Survival trends among patients with acute myeloid leukemia in the United States.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17598-e17598
Author(s):  
Dipesh Uprety ◽  
Krishna Bilas Ghimire ◽  
Barsha Nepal ◽  
Binay Kumar Shah
Keyword(s):  
United States ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Chemotherapy Regimen ◽  
Survival Rates ◽  
Relative Survival ◽  
The United States ◽  
Z Score ◽  
Survival Differences ◽  
Acute Myeloid

e17598 Background: The chemotherapy regimen for acute myeloid leukemia (AML) has not changed significantly over the last two decades. Better patient care may have improved survival in AML patients. This study was conducted to evaluate the relative survival rates in AML patients over two decades in the United States. Methods: Adult patients (age≥20 years) diagnosed with AML were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Several cohorts categorized by race (Caucasians & African-Americans (AA)), gender & age (20-59, ≥60 years) were compared to see survival differences from 1992-2000 & 2001-2009. We used SEER Stat software to calculate 1- and 5-year relative survival rates (RS). The survival rates accompany standard errors. Results: The database comprised of 28,217 patients. The relative survival rates of AML improved significantly during 2001-2009 compared to 1992-2000 1-year 39.2±0.4 vs 33.7±0.5,( Z score 9.079, p<0.0005); 5- year 20.1±0.4 vs 15.3±0.4, (Z score 10.357, p<0.0005). The 1-and 5-year RS for men during 1992-2000 vs 2001-2009 were 32.3±0.7% vs 39.2±0.5% (Zscore=8.392, p<0.0005) & 13.9±0.5% vs 18.7±0.5% (Zscore= 8.710, p<0.0005) respectively. For women, the survival rates during 1992-2000 vs 2001-2009 were 35.3±0.7% vs 39.1±0.5% (Zscore=4.318, p<0.0005) at 1-year & 16.9±0.6% vs 21.7±0.5% (Z score=5.917, p<0.0005) at 5-years. For younger patients (<60 years), relative survival rates at during 1992-2000 and 2001-2009 were: 1- year: 56.7±0.9 vs 63.5±0.6, (Z score=6.462, p<0.0005); 5- year: 33.0±0.8 vs 40.6±0.7, (Z score= 7.070, p <0.0005). Similarly, the survival rates were significantly better for older patients and for all ethnic groups during 2001-2009 compared to 1992-2000. Conclusions: The relative survival in AML has increased significantly during 2001-2009 compared to 1992-2000. This may be secondary to improvement in supportive care.

Acute Myeloid Leukemia Survival In Elderly Patients In The United States

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1690-1690
Author(s):  
Binay K. Shah ◽  
Krishna B Ghimire
Keyword(s):  
United States ◽  
Acute Myeloid Leukemia ◽  
Elderly Patients ◽  
Myeloid Leukemia ◽  
Survival Rates ◽  
Relative Survival ◽  
The United States ◽  
Very Elderly ◽  
Z Value ◽  
Acute Myeloid

Abstract Background Survival in Acute myeloid leukemia (AML) has improved in younger patients over the last decade. Though chemotherapy has not changed significantly, better patient care may have improved survival in AML patients. This study was conducted to evaluate the relative survival rates in older AML patients over two decades in the United States. Methods Newly diagnosed AML (first primary only) in older (age≥75 years) patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database. We analyzed SEER 18 registry database to evaluate relative survival rate in older (≥75 years) AML population diagnosed during 1992-2000. We selected AML patients from 13 SEER registries to compare RS during 1992-2000 and 2001-2009. The relative survival rates at 1 and 5 year were analyzed for various cohorts categorized by race (White, African-Americans (AA) & other), gender & age (≥75-84 and ≥85 years). The relative survival rates accompany standard error (SE). We used SEER-Stat, statistical software provided by NCI for statistical analysis. Results The relative survival rates improved significantly during 2001-2009 compared to 1992-2000 for all age groups, sex. For young elderly patients (≥75-84 years) RS increased from 13.1±0.8% to 17.4±0.9% at 1 year Z value=3.98, P<0.0001 and from 2.0±0.4 to 2.6±0.5%, Z value= 3.61, P<0.0005 at 5 years with improvement in median relative survival from 2.41 to 2.75 months. Similarly, for very elderly (≥85 years) patients RS increased from 5.3±1.0% to 8.0±1.0%, Z value=3.03, P<0.005 at 1 year, 0.7±0.4% to 1.3±0.5% at 3 years Z value= 2.81, P=0.005, but no improvement seen at 5 years. There was significant improvement in RS from 1992-2000 to 2001-2009 in both sexes, caucasian and other races. There was no improvement in RS at 1 year and 5 year for older AA population. (Table) Conclusion The relative survival in elderly AML has increased significantly during 2001-2009 compared to 1992-2000. The RS improved both at 1 year and 5 years for young elderly patients. Improvement in RS was observed at 1 year and 3 years for very elderly (>85 years) AML patients. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Treatment patterns in patients with acute myeloid leukemia in the United States: a cross-sectional, real-world survey

