Survival and cure of acute myeloid leukaemia in England, 1971‐2006: a population–based study

Abstract

SummaryThe 5-year relative survival of adults diagnosed with acute myeloid leukaemia (AML) was less than 10% during the 1970s and 1980s in England. This population-based study estimated the 5-year relative survival and 'cure' for 48 380 adult patients diagnosed with AML in England during . Relative survival and cure mixture models were used to produce estimates of 5-year relative survival and the percentage 'cured'. 'Cure' was defined as the proportion of a group of survivors for whom there is no excess mortality compared with the general population. The 5-year relative survival and the percentage 'cured' increased for patients aged under 70 years at diagnosis during 1971-2006, but advancing age was associated with poorer outcome. During the study period a dramatic increase in 5-year relative survival occurred in those aged 15-24 years, from 7% to 53%. The percentage 'cured' was less than 10% for all ages in 1975, but increased to 45% for those aged 15-24 years in 2000. Cure could not be estimated for patients over 70 years, because survival was consistently low (<5%). The long-term outcome of patients with AML has improved substantially, particularly in younger patients. The potential exists for further increasing levels of 'cure'.

Patient-derived antibody recognizes a unique CD43 epitope expressed on all AML and has antileukemia activity in mice

“…[3][4][5] For patients younger than 60 years fit enough to be treated aggressively with chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT), the prognosis is better, with 5-year survival rates of 40% to 50%. 4,5 A significant proportion of allogeneic HSCT recipients die, however, as a result of transplantation-related complications such as graft-versus-host disease and infections, whereas the lives of allogeneic HSCT survivors are often significantly affected by the detrimental effects of acute and chronic graft-versus-host disease. 6 Hence, alternative and less harmful treatment approaches that can also be applied to elderly or less-fit younger patients are highly needed.…”

The European Medicines Agency Review of Decitabine (Dacogen) for the Treatment of Adult Patients With Acute Myeloid Leukemia: Summary of the Scientific Assessment of the Committee for Medicinal Products for Human Use

“…In the older segment, median survival generally is short (2.4 months overall); it ranges from 3.9 months among those age 65-74 years to 1.4 months among those age 85 years or older [6][7][8]. Cytogenetic abnormalities represent an important prognostic factor for predicting remission rate, relapse risk, and survival outcome.…”

“…Azacitidine is approved in patients with marrow blast percentages between 20% and 30% who fulfill the criteria for AML according to the 2008 World Health Organization (WHO) classification. Despite improvements in outcomes for younger patients in recent decades, there has been little progress in improving prognosis for patients age $60 years [7,8]. AML, especially in older patients, remains an area of significant unmet need.…”

Chemotherapy-induced hypomethylation of N-myc downstream-regulated gene 4 in the bone marrow of patients with acute myeloid leukemia

“…In the current study, patients with M2 subtype AML exhibited a significant reduction in NDRG4 methylation levels during chemotherapy. The incidence of AML is frequently associated with increased age, but may occur at any age (30)(31)(32)(33). The clinical characteristics of elderly patients with AML differ from those of younger patients, with poorer survival and treatment outcomes (34).…”