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Survival in adult acute lymphoblastic leukaemia (ALL): A report from the Swedish ALL Registry
Author(s) -
Lennmyr Emma,
Karlsson Karin,
Ahlberg Lucia,
Garelius Hege,
Hulegårdh Erik,
Izarra Antonio S,
Joelsson Joel,
Kozlowski Piotr,
Moicean Andreea,
TomaszewskaToporska Beata,
Lübking Anna,
Hallböök Helene
Publication year - 2019
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13247
Subject(s) - medicine , incidence (geometry) , population , pediatrics , cohort , confidence interval , surgery , environmental health , optics , physics
Objectives As new, effective therapies emerge for acute lymphoblastic leukaemia (ALL), the results of clinical trials need to relate to standard of care. Methods We used the population‐based Swedish ALL Registry to evaluate characteristics, treatment and long‐term outcome in 933 patients with diagnosis between 1997 and 2015. Results The median age was 53 years. The frequency of Philadelphia (Ph)‐positive leukaemia was 34% of examined B‐ALL with a peak incidence at 50‐59 years. Five‐year overall survival (OS) improved between 1997‐2006 and 2007‐2015; in patients 18‐45 years from 50% (95% CI 43‐57) to 65% (95% CI 58‐72), 46‐65 years from 25% (95% CI 18‐32) to 46% (95% CI 37‐55) and >65 years from 7% (95% CI 2.6‐11) to 11% (95% CI 5.9‐16) ( P < 0.05). Men with Ph‐neg B‐ALL 46‐65 years had inferior OS compared with women ( P < 0.01). Standardised mortality ratio was 5.7 (95% CI 5.0‐6.3) for patients who survived 5 years from diagnosis. In multivariable analysis, Ph‐positive disease was not associated with impaired prognosis but with lower risk of death in 2007‐2015. Conclusions In a population‐based cohort, OS has improved in adult ALL, especially for Ph‐positive disease but for middle‐aged men with Ph‐negative B‐ALL outcome was poor. Cure without late toxicity or relapse is still desired.