Published on September 8, 2020
How do Acute Lymphoblastic Leukemia Treatments Differ by Age?
Treatments for adult, adolescent and pediatric acute lymphoblastic leukemia are different because the biology of the disease is different. Dr. Gail Roboz from Weill Cornell joins Patient Power host and advocate, Ruth Fein to discuss choosing doctors and cancer centers according to the unique needs of the patient. Dr. Roboz addresses that young adult patients can be treated by either a pediatric or an adult provider depending on the family situation and individual needs of the adolescent patient. Watch to hear the full discussion.
Transcript | Treating Adult, Adolescent and Pediatric Acute Lymphoblastic Leukemia (ALL)
How Does ALL Patient Age Affect Treatment?
Today, we're here with Dr. Gail Roboz to talk about another much more acute blood cancer, adult ALL, which is acute lymphoblastic leukemia, or sometimes called lymphocytic leukemia. So, Dr. Roboz is Director of the Clinical and Transitional Leukemia Program at Weill Cornell Medical Center in New York. Welcome, Dr. Roboz.
Thank you very much. Nice to be here.
Thanks. So first, can you tell us what we're talking about when we talk about adult ALL versus pediatric?
It's really important as a question because it gets at first biology differences between pediatric and adolescent and adult cases, but it also is really important for making some treatment decisions. So, ALL is the most common type of acute leukemia in children, and this can happen in babies, it can happen in young kids and it is by far more common than what happens in adults. Usually, the AYA or adolescent and young adult population is defined as between 18 and about 35, 40, sometimes up to 45, depending on your center. But actually, biology of these diseases of this age group is different from older patients in their sixties and seventies, and also different from what you see in the young kids. So, that's why when you hear ALL, it's not all the same, depending on what age we’re talking about.
Also, for patients who are watching and for family members, it's a huge consideration that 18, 19, 20, 21, are you going to be treated by a grownup hematologist or are you going to be treated by a pediatric hematologist? And this really depends on your center because in a lot of centers, whether it's a hospital or a cancer center, 18-year old’s are not always the same. You can have 18-year old’s who are married and have two children who would not be treated well or feel comfortable on a pediatric service. And you can also have 21-year old’s who are very much dependent on their parents, still living at home, very, very much more pediatric in their kind of cultural and societal orientation.
So, these decisions lead to some careful discussion between the treatment teams of, are you going to be in a pediatric group or are you going to be in an adult group? And also, are you going to get the same treatment if you get treated on the adult side of the fence or the pediatric side of the fence? So, I would say that for those 18, 19, 20, 21 year old’s, a lot of that discussion is going to be logistics. It's going to be, what's your life like, what's your family like, what's your personal life like, but also what are going to be the treatment differences in the actual chemotherapy between being on the pediatric side of the fence and the adult side of the fence? It's a little complicated.
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