For this study, Ardine Reedijk, who conducted the research with Prof Dr Gertjan Kaspers (among others), used data from the Netherlands Cancer Registry (NCR) that has been collected nationally since 1990. The study, which has been published in the scientific journal Leukemia, revealed that the chance of curing AML during the last period measured, from 2010 to 2015, increased from 40 to 74%.
The researchers placed the data from the Netherlands Cancer Registry alongside those of SKION (Stichting Kinderoncologie Nederland). In their data comparison, they zoomed in on the progress made in treating children and young adults in the areas of incidence, survival and death.
Incidence
The incidence of AML (the number of new cases of the disease) is higher among 1 to 4 year olds, explains Reedijk. "That's due, first of all, to more children being diagnosed with cancer. If you look at all forms of cancer in both children and adults, the number of cases rises by 1% per year. The increase in this specific age group could be explained by the relatively high number of children with Down's syndrome in the Netherlands."
Death
In the study, researchers established that the Netherlands has made demonstrable progress in the treatment of childhood AML. The chance of dying from childhood AML is decreasing by 2.8% each year. The fatality rate, according to the most recent protocol, has decreased by 49%. The researchers are unable to point out the exact cause of this declining fatality rate. They believe it to be a combination of factors, including improved diagnostics, better utilization of chemotherapy and improved care and therapy for relapsed AML.
Treatment
The treatment regimens are different, notes Kaspers. "We now know a smidgen better which children are at a higher risk. In those cases, we adapt another course of treatment by, for example, scheduling it closer to the first course. It's not so much about new medication, but we do have a better understanding of when to give higher or lower doses. We also examine the properties of the leukemia cells. By zooming in on these cells in the bone marrow, we can make predictions about their behavior. Adapting and improving treatment protocols is an ongoing process for us."
Based on the study, it is also apparent that children are dying less frequently from side effects. Serious side effects, such as inflammation and lung damage, were more often the cause of death in children in the past. "Back then, I remember talking about 10 to 15% of the children," according to Kaspers. "Now it's just a few percent."
Acute Myeloid Leukemia
Children develop two types of leukemia: chronic and acute; the latter being the most common by far. Of the types of acute leukemia — acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) — AML is less prevalent. On average, twenty-five children are affected by AML each year in the Netherlands.