Changes in the survival of older patients with hematologic malignancies in the early 21st century

Abstract

BACKGROUND Survival for patients with hematologic malignancies has improved during the early 21st century. However, it is unclear whether older patients have benefited to the same extent as younger patients. This study examines changes in survival for older patients with the 7 most common hematologic malignancies. METHODS Period analysis was used to examine survival for patients who were 65 years old or older and were diagnosed with a common hematologic malignancy between 1992 and 2012 with data from the Surveillance, Epidemiology, and End Results database. RESULTS Five‐year relative survival increased for older patients with hematologic malignancies with the partial exception of acute myelogenous leukemia, for which no change in survival was seen for patients who were 75 years old or older. Patients with chronic lymphocytic leukemia and non‐Hodgkin lymphoma, including the oldest patients, had especially strong improvements, with increases in 5‐year relative survival for patients who were 85 years old or older of 31.5% and 39.6%, respectively, between 1997‐2000 and 2009‐2012. CONCLUSIONS Despite these increases, survival rates did not reach those observed for patients aged 50 to 59 years for any hematologic malignancy. Newer therapies and a better understanding of how to treat older patients have led to increased survival expectations for older patients with most hematologic malignancies, but an age‐related survival disparity persists. Cancer 2016;122:2031–40. © 2016 American Cancer Society.

Quality of life in survivors of adult haematological malignancy

“…Contrary to other malignant diseases, chemotherapy treatment regimens for B‐cell malignancies are often more complex and intense. Hence, they can be more physically and psychologically burdensome with prolonged, intensive treatments (De Vita, Lawrence, & Rosenburg, ; Junlen et al, ; Mounier et al, ; Pulte, Jansen, Castro, & Brenner, ). These treatments have also led to significant improvements in survival rates (Mounier et al, ; Pulte et al, ).…”

“…Hence, they can be more physically and psychologically burdensome with prolonged, intensive treatments (De Vita, Lawrence, & Rosenburg, ; Junlen et al, ; Mounier et al, ; Pulte, Jansen, Castro, & Brenner, ). These treatments have also led to significant improvements in survival rates (Mounier et al, ; Pulte et al, ). When a patient is diagnosed with a B‐cell malignancy, the treatment not only affects clinical outcomes, but also it can influence their quality of life (QoL) (van de Poll‐Franse et al, ).…”

Changes in population‐level survival for advanced solid malignancies with new treatment options in the second decade of the 21st century

“…The changes observed for melanoma are strongest in younger patients. A similar pattern has been observed with other conditions, ie, population‐level survival for chronic myelocytic leukemia increased far more for younger than for older patients after the approval of tyrosine kinase inhibitors, although recent data suggest that this pattern may be changing . It is possible that physicians and patients are reluctant to use the newer medications in older patients out of fear of the potential toxicity.…”

“…A similar pattern has been observed with other conditions, ie, population-level survival for chronic myelocytic leukemia increased far more for younger than for older patients after the approval of tyrosine kinase inhibitors, 16 although recent data suggest that this pattern may be changing. 17 It is possible that physicians and patients are reluctant to Cancer August 1, 2019 use the newer medications in older patients out of fear of the potential toxicity. However, a recent clinical trial suggests that ipilimumab is safe and effective in older patients, 18 and this information, along with increased experience with the medication in clinical practice, may lead to increased acceptance of its use in older patients and improved population-level survival for older patients with advanced melanoma.…”

Still lost in transition: a qualitative descriptive study of people’s experiences following treatment completion for haematological cancer in Wales, UK

“…However, for people affected by haematological cancers, this distinct point in the illness trajectory is still poorly understood, for it remains relatively unexplored. Yet the experiences of and issues for people living with and beyond haematological cancers are increasingly relevant, not least because their incidence and prevalence are steadily rising globally [30,31]. While clinical outcomes vary across the numerous haematological cancer sub-types [30,32,33], the UK has 44,390 new cases annually, 5-year prevalence is 163,800 [11] and survival across most of Europe is improving [34].…”