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Rebecca Olin, MD, MS


Have Outcomes in AML Improved Over the Past 40 Years?

By: Lauren Harrison, MS
Posted: Friday, May 7, 2021

Population data showed improved outcomes for all patients with acute myeloid leukemia (AML) over the past 4 decades, likely a result of advances in chemotherapy, targeted therapeutics, stem cell transplantation, and supportive care. Hagop M. Kantarjian, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues reported these results in Cancer.

Researchers identified patients diagnosed with de novo AML between 1980 and 2017 using the National Cancer Institute’s Surveillance, Epidemiology, and End Results program. Patients were subdivided into five age groups (birth to age 14, 15–39, 40–59, 60–69, and older than age 70) and four calendar periods (1980–1989, 1990–1999, 2000–2009, 2010–2017). Patient outcomes within these categories were analyzed.

The median survival for the entire population was 4 months in the 1980s, 5 months in the 1990s, 7 months in the 2000s, and 11 months from 2000 to 2017. The 5-year survival rates were 9%, 15%, 22%, and 28%, respectively, across these same periods. Likewise, the 4-week mortality decreased from 37% in the 1980s to 27% in the 2010s. Within the youngest cohort of patients, the 5-year survival rate improved from 31% to 69% from 1980 to 2017. The 5-year survival rate increased only modestly over the same period among patients older than 60, from 4% to 18%. For the eldest group (older than 70), the survival rate remained relatively unchanged, from 1% in the 1980s to 4% during the 2010s. The most common cause of death among all patients was leukemia.

Multivariate analysis found that age at diagnosis, decade of diagnosis, AML subtype, and ethnicity were all independent prognostic factors for survival. The average lifespan was slightly longer among Hispanic individuals: 81.8 years in Hispanic patients and 78.6 years among non-Hispanic White patients. Black patients had a lower survival compared with other ethnicities across all age categories.

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