PMID- 35201611
OWN - NLM
STAT- MEDLINE
DCOM- 20220412
LR  - 20231020
IS  - 1097-0142 (Electronic)
IS  - 0008-543X (Print)
IS  - 0008-543X (Linking)
VI  - 128
IP  - 9
DP  - 2022 May 1
TI  - Sex-based disparities in outcome in pediatric acute lymphoblastic leukemia: a 
      Children's Oncology Group report.
PG  - 1863-1870
LID - 10.1002/cncr.34150 [doi]
AB  - BACKGROUND: Boys with acute lymphoblastic leukemia (ALL) have historically 
      experienced inferior survival compared to girls. This study determined whether 
      sex-based disparities persist with contemporary therapy and whether patterns of 
      treatment failure vary by sex. METHODS: Patients 1 to 30.99 years old were 
      enrolled on frontline Children's Oncology Group trials between 2004 and 2014. 
      Boys received an additional year of maintenance therapy. Sex-based differences in 
      the distribution of various prognosticators, event-free survival (EFS) and 
      overall survival (OS), and subcategories of relapse by site were explored. 
      RESULTS: A total of 8202 (54.4% male) B-cell ALL (B-ALL) and 1562 (74.3% male) 
      T-cell ALL (T-ALL) patients were included. There was no sex-based difference in 
      central nervous system (CNS) status. Boys experienced inferior 5-year EFS and OS 
      (EFS, 84.6% +/- 0.5% vs 86.0% +/- 0.6%, P = .009; OS, 91.3% +/- 0.4% vs 92.5% +/- 0.4%, 
      P = .02). This was attributable to boys with B-ALL, who experienced inferior EFS 
      (hazard ratio [HR], 1.2; 95% confidence interval [95% CI], 1.1-1.3; P = .004) and 
      OS (HR, 1.2; 95% CI, 1.0-1.4; P = .046) after adjustment for prognosticators. 
      Inferior B-ALL outcomes in boys were attributable to more relapses (5-year 
      cumulative incidence 11.2% +/- 0.5% vs 9.6% +/- 0.5%; P = .001), particularly 
      involving the CNS (4.2% +/- 0.3% vs 2.5% +/- 0.3%; P < .0001). There was no 
      difference in isolated bone marrow relapses (5.4% +/- 0.4% vs 6.2% +/- 0.4%; 
      P = .49). There were no sex-based differences in EFS or OS in T-ALL. CONCLUSIONS: 
      Sex-based disparities in ALL persist, attributable to increased CNS relapses in 
      boys with B-ALL. Studies of potential mechanisms are warranted. Improved 
      strategies to identify and modify treatment for patients at highest risk of CNS 
      relapse may have particular benefit for boys.
CI  - (c) 2022 American Cancer Society.
FAU - Gupta, Sumit
AU  - Gupta S
AUID- ORCID: 0000-0003-1334-3670
AD  - Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, 
      Canada.
FAU - Teachey, David T
AU  - Teachey DT
AD  - Department of Pediatrics and Center for Childhood Cancer Research, Children's 
      Hospital of Philadelphia and Perelman School of Medicine, University of 
      Philadelphia, Philadelphia, Pennsylvania.
FAU - Chen, Zhiguo
AU  - Chen Z
AD  - Department of Biostatistics, Colleges of Medicine, Public Health, and Health 
      Professions, University of Florida, Gainesville, Florida.
FAU - Rabin, Karen R
AU  - Rabin KR
AUID- ORCID: 0000-0002-4081-8195
AD  - Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
FAU - Dunsmore, Kimberly P
AU  - Dunsmore KP
AD  - Department of Pediatrics, University of Virginia School of Medicine, 
      Charlottesville, Virginia.
FAU - Larsen, Eric C
AU  - Larsen EC
AD  - Department of Pediatrics, Maine Children's Cancer Program, Scarborough, Maine.
FAU - Maloney, Kelly W
AU  - Maloney KW
AD  - Department of Pediatrics, University of Colorado and Children's Hospital 
      Colorado, Aurora, Colorado.
FAU - Mattano, Leonard A Jr
AU  - Mattano LA Jr
AD  - HARP Pharma Consulting, Mystic, Connecticutt.
FAU - Winter, Stuart S
AU  - Winter SS
AD  - Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota.
FAU - Carroll, Andrew J
AU  - Carroll AJ
AD  - Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama.
FAU - Heerema, Nyla A
AU  - Heerema NA
AD  - Department of Pathology, The Ohio State University Wexner School of Medicine, 
      Columbus, Ohio.
FAU - Borowitz, Michael J
AU  - Borowitz MJ
AD  - Division of Hematologic Pathology, Johns Hopkins University, Baltimore, Maryland.
FAU - Wood, Brent L
AU  - Wood BL
AD  - Department of Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, 
      California.
FAU - Carroll, William L
AU  - Carroll WL
AD  - Department of Pediatrics, NYU Langone Health, New York, New York.
FAU - Raetz, Elizabeth A
AU  - Raetz EA
AD  - Department of Pediatrics, NYU Langone Health, New York, New York.
FAU - Winick, Naomi J
AU  - Winick NJ
AD  - Department of Pediatrics, Harold C. Simmons Comprehensive Cancer Center, UT 
      Southwestern Medical Center, Dallas, Texas.
FAU - Loh, Mignon L
AU  - Loh ML
AD  - Division of Pediatric Hematology, Oncology, Bone Marrow Transplant and Cellular 
      Therapy, Seattle Children's Hospital, Seattle, Washington.
FAU - Hunger, Stephen P
AU  - Hunger SP
AD  - Department of Pediatrics and Center for Childhood Cancer Research, Children's 
      Hospital of Philadelphia and Perelman School of Medicine, University of 
      Philadelphia, Philadelphia, Pennsylvania.
FAU - Devidas, Meenakshi
AU  - Devidas M
AD  - Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, 
      Memphis, Tennessee.
LA  - eng
GR  - U10 CA098413/CA/NCI NIH HHS/United States
GR  - U10 CA098543/CA/NCI NIH HHS/United States
GR  - U10 CA180899/CA/NCI NIH HHS/United States
GR  - U10 CA180886/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20220224
PL  - United States
TA  - Cancer
JT  - Cancer
JID - 0374236
SB  - IM
CIN - Cancer. 2022 May 1;128(9):1727-1729. PMID: 35201616
MH  - Adolescent
MH  - Adult
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Bone Marrow
MH  - Child
MH  - Child, Preschool
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - *Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy
MH  - *Precursor T-Cell Lymphoblastic Leukemia-Lymphoma
MH  - Recurrence
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC9007837
MID - NIHMS1778922
OTO - NOTNLM
OT  - acute lymphoblastic leukemia
OT  - childhood
OT  - disparities
OT  - sex
OT  - survival
COIS- Conflict of Interest Statement: The authors acknowledge no relevant conflicts of 
      interest.
EDAT- 2022/02/25 06:00
MHDA- 2022/04/13 06:00
PMCR- 2023/05/01
CRDT- 2022/02/24 12:25
PHST- 2021/10/15 00:00 [revised]
PHST- 2021/08/24 00:00 [received]
PHST- 2021/11/22 00:00 [accepted]
PHST- 2022/02/25 06:00 [pubmed]
PHST- 2022/04/13 06:00 [medline]
PHST- 2022/02/24 12:25 [entrez]
PHST- 2023/05/01 00:00 [pmc-release]
AID - 10.1002/cncr.34150 [doi]
PST - ppublish
SO  - Cancer. 2022 May 1;128(9):1863-1870. doi: 10.1002/cncr.34150. Epub 2022 Feb 24.