2019 ◽  
Vol 35 (5) ◽  
pp. 927-935 ◽  
Author(s):  
Bruno C. Medeiros ◽  
Bhavik J. Pandya ◽  
Anna Hadfield ◽  
James Pike ◽  
Samuel Wilson ◽  
...  
Keyword(s):  
United States ◽  
Acute Myeloid Leukemia ◽  
Real World ◽  
Myeloid Leukemia ◽  
The United States ◽  
Treatment Patterns ◽  
Cross Sectional ◽  
World Survey ◽  
Acute Myeloid

scholarly journals Economic burden of elderly patients with acute myeloid leukemia treated in routine clinical care in the United States

2018 ◽  
Vol 71 ◽  
pp. 27-33 ◽  
Author(s):  
Jill A. Bell ◽  
Aaron Galaznik ◽  
Eileen Farrelly ◽  
Marlo Blazer ◽  
Sharanya Murty ◽  
...  
Keyword(s):  
United States ◽  
Acute Myeloid Leukemia ◽  
Elderly Patients ◽  
Economic Burden ◽  
Myeloid Leukemia ◽  
Clinical Care ◽  
The United States ◽  
Routine Clinical Care ◽  
Acute Myeloid

scholarly journals Utilization of initial chemotherapy for newly diagnosed acute myeloid leukemia in the United States

2018 ◽  
Vol 2 (11) ◽  
pp. 1277-1282 ◽  
Author(s):  
Vijaya Raj Bhatt ◽  
Valerie Shostrom ◽  
Krishna Gundabolu ◽  
James O. Armitage
Keyword(s):  
United States ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
The United States ◽  
Insurance Status ◽  
Newly Diagnosed ◽  
Key Points ◽  
Facility Type ◽  
Acute Myeloid

Key Points An analysis of 61 775 adults with AML diagnosed between 2003 and 2011 demonstrated that 25% did not receive any chemotherapy. Factors such as facility type, patients’ race, income, and insurance status were associated with the rates of use of chemotherapy.

scholarly journals Big data analysis of treatment patterns and outcomes among elderly acute myeloid leukemia patients in the United States

2015 ◽  
Vol 94 (7) ◽  
pp. 1127-1138 ◽  
Author(s):  
Bruno C. Medeiros ◽  
Sacha Satram-Hoang ◽  
Deborah Hurst ◽  
Khang Q. Hoang ◽  
Faiyaz Momin ◽  
...  
Keyword(s):  
United States ◽  
Acute Myeloid Leukemia ◽  
Big Data ◽  
Data Analysis ◽  
Myeloid Leukemia ◽  
The United States ◽  
Big Data Analysis ◽  
Treatment Patterns ◽  
Acute Myeloid

Variations in incidence, overall survival, and cytogenetic risk in patients of white and Korean ethnicity with acute myeloid leukemia in the United States.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e18516-e18516
Author(s):  
Peter G Kim ◽  
Tao Zou ◽  
Andrew Mark Brunner ◽  
Ashley M. Perry ◽  
Kristin L McGregor ◽  
...  
Keyword(s):  
United States ◽  
Overall Survival ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
The United States ◽  
Acute Myeloid

Real-world prescribing patterns in acute myeloid leukemia in the United States.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18524-e18524 ◽  
Author(s):  
Bruno C. Medeiros ◽  
Bhavik J. Pandya ◽  
Anna Hadfield ◽  
Samuel Wilson ◽  
Cynthia Mueller ◽  
...  
Keyword(s):  
United States ◽  
Acute Myeloid Leukemia ◽  
Real World ◽  
High Intensity ◽  
Myeloid Leukemia ◽  
Patient Characteristics ◽  
The United States ◽  
First Line ◽  
Low Intensity ◽  
Acute Myeloid

e18524 Background: The effective treatment of patients with acute myeloid leukemia (AML) remains a challenge in clinical practice. This analysis describes the patient characteristics and real-world use of AML treatments in the United States for patients on high- and low-intensity treatment. Methods: Data from the Adelphi AML Disease-Specific Programme, a real-world, cross-sectional survey conducted between February–May 2015, were analysed. A total of 61 hematologist/hem-oncologists, across academic, non-academic and office-based practice locations, provided data on 457 AML patients. Patient characteristics were derived from physician-completed patient record forms where each physician was asked to provide treatment details, including the treatment intensity, for each line of therapy. Results: A total of 91% (n = 415) of patients included in this analysis were previously untreated for AML. Patients had a mean age of 60 years and been diagnosed with AML for a median of 5.0 months. At first-line induction therapy, over half (53%; n = 241) of the patients were initiated on a high-intensity treatment, the most common regimen being cytarabine plus anthracycline (61%; n = 147). The remaining 47% (n = 216) of patients received a low-intensity induction therapy such as low dose cytarabine monotherapy (28%, n = 61), azacitidine monotherapy (25%, n = 54), or decitabine monotherapy (21%, n = 45). Over half (55%, n = 62) of patients suited to high intensity treatment went on to receive cytarabine monotherapy during the consolidation phase of their first-line treatment. Conclusions: According to treating physicians, the large majority of patients receive traditional, well-established therapies at first-line induction for AML. Whilst cytarabine combinations dominate the high-intensity treatment setting, the hypomethylating agents, azacitidine and decitabine, are frequently used for those more suited to low-intensity treatment.

