, Pfreundschuh M, Waller CF, Spiekermann K, Krause SW, Heim D, Nerl C, Hossfeld DK, Kolb HJ, Hochhaus A, Hasford J, Hehlmann R; German Chronic Myeloid Leukemia Study Group; Schweizerische Arbeitsgemeinschaft für Klinische Krebsforschung: Younger patients with chronic myeloid leukemia do well in spite of poor prognostic indicators: results from the randomized CML study IV. Ann Hematol 2014;93:71-80.
- Santoleri F, Sorice P, Lasala R, Rizzo RC, Costantini A: Patient adherence and persistence with imatinib, nilotinib, dasatinib in clinical practice. PLoS One 2013;8:e56813.
- Marin D, Bazeos A, Mahon FX, Eliasson L, Milojkovic D, Bua M, Apperley JF, Szydlo R, Desai R, Kozlowski K, Paliompeis C, Latham V, Foroni L, Molimard M, Reid A, Rezvani K, de Lavallade H, Guallar C, Goldman J, Khorashad JS: Adherence is the critical factor for achieving molecular responses in patients with chronic myeloid leukemia who achieve complete cytogenetic responses on imatinib. J Clin Oncol 2010;28:2381-2388.
- Jain N, O'Brien S: The frontline treatment of chronic myeloid leukemia in the chronic phase: current clinical decisions and future prospects for treatment. Expert Rev Hematol 2013;6:575-586.
- Parsons HM, Harlan LC, Seibel NL, Stevens JL, Keegan TH: Clinical trial participation and time to treatment among adolescents and young adults with cancer: does age at diagnosis or insurance make a difference? J Clin Oncol 2011;29:4045-4053.
- Moy B, Polite BN, Halpern MT, Stranne SK, Winer EP, Wollins DS, Newman LA: American Society of Clinical Oncology policy statement: opportunities in the patient protection and affordable care act to reduce cancer care disparities. J Clin Oncol 2011;29:3816-3824.
- O'Brien SG, Guilhot F, Larson RA, Gathmann I, Baccarani M, Cervantes F, Cornelissen JJ, Fischer T, Hochhaus A, Hughes T, Lechner K, Nielsen JL, Rousselot P, Reiffers J, Saglio G, Shepherd J, Simonsson B, Gratwohl A, Goldman JM, Kantarjian H, Taylor K, Verhoef G, Bolton AE, Capdeville R, Druker BJ; IRIS Investigators: Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med 2003;348:994-1004.
- Kantarjian HM, Shah NP, Cortes JE, Baccarani M, Agarwal MB, Undurraga MS, Wang J, Ipiña JJ, Kim DW, Ogura M, Pavlovsky C, Junghanss C, Milone JH, Nicolini FE, Robak T, Van Droogenbroeck J, Vellenga E, Bradley-Garelik MB, Zhu C, Hochhaus A: Dasatinib or imatinib in newly diagnosed chronic-phase chronic myeloid leukemia: 2-year follow-up from a randomized phase 3 trial (DASISION). Blood 2012;119:1123-1129.
- Saglio G, Kim DW, Issaragrisil S, le Coutre P, Etienne G, Lobo C, Pasquini R, Clark RE, Hochhaus A, Hughes TP, Gallagher N, Hoenekopp A, Dong M, Haque A, Larson RA, Kantarjian HM; ENESTnd Investigators: Nilotinib versus imatinib for newly diagnosed chronic myeloid leukemia. N Engl J Med 2010;362:2251-2259.
- Cortes JE, Kantarjian H, Shah NP, Bixby D, Mauro MJ, Flinn I, OʼHare T, Hu S, Narasimhan NI, Rivera VM, Clackson T, Turner CD, Haluska FG, Druker BJ, Deininger MW, Talpaz M: Ponatinib in refractory Philadelphia chromosome-positive leukemias. N Engl J Med 2012;367:2075-2088.
- Cortes JE, Kantarjian HM, Brümmendorf TH, Kim DW, Turkina AG, Shen ZX, Pasquini R, Khoury HJ, Arkin S, Volkert A, Besson N, Abbas R, Wang J, Leip E, Gambacorti-Passerini C: Safety and efficacy of bosutinib (SKI-606) in chronic phase Philadelphia chromosome-positive chronic myeloid leukemia patients with resistance or intolerance to imatinib. Blood 2011;118:4567-4576.
