Survival of adult AML patients treated with chemotherapy in the U.S. population by age, race and ethnicity, sex, calendar-year period, and AML subgroup, 2001–2019Research in context
Summary: Background: Population-based survival studies of adult acute myeloid leukemia (AML) have not simultaneously evaluated age at diagnosis, race and ethnicity, sex, calendar period or AML subtypes/subgroups among chemotherapy-treated patients. Methods: For 28,473 chemotherapy-treated AML patie...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-05-01
|
| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537024001287 |
| _version_ | 1797258634432872448 |
|---|---|
| author | Martha S. Linet Rochelle E. Curtis Sara J. Schonfeld Jacqueline B. Vo Lindsay M. Morton Graça M. Dores |
| author_facet | Martha S. Linet Rochelle E. Curtis Sara J. Schonfeld Jacqueline B. Vo Lindsay M. Morton Graça M. Dores |
| author_sort | Martha S. Linet |
| collection | DOAJ |
| description | Summary: Background: Population-based survival studies of adult acute myeloid leukemia (AML) have not simultaneously evaluated age at diagnosis, race and ethnicity, sex, calendar period or AML subtypes/subgroups among chemotherapy-treated patients. Methods: For 28,473 chemotherapy-treated AML patients diagnosed at ages ≥20 years in population-based cancer registry areas of the Surveillance, Epidemiology, and End Results Program (2001–2018, followed through 2019), we evaluated 1-month through 5-year relative survival (RS) and 95% confidence intervals (95% CI) using the actuarial method in the SEER∗Stat Survival Session and overall survival (OS) using multivariable Cox regression to estimate proportional hazard ratios (HR) and 95% CI. Findings: RS decreased with increasing age (20–39, 40–59, 60–74, 75–84, ≥85 years) at AML diagnosis. RS declined substantially within the first month and, except for acute promyelocytic leukemia, decreasing patterns continued thereafter for core binding factor AML, AML with antecedent condition/therapy, and all other AML. For all ages, acute promyelocytic leukemia RS stabilized after the first year. For total AML the hazard of death was significantly increased for non-Hispanic (NH)-Black (HR = 1.18, 95% CI = 1.12–1.24) and NH-Pacific Islander patients (HR = 1.31, 95% CI = 1.11–1.55) compared with NH-White patients. In contrast, NH-Asian and Hispanic patients had similar OS to NH-White patients across all ages and most AML subgroups. Males had significantly inferior survival to females with some exceptions. Compared to 2001–2006, in 2013–2018 OS improved for all age and AML subgroups. Interpretation: Chemotherapy-treated U.S. adults with AML have notable differences in survival by age, race and ethnicity, sex, calendar-year period, and AML subgroup. Despite survival gains over time, our findings highlight the need for improving early outcomes across all AML subgroups, older ages, and Black and Pacific Islander patients and long-term outcomes among most treated groups. Funding: Intramural Research Program of the U.S. National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics, and the U.S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Surveillance and Epidemiology. |
| first_indexed | 2024-04-24T22:56:39Z |
| format | Article |
| id | doaj.art-0d42ebd4cedb4295b9999b5500420644 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-04-24T22:56:39Z |
| publishDate | 2024-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-0d42ebd4cedb4295b9999b55004206442024-03-18T04:34:14ZengElsevierEClinicalMedicine2589-53702024-05-0171102549Survival of adult AML patients treated with chemotherapy in the U.S. population by age, race and ethnicity, sex, calendar-year period, and AML subgroup, 2001–2019Research in contextMartha S. Linet0Rochelle E. Curtis1Sara J. Schonfeld2Jacqueline B. Vo3Lindsay M. Morton4Graça M. Dores5Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive 7E, Rockville, MD 20850, USA; Corresponding author. Radiation Epidemiology Branch, DCEG, NCI, NIH, 9609 Medical Center Drive 7E, Rockville, MD 20850, USA.Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive 7E, Rockville, MD 20850, USARadiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive 7E, Rockville, MD 20850, USARadiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive 7E, Rockville, MD 20850, USARadiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive 7E, Rockville, MD 20850, USARadiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive 7E, Rockville, MD 20850, USA; U.S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Surveillance and Epidemiology, Silver Spring, MD, USASummary: Background: Population-based survival studies of adult acute myeloid leukemia (AML) have not simultaneously evaluated age at diagnosis, race and ethnicity, sex, calendar period or AML subtypes/subgroups among chemotherapy-treated patients. Methods: For 28,473 