Flexible Modeling of Net Survival and Cure by AML Subtype and Age: A French Population-Based Study from FRANCIM
With improvements in acute myeloid leukemia (AML) diagnosis and treatment, more patients are surviving for longer periods. A French population of 9453 AML patients aged ≥15 years diagnosed from 1995 to 2015 was studied to quantify the proportion cured (P), time to cure (TTC) and median survival of p...
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| Format: | Article |
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MDPI AG
2021-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/8/1657 |
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| author | Morgane Mounier Gaëlle Romain Mary Callanan Akoua Denise Alla Olayidé Boussari Marc Maynadié Marc Colonna Valérie Jooste |
| author_facet | Morgane Mounier Gaëlle Romain Mary Callanan Akoua Denise Alla Olayidé Boussari Marc Maynadié Marc Colonna Valérie Jooste |
| author_sort | Morgane Mounier |
| collection | DOAJ |
| description | With improvements in acute myeloid leukemia (AML) diagnosis and treatment, more patients are surviving for longer periods. A French population of 9453 AML patients aged ≥15 years diagnosed from 1995 to 2015 was studied to quantify the proportion cured (P), time to cure (TTC) and median survival of patients who are not cured (MedS). Net survival (NS) was estimated using a flexible model adjusted for age and sex in sixteen AML subtypes. When cure assumption was acceptable, the flexible cure model was used to estimate P, TTC and MedS for the uncured patients. The 5-year NS varied from 68% to 9% in men and from 77% to 11% in women in acute promyelocytic leukemia (AML-APL) and in therapy-related AML (t-AML), respectively. Major age-differenced survival was observed for patients with a diagnosis of AML with recurrent cytogenetic abnormalities. A poorer survival in younger patients was found in t-AML and AML with minimal differentiation. An atypical survival profile was found for acute myelomonocytic leukemia and AML without maturation in both sexes and for AML not otherwise specified (only for men) according to age, with a better prognosis for middle-aged compared to younger patients. Sex disparity regarding survival was observed in younger patients with t-AML diagnosed at 25 years of age (+28% at 5 years in men compared to women) and in AML with minimal differentiation (+23% at 5 years in women compared to men). All AML subtypes included an age group for which the assumption of cure was acceptable, although P varied from 90% in younger women with AML-APL to 3% in older men with acute monoblastic and monocytic leukemia. Increased P was associated with shorter TTC. A sizeable proportion of AML patients do not achieve cure, and MedS for these did not exceed 23 months. We identify AML subsets where cure assumption is negative, thus pointing to priority areas for future research efforts. |
| first_indexed | 2024-03-10T12:22:17Z |
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| id | doaj.art-831221bfe8bf4bcf9839f7c2efde7024 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T12:22:17Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-831221bfe8bf4bcf9839f7c2efde70242023-11-21T15:23:04ZengMDPI AGJournal of Clinical Medicine2077-03832021-04-01108165710.3390/jcm10081657Flexible Modeling of Net Survival and Cure by AML Subtype and Age: A French Population-Based Study from FRANCIMMorgane Mounier0Gaëlle Romain1Mary Callanan2Akoua Denise Alla3Olayidé Boussari4Marc Maynadié5Marc Colonna6Valérie Jooste7Dijon-Bourgogne University Hospital, Registre des Hémopathies Malignes de Côte d’Or, F-21000 Dijon, FranceDijon-Bourgogne University Hospital, Registre Bourguignon des Cancers Digestifs, F-21000 Dijon, FranceDijon-Bourgogne University Hospital, Registre des Hémopathies Malignes de Côte d’Or, F-21000 Dijon, FranceDijon-Bourgogne University Hospital, Registre des Hémopathies Malignes de Côte d’Or, F-21000 Dijon, FranceLabEX LipSTIC, ANR-11-LABX-0021, F-21000 Dijon, FranceDijon-Bourgogne University Hospital, Registre des Hémopathies Malignes de Côte d’Or, F-21000 Dijon, FranceGrenoble University Hospital, Registre du Cancer de l’Isère, F-38000 Grenoble, FranceDijon-Bourgogne University Hospital, Registre Bourguignon des Cancers Digestifs, F-21000 Dijon, FranceWith improvements in acute myeloid leukemia (AML) diagnosis and treatment, more patients are surviving for longer periods. A French population of 9453 AML patients aged ≥15 years diagnosed from 1995 to 2015 was studied to quantify the proportion cured (P), time to cure (TTC) and median survival of patients who are not cured (MedS). Net survival (NS) was estimated using a flexible model adjusted for age and sex in sixteen AML subtypes. When cure assumption was acceptable, the flexible cure model was used to estimate P, TTC and MedS for the uncured patients. The 5-year NS varied from 68% to 9% in men and from 77% to 11% in women in acute promyelocytic leukemia (AML-APL) and in therapy-related AML (t-AML), respectively. Major age-differenced survival was observed for patients with a diagnosis of AML with recurrent cytogenetic abnormalities. A poorer survival in younger patients was found in t-AML and AML with minimal differentiation. An atypical survival profile was found for acute myelomonocytic leukemia and AML without maturation in both sexes and for AML not otherwise specified (only for men) according to age, with a better prognosis for middle-aged compared to younger patients. Sex disparity regarding survival was observed in younger patients with t-AML diagnosed at 25 years of age (+28% at 5 years in men compared to women) and in AML with minimal differentiation (+23% at 5 years in women compared to men). All AML subtypes included an age group for which the assumption of cure was acceptable, although P varied from 90% in younger women with AML-APL to 3% in older men with acute monoblastic and monocytic leukemia. Increased P was associated with shorter TTC. A sizeable proportion of AML patients do not achieve cure, and MedS for these did not exceed 23 months. We identify AML subsets where cure assumption is negative, thus pointing to priority areas for future research efforts.https://www.mdpi.com/2077-0383/10/8/1657acute myeloid leukemia subtypeFrancepopulation-based studynet survivalexcess mortalitycure |
| spellingShingle | Morgane Mounier Gaëlle Romain Mary Callanan Akoua Denise Alla Olayidé Boussari Marc Maynadié Marc Colonna Valérie Jooste Flexible Modeling of Net Survival and Cure by AML Subtype and Age: A French Population-Based Study from FRANCIM Journal of Clinical Medicine acute myeloid leukemia subtype France population-based study net survival excess mortality cure |
| title | Flexible Modeling of Net Survival and Cure by AML Subtype and Age: A French Population-Based Study from FRANCIM |
| title_full | Flexible Modeling of Net Survival and Cure by AML Subtype and Age: A French Population-Based Study from FRANCIM |
| title_fullStr | Flexible Modeling of Net Survival and Cure by AML Subtype and Age: A French Population-Based Study from FRANCIM |
| title_full_unstemmed | Flexible Modeling of Net Survival and Cure by AML Subtype and Age: A French Population-Based Study from FRANCIM |
| title_short | Flexible Modeling of Net Survival and Cure by AML Subtype and Age: A French Population-Based Study from FRANCIM |
| title_sort | flexible modeling of net survival and cure by aml subtype and age a french population based study from francim |
| topic | acute myeloid leukemia subtype France population-based study net survival excess mortality cure |
| url | https://www.mdpi.com/2077-0383/10/8/1657 |
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