- Cortes J, Digumarti R, Parikh PM, Wetzler M, Lipton JH, Hochhaus A, Craig AR, Benichou AC, Nicolini FE, Kantarjian HM; Omacetaxine 203 Study Group: Phase 2 study of subcutaneous omacetaxine mepesuccinate for chronic-phase chronic myeloid leukemia patients resistant to or intolerant of tyrosine kinase inhibitors. Am J Hematol 2013;88:350-354.
- Saussele S, Lauseker M, Gratwohl A, Beelen DW, Bunjes D, Schwerdtfeger R, Kolb HJ, Ho AD, Falge C, Holler E, Schlimok G, Zander AR, Arnold R, Kanz L, Dengler R, Haferlach C, Schlegelberger B, Pfirrmann M, Müller MC, Schnittger S, Leitner A, Pletsch N, Hochhaus A, Hasford J, Hehlmann R; German CML Study Group: Allogeneic hematopoietic stem cell transplantation (allo SCT) for chronic myeloid leukemia in the imatinib era: evaluation of its impact within a subgroup of the randomized German CML Study IV. Blood 2010;115:1880-1885.
- Veldman R, El Rassi F, Holloway S, Langston A, Khoury HJ: Advances in hematopoietic stem cell transplantation in chronic myeloid leukemia. Discov Med 2013;16:179-186.
- Levine J, Canada A, Stern CJ: Fertility preservation in adolescents and young adults with cancer. J Clin Oncol 2010;28:4831-4841.
- Bresee JM, Nagler HM: Is cryopreservation of sperm effective for preserving fertility in adolescents and young adults with cancer? Nat Clin Pract Urol 2008;5:14-15.
- Iqbal J, Ali Z, Khan AU, Aziz Z: Pregnancy outcomes in patients with chronic myeloid leukemia treated with imatinib mesylate: short report from a developing country. Leuk Lymphoma, Epub ahead of print.
- Ault P, Kantarjian H, O'Brien S, Faderl S, Beran M, Rios MB, Koller C, Giles F, Keating M, Talpaz M, Cortes J: Pregnancy among patients with chronic myeloid leukemia treated with imatinib. J Clin Oncol 2006;24:1204-1208.
- Pye SM, Cortes J, Ault P, Hatfield A, Kantarjian H, Pilot R, Rosti G, Apperley JF: The effects of imatinib on pregnancy outcome. Blood 2008;111:5505-5508.
Cortes J, O'Brien S, Ault P, Borthakur G, Jabbour E, Bradley-Garelik B, Debreczeni K, Yang D, Liu D, Kantarjian H: Pregnancy Outcomes among Patients with Chronic Myeloid Leukemia Treated with Dasatinib. ASH Annual Meeting Abstracts 2008;112:3230.
- Yadav U, Solanki SL, Yadav R: Chronic myeloid leukemia with pregnancy: successful management of pregnancy and delivery with hydroxyurea and imatinib continued till delivery. J Cancer Res Ther 2013;9:484-486.
- Martin J, Ramesh A, Devadasan L, Palaniappan, Martin JJ: An uneventful pregnancy and delivery, in a case with chronic myeloid leukemia on imatinib. Indian J Med Paediatr Oncol 2011;32:109-111.
- Meera V, Jijina F, Shrikande M, Madkaikar M, Ghosh K: Twin pregnancy in a patient of chronic myeloid leukemia on imatinib therapy. Leuk Res 2008;32:1620-1622.
- Pavlovsky C, Giere I, Van Thillo G: Planned pregnancy in a chronic myeloid leukemia patient in molecular remission. Case Rep Hematol 2012;2012:624590.
- Apperley J: Issues of imatinib and pregnancy outcome. J Natl Compr Canc Netw 2009;7:1050-1058.
- Apperley J: CML in pregnancy and childhood. Best Pract Res Clin Haematol 2009;22:455-474.
- Cole S, Kantarjian H, Ault P, Cortes JE: Successful completion of pregnancy in a patient with chronic myeloid leukemia without active intervention: a case report and review of the literature. Clin Lymphoma Myeloma 2009;9:324-327.
