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Outcome of older patients with acute myeloid leukemia
Author(s) -
Thein Mya S.,
Ershler William B.,
Jemal Ahmedin,
Yates Jerome W.,
Baer Maria R.
Publication year - 2013
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.28129
Subject(s) - medicine , relative survival , myeloid leukemia , confidence interval , epidemiology , leukemia , cancer , survival analysis , relative risk , survival rate , pediatrics , cancer registry
BACKGROUND Acute myeloid leukemia (AML) is the common form of acute leukemia in adults, accounting for over 80% of all acute leukemias in individuals aged >18 years. Overall 5‐year survival remains poor in older AML patients; it is <5% in patients aged >65 years. In this study, the authors examined whether survival has improved for subsets of geriatric AML patients over 3 successive decades. METHODS Surveillance, Epidemiology and End Results (SEER) data were used to determine trends in relative survival by age among 19,000 patients with AML over 3 successive decades (1977‐1986, 1987‐1996, and 1997‐2006). Relative survival rates (RRs) with 95% confidence intervals (CIs) were calculated as measures of survival. RESULTS Overall, the RRs increased for each successive decade (1977‐1986, 1987‐1996, and 1997‐2006) in patients ages 65 to 74 years, with improvements in 12‐month survival from 20%, to 25%, to 30%, respectively. Findings were similar for 24‐month, 36‐month, 48‐month, and 60‐month survival. However, survival rates did not improve in patients aged ≥75 years. The oldest old patients (aged ≥85 years) had the lowest survival rates, with no apparent improvement. CONCLUSIONS This analysis of a large data set demonstrated that, although overall survival remained unsatisfactory among older patients, it improved in the younger old (ages 65‐74 years). Survival of older old AML patients has not been favorably impacted by available AML therapies or supportive care, and intervention in this age group is best undertaken on a clinical trial. Cancer 2013 ;119:2720–2727. © 2013 American Cancer Society .