Stage at diagnosis for children with blood cancers in Australia: Application of the Toronto Paediatric Cancer Stage Guidelines in a population-based national childhood cancer registry

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Author(s)
Youlden, Danny R
Gupta, Sumit
Frazier, A Lindsay
Moore, Andrew S
Baade, Peter D
Valery, Patricia C
Green, Adele C
Aitken, Joanne F
Year published
2019
Metadata
Show full item recordAbstract
Background
Information on stage at diagnosis for childhood blood cancers is essential for surveillance but is not available on a population basis in most countries. Our aim was to apply the internationally endorsed Toronto Paediatric Cancer Stage Guidelines to children (<15 years) with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), Hodgkin lymphoma (HL), or non‐Hodgkin lymphoma (NHL) and to assess differences in survival by stage at diagnosis.
Procedure
Stage was defined by extent of involvement of the central nervous system (CNS) for ALL and AML and using the Ann Arbor and St Jude‐Murphy systems for HL ...
View more >Background Information on stage at diagnosis for childhood blood cancers is essential for surveillance but is not available on a population basis in most countries. Our aim was to apply the internationally endorsed Toronto Paediatric Cancer Stage Guidelines to children (<15 years) with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), Hodgkin lymphoma (HL), or non‐Hodgkin lymphoma (NHL) and to assess differences in survival by stage at diagnosis. Procedure Stage was defined by extent of involvement of the central nervous system (CNS) for ALL and AML and using the Ann Arbor and St Jude‐Murphy systems for HL and NHL, respectively. The study cohort was drawn from the population‐based Australian Childhood Cancer Registry, consisting of children diagnosed with one of these four blood cancers between 2006 and 2014 with follow‐up to 2015. Five‐year observed survival was estimated from the Kaplan–Meier method. Results Stage was assigned to 2201 of 2351 eligible patients (94%), ranging from 85% for AML to 95% for ALL, HL, and NHL. Survival following ALL varied from 94% (95% CI = 93%–95%) for CNS1 disease to 89% (95% CI = 79%–94%) for CNS2 (P = 0.07), whereas for AML there was essentially no difference in survival between CNS− (77%) and CNS+ disease (78%; P = 0.94). Nearly all children with HL survived for five years. There was a trend (P = 0.04) toward worsening survival with higher stage for NHL. Conclusions These results provide the first population‐wide picture of the distribution and outcomes for childhood blood cancers in Australia by extent of disease at diagnosis and provide a baseline for future comparisons.
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View more >Background Information on stage at diagnosis for childhood blood cancers is essential for surveillance but is not available on a population basis in most countries. Our aim was to apply the internationally endorsed Toronto Paediatric Cancer Stage Guidelines to children (<15 years) with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), Hodgkin lymphoma (HL), or non‐Hodgkin lymphoma (NHL) and to assess differences in survival by stage at diagnosis. Procedure Stage was defined by extent of involvement of the central nervous system (CNS) for ALL and AML and using the Ann Arbor and St Jude‐Murphy systems for HL and NHL, respectively. The study cohort was drawn from the population‐based Australian Childhood Cancer Registry, consisting of children diagnosed with one of these four blood cancers between 2006 and 2014 with follow‐up to 2015. Five‐year observed survival was estimated from the Kaplan–Meier method. Results Stage was assigned to 2201 of 2351 eligible patients (94%), ranging from 85% for AML to 95% for ALL, HL, and NHL. Survival following ALL varied from 94% (95% CI = 93%–95%) for CNS1 disease to 89% (95% CI = 79%–94%) for CNS2 (P = 0.07), whereas for AML there was essentially no difference in survival between CNS− (77%) and CNS+ disease (78%; P = 0.94). Nearly all children with HL survived for five years. There was a trend (P = 0.04) toward worsening survival with higher stage for NHL. Conclusions These results provide the first population‐wide picture of the distribution and outcomes for childhood blood cancers in Australia by extent of disease at diagnosis and provide a baseline for future comparisons.
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Journal Title
PEDIATRIC BLOOD & CANCER
Volume
66
Issue
6
Copyright Statement
© 2019 Wiley Periodicals Inc. This is the peer reviewed version of the following article: Stage at diagnosis for children with blood cancers in Australia: Application of the Toronto Paediatric Cancer Stage Guidelines in a population‐based national childhood cancer registry, Pediatric Blood & Cancer, Vol. 66:e27683, 2019, which has been published in final form at https://doi.org/10.1002/pbc.27683. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)
Subject
Clinical sciences
Oncology and carcinogenesis