scholarly journals Pediatric Acute Promyelocytic Leukemia in Brazil: Epidemiology, Molecular Features, and Importance of GST-Theta 1 in Chemotherapy Response and Outcome

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5187-5187
Author(s):  
Francianne G. Andrade ◽  
Suellen V. M. Feliciano ◽  
Ingrid Sardou-Cezar ◽  
Gisele D. Brisson ◽  
Filipe V. S. Bueno ◽  
...  
Keyword(s):  
United States ◽  
Overall Survival ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Early Death ◽  
The United States ◽  
Promyelocytic Leukemia ◽  
Molecular Features ◽  
Gstt1 Polymorphism ◽  
Acute Myeloid

Background. Previous studies have suggested a variation in the incidence of acute promyelocytic leukemia (APL) among geographic regions with relatively higher percentages within the Latin American population. We aimed to describe the population burden of pediatric APL (p-APL) in Brazil assessing the incidence rates according to a hospital-based and population-based cancer (PBCR) registries. We also explored mutations in genes of the RAS pathway and the association of polymorphisms in genes of glutathione S-transferases (GSTs) with outcome. Our goal was to provide insights into the distribution of clinical-demographic data and the molecular epidemiology characteristics associated with APL outcome. Methods. One hundred and sixty-four p-APL cases (<19 years old) were identified from a dataset of a hospital-based registry based at a leukemia diagnostic central reference laboratory (2002-2018) and from 15 PBCR (2002-2009). Diagnostic criteria included morphological, immunophenotypic, and cytogenetic-molecular features. The PML-RARafusion gene was detected by FISH and/or RT-PCR. Additionally, mutations in FLT3 [D835 and internal tandem duplications (ITD)], KRAS, NRAS, and PTPN11 mutations were analyzed. We also evaluated the risk association of pharmacogenetically important GST deletion polymorphisms (GSTT1 and GSTM1) by multiplex-PCR, in a case-case analysis to test the effect of genetic susceptibility on overall survival (OS). Patients were treated with the inclusion of all-trans retinoic acid in chemotherapy with anthracyclines and cytarabine. Kaplan-Meier survival analysis was used to calculate the 5-year probabilities of OS (pOS), and estimated survival values were compared using the log-rank test. Cox proportional-hazard regression model estimated the hazard ratio (HR) and 95% confidence intervals (CI). All p-values were two-sided using significance level of 0.05. Results. From the hospital-based registry, APL patients represented 17.6% of the cohort (164 out of 933 acute myeloid leukemia cases), while in the PBCR, they represented 4.4% (35 out of 805 acute myeloid leukemia cases registered). The age-adjusted incidence rate was 0.32 per million persons during 2000-2009 based on PBCR. According to the hospital-based registry, we found similar distribution of patients among age ranges >2-10 and >10-21 years old (43.3% and 51.8%, respectively) and sex. RAS mutations were observed in 51.7% of APLs, including FLT3 (43.0%), NRAS (6.5%), and KRAS (2.2%). Variants in PTPN11 were silent amino acid substitutions (rs61736914; 4.9%). We observed a statistically significant association between FLT3 mutations and high white blood cell count at diagnosis (>10x109/L; 72.6%), low platelet count (<40×109/L; 83.0%), and the PML-RARa breakpoint cluster region 3 (90.5%). Death in the first ten days after diagnosis (early death) affected 17.5% (24/137) patients and these cases were excluded from the survival analysis. The mean of overall survival was 45.1 months (95% CI 40.1-50.1 months; pOS 66.9±5.8%). Univariate analysis did not show an association between variables and OS rates, except for APL patients carrying the GSTT1 polymorphism. GSTT1 null genotype conferred adverse prognosis compared to wild-type genotype (pOS 48.2±13.4% and 79.0±6.3%, p=0.024; hazard ratio 2.6, 95% CI 1.1-6.2, p=0.030; Figure 1). Conclusions. APL represented 17.6% of acute myeloid leukemia in our cohort of Latino patients, which is a higher proportion compared to Northern European countries and the United States (5-10%). GSTT1 polymorphism modulated outcome, suggesting that lower enzyme activity may impact response to therapy. Decreasing early death and inclusion of GSTT1 polymorphism in therapeutic protocols for chemotherapy dose modulation may allow patients to reach the same overall survival observed in the United States (>70%). Disclosures No relevant conflicts of interest to declare.

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