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An ethnic comparison of incidence, cytogenetic risk, and survival for NZ children and AYA diagnosed with Acute Myeloid Leukaemia

A 2019/2020 Summer Studentship research project

This study will add to our understanding of the biological and non-biological factors which contribute to the survival outcomes for younger AML

Student: Olivia Gray
Supervisors:  Dr Siobhan Cross, Mrs Kirsten Ballantine, Research Manager, National Child Cancer Network, Christchurch, Dr Lochie Teague, Paediatric Haematologist, Starship Blood & Cancer Centre
Sponsor: Leukaemia & Blood Cancer New Zealand

Introduction

A recent ad hoc analysis of New Zealand Children’s Cancer Registry (NZCCR) data identified some potential ethnic survival disparities for children diagnosed with Acute Myeloid Leukaemia (AML). Athough our small patient numbers mean that the group differences are not yet statistically significant, the survival rate for Maori: 68% and Pacific People: 63% is notably lower than for non-Maori/Pacific: 80%. We intend to investigate this further by widening our age range to include Adolescent and Young Adults (AYAs, 15-24 years) and conducting a case review to establish whether there is a difference in the incidence of high-risk cytogenetics between ethnic groups. This would be a similar methodology to a national study conducted at Starship Blood and Cancer Centre and The Children’s Haemaotology Oncology Centre (CHOC) in 2015 which identified that Maori children with ALL were significantly less likely to carry the ETV6-RUNX1 gene, which is associated with a favourable prognosis.

Aim

This study aims to explore the biological and non-biological factors that may contribute to ethnic differences in survival outcomes for children and AYA diagnosed with AML.

Method

The NZCCR will be used to identify a cohort of patients under the age of 15 who underwent treatment for AML at Starship or CHOC between 2005 and 2019. Patient information will include sex, ethnicity, treatment centre, age at diagnosis, and treatment protocol. The student will access each patient’s electronic medical record to source diagnostic cytogenetic information and further relevant information about the child’s treatment (e.g. use of chemotherapy, treatment complications, and haematopoietic blood and stem cell transplation). In addition to the NZCCR cohort, anonymised data for AYA AML registrations will also be obtained from the New Zealand Cancer Registry (NZCR) including ethnicity, age, sex and some cytogenetic information which comes from the histology code. This will provide us with a larger sample and greater potential to identify any ethnic incidence and survival differences which may exist.

Student researcher’s component of the study

It is hoped that their involvement in the study will stimulate the student’s interest in research and cancer epidemiology. During the project the student will gain valuable experience in…

  • Conducting a literature review of the topic
  • Working with the project supervisors to develop a template for data recording/coding
  • Reviewing the medical records to obtain the required information
  • Analysing the results (with support from the supervisors and/or biostatistician as required)
  • Writing up and presenting the study findings at the completion of the summer studentship
  • Assisting in the preparation of a manuscript draft suitable for journal publication

Student Prerequisites

Medical student. Competent user of excel. Statistical knowledge would be helpful.

How to apply

Email siobhan.cross@cdhb.health.nz