- Babson KA, Heinz AJ, Bonn-Miller MO: HIV medication adherence and HIV symptom severity: the roles of sleep quality and memory. AIDS Patient Care STDS 2013;27:544-552.
- Uplekar M, Walley J, Newell J: Directly observed treatment for tuberculosis. Lancet 1999;353:145, author reply 7-8.
- Bayer R, Wilkinson D: Directly observed therapy for tuberculosis: history of an idea. Lancet 1995;345:1545-1548.
- Saponara M, Pantaleo MA, Nannini M, Biasco G: Chronic therapy in gastrointestinal stromal tumours (GISTs): the big gap between theory and practice. Target Oncol 2012;7:243-246.
- Pemmaraju N, Munsell MF, Hortobagyi GN, Giordano SH: Retrospective review of male breast cancer patients: analysis of tamoxifen-related side-effects. Ann Oncol 2012;23:1471-1474.
- Anelli TF, Anelli A, Tran KN, Lebwohl DE, Borgen PI: Tamoxifen administration is associated with a high rate of treatment-limiting symptoms in male breast cancer patients. Cancer 1994;74:74-77.
- Cummins M, Pavlakis N: The use of targeted therapies in pancreatic neuroendocrine tumours: patient assessment, treatment administration, and management of adverse events. Ther Adv Med Oncol 2013;5:286-300.
- Geynisman DM, Wickersham KE: Adherence to targeted oral anticancer medications. Discov Med 2013;15:231-241.
- Danesi R, Boni JP, Ravaud A: Oral and intravenously administered mTOR inhibitors for metastatic renal cell carcinoma: pharmacokinetic considerations and clinical implications. Cancer Treat Rev 2013;39:784-792.
- Huiart L, Bardou VJ, Giorgi R: The importance of adherence to oral therapies in the field of oncology: the example of breast cancer. Bull Cancer 2013;100:1007-1015.
- Chen LC, Chen TC, Huang YB, Chang CS: Disease acceptance and adherence to imatinib in Taiwanese chronic myeloid leukaemia outpatients. Int J Clin Pharm 2014;36:120-127.
- Conde-Estevez D, Salas E, Albanell J: Survey of oral chemotherapy safety and adherence practices of hospitals in Spain. Int J Clin Pharm 2013;35:1236-1244.
- Vander Velde N, Chen L, Guo A, Sharma H, Marynchenko M, Wu EQ, Liu J, Yang H, Lizheng S: Study of imatinib treatment patterns and outcomes among US veteran patients with Philadelphia chromosome-positive chronic myeloid leukemia. J Oncol Pract 2013;9:e212-e219.
- Johnson RH, Kroon L: Optimizing fertility preservation practices for adolescent and young adult cancer patients. J Natl Compr Canc Netw 2013;11:71-77.
- Morgan S, Davies S, Palmer S, Plaster M: Sex, drugs, and rock ‘n' roll: caring for adolescents and young adults with cancer. J Clin Oncol 2010;28:4825-4830.
- Kondryn HJ, Edmondson CL, Hill J, Eden TO: Treatment non-adherence in teenage and young adult patients with cancer. Lancet Oncol 2011;12:100-108.
- Experts in Chronic Myeloid Leukemia: The price of drugs for chronic myeloid leukemia (CML) is a reflection of the unsustainable prices of cancer drugs: from the perspective of a large group of CML experts. Blood 2013;121:4439-4442.
- Kantarjian H, Zwelling L: Cancer drug prices and the free-market forces. Cancer 2013;119:3903-3905.
- Freyer DR: Transition of care for young adult survivors of childhood and adolescent cancer: rationale and approaches. J Clin Oncol 2010;28:4810-4818.
- Klosky JL, Cash DK, Buscemi J, Lensing S, Garces-Webb DM, Zhao W, Wiard S, Hudson MM: Factors influencing long-term follow-up clinic attendance among survivors of childhood cancer. J Cancer Surviv 2008;2:225-232.
- McDonough JE: The road ahead for the Affordable Care Act. N Engl J Med 2012;367:199-201.
- Ferrari A, Thomas D, Franklin AR, Hayes-Lattin BM, Mascarin M, van der Graaf W, Albritton KH: Starting an adolescent and young adult program: some success stories and some obstacles to overcome. J Clin Oncol 2010;28:4850-4857.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.