The University of Alabama at Birmingham Archives - Page 2 of 4

2017

Scholar Grant

Dr. Julie Anna Wolfson

Birmingham, AL

Understanding Causes of Outcome Disparities in Adolescents and Young Adults with ALL
Despite sharing diagnoses with younger patients, adolescents and young adults (AYAs: ages15-39y) with cancer have not seen the same improvement in survival over the last 3 decades. In acute lymphoblastic leukemia {ALL) in particular, 5y survival rates decline with age at diagnosis (1-9y: >80%; 10-14y: >60%; 15-19y: 45%; 20-34y: 35%; 35-39y: 30%) These phenomena have resulted in the coinage of the term, AYA Gap, and the National Cancer Institute has recognized that AYAs are a vulnerable population. Several factors could potentially impact inferior outcome in AYAs with ALL; some of these have been examined individually in small samples. We have established an 8-institution consortium that is geographically-diverse and where both children and adults are treated. With this group, we will take a comprehensive approach and evaluate all possible factors that could contribute to the inferior outcome experienced by A YAs with ALL.

We will examine:
Adherence to prescribed oral chemotherapy
Sociocultural factors including material hardship
Pediatric vs. adult approach to therapy
Intensity of prescribed treatment
Disease {ALL) biology
Host germline variants
Findings from this study will allow us to understand the independent contribution of each of the factors described above in determining the inferior outcomes experienced by AYAs withALL, and will also inform targeted intervention strategies to close the AYA Gap. This project will serve as a paradigm for a systematic and comprehensive evaluation of cause(s) of inferior outcomes experienced by AYAs with other cancer diagnoses.