Cancer Care Delivery in Adolescent and Young Adult Patients With Acute Lymphoblastic Leukemia

PRIMARY OBJECTIVES:

I. To evaluate the proportion of adolescent and young adult (AYA) acute lymphoblastic
leukemia (ALL) patients with a documented treatment plan consistent with NCCN guidelines for
AYAs with ALL.

II. To evaluate the proportion of AYA ALL patients whose delivered treatment during induction
and post-induction therapy (PIT) is consistent with NCCN guidelines for AYAs with ALL.

III. To determine the impact of treating physician specialty and facility type on likelihood
of AYA ALL patients having a documented treatment plan concordant with NCCN guidelines when
stratified by age group (15-17year[y], 18-21y, and 22-39y).

IV. To determine the impact of treating physician specialty and facility type on the
likelihood of AYA ALL patients receiving induction and post-induction therapy (PIT)
concordant with NCCN guidelines when stratified by age group (15-17y, 18-21y, and 22-39y).

V. To identify for AYAs with ALL, targetable structure- and process-level barriers and
facilitators which will increase the proportion of patients having a documented treatment
plan and receiving treatment according to NCCN guidelines.

SECONDARY OBJECTIVES:

I. To explore potential correlations with clinical and social demographic variables to the
presence of a documented treatment plan and delivered treatment consistent with NCCN
guidelines in AYAs with ALL.

OUTLINE:

CHART REVIEW: Patient medical record data is abstracted and treatment plans are reviewed for
consistency to NCCN guidelines. For each patient, induction and post-induction care is
recorded as either concordant with NCCN guidelines or non-concordant with NCCN guidelines.

SITE QUESTIONNAIRE: Participating sites complete a questionnaire which is designed to capture
facility-oriented data.

FOCUS GROUPS: Healthcare providers participate in focus groups over 1-2 hours to discuss
facilitators and barriers to AYA ALL guideline concordance. Participants provide responses
via electronic handheld technology in order to maintain anonymity followed by discussion of
the ideas for clarification.

Inclusion Criteria:

- Newly diagnosed with either Ph- or Ph+ ALL between January 1st, 2012 and December
31st, 2016

- Both diagnosed and initially treated at the participating National Cancer Institute
Community Oncology Research Program (NCORP) institution during induction and
post-induction therapy (PIT)

- Aim 3: Healthcare professional currently employed at a participating NCORP institution

- Eligible healthcare providers include but are not limited to: physicians,
registered nurses (RNs), nurse practitioners, physician assistants, patient
advocates, social workers, pharmacists and clinical research associates (CRAs)

- Aim 3a: Direct involvement in the care of AYA ALL patients

Exclusion Criteria:

- Diagnosis of secondary ALL

- Diagnosis of mixed lineage acute leukemia

- Diagnosis of acute leukemia of ambiguous lineage (ALAL)

- Diagnosis of Burkitt?s leukemia

- Transfer of care to another institution during induction or post-induction therapy
(PIT)

- Aim 3: Trainee