Improvements in the early death rate among 9380 patients with acute myeloid leukemia after initial therapy: A SEER database analysis. Issue 12 (4th March 2015)

• Record Type: Journal Article
• Authors: Percival, Mary‐Elizabeth M.; Tao, Li; Medeiros, Bruno C.; Clarke, Christina A.
• Is Part Of: Cancer. Volume 121:Issue 12(2015)
• Page Start: 2004
• Page End: 2012
• Publication Date: 2015-03-04
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.29319
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr29319-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>Acute myeloid leukemia (AML) is treated with conventional induction chemotherapy shortly after diagnosis for the majority of patients aged ≤65 years. A recent report suggested a substantial decline in the early, or 1‐month, mortality rate in patients treated on clinical trials over the past 2 decades. It is unknown whether a similar improvement has been observed in the general population.</p> </sec> <sec id="cncr29319-sec-0002" sec-type="section"> <title>METHODS</title> <p>The authors examined the 1‐month mortality rate in a large population‐based series of 9380 patients with AML who were aged ≤65 years and were diagnosed and treated with chemotherapy between 1973 and 2010.</p> </sec> <sec id="cncr29319-sec-0003" sec-type="section"> <title>RESULTS</title> <p>A significant decline was observed in the 1‐month mortality rate from 18.7% among patients diagnosed from 1973 through 1977 (95% confidence interval [95% CI], 16.4%‐21.2%) to 5.8% for those diagnosed between 2008 and 2010 (95% CI, 4.5%‐7.6%) (<italic>P</italic> <.001). The median overall survival improved significantly from 6 months (95% CI, 5 months‐7 months) in 1973 to 1977 to 23 months (95% CI, 16 months‐20 months) in 2008 to 2010 (<italic>P</italic> <.001). Although age and geographic variation were found to significantly influence the 1‐month mortality for the period between 1973 and 1977, these differences in 1‐month mortality were no longer significant among patients with AML who were treated more recently (2008‐2010).</p> </sec> <sec id="cncr29319-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>Over the past 4 decades, early mortality has become uncommon in younger patients (aged ≤65 years) with newly diagnosed AML undergoing induction chemotherapy. It is encouraging that the improvements noted in 1‐month mortality rate among a selective cohort of patients in clinical trials have also been observed in a population‐based analysis. <bold><italic>Cancer</italic> 2015;121:2004–2012.</bold> © <italic>2015 American Cancer Society</italic>.</p> </sec> </abstract>