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The study subjects comprised 2254 children (0\u201014\u00a0years) and 2,905 AYAs (15\u201039\u00a0years) who were diagnosed with leukemia during 1975\u20102011. Leukemia was divided into four types: acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and other leukemias. We analyzed 5\u2010year overall survival probability (5y\u2010OS), using the Kaplan\u2010Meier method and expressed time trends using the joinpoint regression model. For recently diagnosed (2006\u20102011) patients, a Cox proportional hazards model was applied to determine predictors of 5y\u2010OS, using age group, gender, and treatment hospital as covariates. Over the 37\u2010year period, 5y\u2010OS greatly improved among both children and AYAs, for each leukemia type. Among AYAs, 5y\u2010OS of ALL improved, especially after 2000 (65% in 2006\u20102011), when the pediatric regimen was introduced but was still lower than that among children (87% in 2006\u20102011, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Survival improvement was most remarkable in CML, and its 5y\u2010OS was over 90% among both children and AYAs after the introduction of molecularly targeted therapy with tyrosine kinase inhibitors. Among patients with recently diagnosed AML, the risk of death was significantly higher for patients treated at nondesignated hospitals than those treated at designated cancer care hospitals. The changes in survival improvement coincided with the introduction of treatment regimens or molecularly targeted therapies. Patient centralization might be one option which would improve survival.<\/jats:p>","DOI":"10.1111\/cas.14808","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T06:21:20Z","timestamp":1610691680000},"page":"1150-1160","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Trends in survival of leukemia among children, adolescents, and young adults: A population\u2010based study in Osaka, Japan"],"prefix":"10.1111","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9782-8637","authenticated-orcid":false,"given":"Kayo","family":"Nakata","sequence":"first","affiliation":[{"name":"Cancer Control Center Osaka International Cancer Institute Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2197-7078","authenticated-orcid":false,"given":"Sumiyo","family":"Okawa","sequence":"additional","affiliation":[{"name":"Cancer Control Center Osaka International Cancer Institute Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeo","family":"Fuji","sequence":"additional","affiliation":[{"name":"Department of Hematology Osaka International Cancer Institute Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Sato","sequence":"additional","affiliation":[{"name":"Cancer Control Center Osaka International Cancer Institute Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0747-3287","authenticated-orcid":false,"given":"Toshitaka","family":"Morishima","sequence":"additional","affiliation":[{"name":"Cancer Control Center Osaka International Cancer Institute Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuma","family":"Tada","sequence":"additional","affiliation":[{"name":"Department of Hematology Osaka International Cancer Institute Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masami","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Hematology\/ Oncology Osaka Women\u2019s and Children\u2019s Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6798-1558","authenticated-orcid":false,"given":"Junichi","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology Osaka City General Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisei","family":"Kawa","sequence":"additional","affiliation":[{"name":"Department of Hematology\/ Oncology Osaka Women\u2019s and Children\u2019s Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isao","family":"Miyashiro","sequence":"additional","affiliation":[{"name":"Cancer Control Center Osaka International Cancer Institute Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Osaka Cancer Association for Children, Adolescents, Young Adults","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,3]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Cancer and Disease Control Divesion Ministry of Health Labour and Welfare.Cancer Incidence of Japan 2017. Tokyo: Cancer and Disease Control Divesion Ministry of Health Labour and Welfare.; 2020.https:\/\/www.e\u2010stat.go.jp\/stat\u2010search\/files?page=1&layout=normal&toukei=00450173&tstat=000001133323. Accessed September 14 2020."},{"key":"e_1_2_9_3_1","unstructured":"Foundation for Promotion of Cancer Research (FPCR).The editorial board of the cancer statistics in Japan. Cancer statistics in Japan 2019. Tokyo: Foundation for Promotion of Cancer Research (FPCR);. 2020.https:\/\/ganjoho.jp\/data\/reg_stat\/statistics\/brochure\/2019\/cancer_statistics_2019_app_J.pdf. 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