chemotherapy-treated AML patients diagnosed at ages ≥20 years in population-based cancer registry areas of the Surveillance, Epidemiology, and End Results Program (2001–2018, followed through 2019), we evaluated 1-month through 5-year relative survival (RS) and 95% confidence intervals (95% CI) using the actuarial method in the SEER∗Stat Survival Session and overall survival (OS) using multivariable Cox regression to estimate proportional hazard ratios (HR) and 95% CI. Findings: RS decreased with increasing age (20–39, 40–59, 60–74, 75–84, ≥85 years) at AML diagnosis. RS declined substantially within the first month and, except for acute promyelocytic leukemia, decreasing patterns continued thereafter for core binding factor AML, AML with antecedent condition/therapy, and all other AML. For all ages, acute promyelocytic leukemia RS stabilized after the first year. For total AML the hazard of death was significantly increased for non-Hispanic (NH)-Black (HR = 1.18, 95% CI = 1.12–1.24) and NH-Pacific Islander patients (HR = 1.31, 95% CI = 1.11–1.55) compared with NH-White patients. In contrast, NH-Asian and Hispanic patients had similar OS to NH-White patients across all ages and most AML subgroups. Males had significantly inferior survival to females with some exceptions. Compared to 2001–2006, in 2013–2018 OS improved for all age and AML subgroups. Interpretation: Chemotherapy-treated U.S. adults with AML have notable differences in survival by age, race and ethnicity, sex, calendar-year period, and AML subgroup. Despite survival gains over time, our findings highlight the need for improving early outcomes across all AML subgroups, older ages, and Black and Pacific Islander patients and long-term outcomes among most treated groups. Funding: Intramural Research Program of the U.S. National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics, and the U.S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Surveillance and Epidemiology.http://www.sciencedirect.com/science/article/pii/S2589537024001287Acute leukemiaMyeloid leukemiaPopulation-based survivalAdultsChemotherapy |
| spellingShingle | Martha S. Linet Rochelle E. Curtis Sara J. Schonfeld Jacqueline B. Vo Lindsay M. Morton Graça M. Dores Survival of adult AML patients treated with chemotherapy in the U.S. population by age, race and ethnicity, sex, calendar-year period, and AML subgroup, 2001–2019Research in context EClinicalMedicine Acute leukemia Myeloid leukemia Population-based survival Adults Chemotherapy |
| title | Survival of adult AML patients treated with chemotherapy in the U.S. population by age, race and ethnicity, sex, calendar-year period, and AML subgroup, 2001–2019Research in context |
| title_full | Survival of adult AML patients treated with chemotherapy in the U.S. population by age, race and ethnicity, sex, calendar-year period, and AML subgroup, 2001–2019Research in context |
| title_fullStr | Survival of adult AML patients treated with chemotherapy in the U.S. population by age, race and ethnicity, sex, calendar-year period, and AML subgroup, 2001–2019Research in context |
| title_full_unstemmed | Survival of adult AML patients treated with chemotherapy in the U.S. population by age, race and ethnicity, sex, calendar-year period, and AML subgroup, 2001–2019Research in context |
| title_short | Survival of adult AML patients treated with chemotherapy in the U.S. population by age, race and ethnicity, sex, calendar-year period, and AML subgroup, 2001–2019Research in context |
| title_sort | survival of adult aml patients treated with chemotherapy in the u s population by age race and ethnicity sex calendar year period and aml subgroup 2001 2019research in context |
| topic | Acute leukemia Myeloid leukemia Population-based survival Adults Chemotherapy |
| url | http://www.sciencedirect.com/science/article/pii/S2589537024001287 |
| work_keys_str_mv | AT marthaslinet survivalofadultamlpatientstreatedwithchemotherapyintheuspopulationbyageraceandethnicitysexcalendaryearperiodandamlsubgroup20012019researchincontext AT rochelleecurtis survivalofadultamlpatientstreatedwithchemotherapyintheuspopulationbyageraceandethnicitysexcalendaryearperiodandamlsubgroup20012019researchincontext AT sarajschonfeld survivalofadultamlpatientstreatedwithchemotherapyintheuspopulationbyageraceandethnicitysexcalendaryearperiodandamlsubgroup20012019researchincontext AT jacquelinebvo survivalofadultamlpatientstreatedwithchemotherapyintheuspopulationbyageraceandethnicitysexcalendaryearperiodandamlsubgroup20012019researchincontext AT lindsaymmorton survivalofadultamlpatientstreatedwithchemotherapyintheuspopulationbyageraceandethnicitysexcalendaryearperiodandamlsubgroup20012019researchincontext AT gracamdores survivalofadultamlpatientstreatedwithchemotherapyintheuspopulationbyageraceandethnicitysexcalendaryearperiodandamlsubgroup20012019researchincontext |