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Do ALL Treatments Depend on Age?

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Published on February 19, 2020

Key Takeaways

  • In childhood, ALL is the most common leukemia and most common cancer. In adults, it is the least common leukemia.
  • Most lessons in treating ALL are learned in the pediatric setting and later applied to adults.
  • When adolescent and young adult ALL patients get more intensive treatments given to children—rather than less intensive treatments given to adults—they have better outcomes.

“It’s one of those areas in cancer that really crosses the boundary between children and adults,” says Dr. Patrick Brown from the Kimmel Cancer Center at Johns Hopkins, speaking about acute lymphoblastic leukemia (ALL) with Patient Power Co-Founder Esther Schorr at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition.

Dr. Brown explains how ALL treatments differ depending on the age of the patient, and why adolescents and young adults should be treated as pediatric patients rather than adults. Watch now to learn more. 

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Transcript | Do ALL Treatments Depend on Age?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Esther Schorr:    
Hi there. This is Esther Schorr with Patient Power at ASH 2019 in Orlando, Florida, here with Dr. Pat Brown from Johns Hopkins, and I’m going to let him give you the rest of his credentials.

Dr. Brown:   
Absolutely. My name’s Pat Brown. I direct the Pediatric Leukemia Program at the Kimmel Cancer Center at Johns Hopkins. Happy to be here.

Esther Schorr:   
Thank you for being here.

Dr. Brown:    
Of course.

Esther Schorr:  
We’re kind of starting at ground zero, a little bit, with our acute leukemia audience. So, I wonder if you could just start talking a little bit about the work that you do both with pediatric ALL patients and with adult patients and how that treatment is different.

Dr. Brown:                 
Great. So, it’s great to be here, Esther. Thank you very much for asking me to be here.

Esther Schorr:                        
Pleasure.

Dr. Brown:                 
So, ALL is an interesting leukemia in that, in childhood, it’s the most common cancer and, by far, the most common leukemia. Whereas, in adults, it’s the least common leukemia of the four major types. And so, many of the treatment lessons that have been learned over the years have been learned in the pediatric setting and then applied to the adult setting. It’s one of those areas in cancer that really crosses the boundary between children and adults and, particularly, in the adolescent and young adult age range that don’t fit neatly into a pediatric or an adult model. That’s been an area that we’ve been particularly interested in.

Esther Schorr:                        
The treatments are different, then, for children versus adults. And what happens in those middle ages? 

Dr. Brown:                 
That’s a great question. So, up until probably about five years ago, typically, the patients in the middle, what treatment they got would depend on which doctors they were seeing. If they were seeing an adult oncologist, they would tend to get therapy that was developed more for adult ALL patients. That therapy was less intensive than what is given to children and was associated with lower cure rates, or lower outcomes. If those patients were treated in a pediatric setting, they would get the more intensive treatments that children with ALL have typically received over the years, and their outcomes were better. And so, over the past 5 to 10 years, there’s really been a push to kind of harmonize the approach to adolescent and young adults so that the lessons learned from the pediatric side can really apply to those patients who it’s been shown, now, over those years, can tolerate the more intensive treatment that children receive and that their outcomes are, in fact, better when they receive that more intensive treatment.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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