Temporal trends in the proportion cured among adults diagnosed with acute myeloid leukaemia in Sweden 1973–2001, a population‐based study

Abstract

Summary Large age‐dependant differences in temporal trends in 1‐ and 5‐year relative survival have been observed in patients with acute myeloid leukaemia (AML) in Sweden. This investigation used an alternative approach to studying patient survival that simultaneously estimated the proportion of patients cured from their cancer and the survival of the ‘uncured’. We conducted a population‐based study including 6439 AML patients aged 19–80 years in Sweden between 1973 and 2001. Mixture cure models were estimated, with age at diagnosis categorised (19–40, 41–60, 61–70 and 71–80) and year of diagnosis modelled using splines. In 1975 the cure proportion was ≤6% in all age groups and the median survival time for ‘uncured’ patients was <0·5 years. In 2000 the cure proportion was 68% (95% confidence interval 56–77%) in the youngest group, and 32% (25–39%), 8% (3–21%), and 4% (2–8%) in the other groups, respectively. The median survival times for ‘uncured’ were 0·74 (0·43–1·26), 0·71 (0·53–0·97), 0·69 (0·51–0·95) and 0·37 (0·31–0·44) years, respectively. A dramatic improvement in the cure proportion was seen in younger patients, whereas improvement in older ages was mainly within the survival of the ‘uncured’. This novel approach of analysing survival data could be a valuable tool for physicians, patients, health care planners and health economists.

Hematological: Low all‐cause mortality and low occurrence of antimicrobial resistance in hematological patients with bacteremia receiving no antibacterial prophylaxis: a single‐center study

“…In spite of this, there was a trend, however, not statistically significant, toward decreased mortality. In accordance with other studies, males seem to be overrepresented in bacteremia, have a higher incidence of hematological malignancies, and increased mortality (25–29).…”

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

“…Improvements in survival in younger patients are attributed to their having more chemo‐sensitive disease, a high proportion are recruited to UK clinical trials (Hills & Burnett, ), intense induction treatment, better management of short‐term toxicity and a reduction in relapse rates (Andersson et al , ). A study restricted to young people (15–29 years) with AML and registered in specialist leukaemia registries during 1984–94 in England and Wales (Stiller et al , ) showed survival estimates similar to our results.…”

“…Sweden now has outstandingly good rates of ‘cure’ of AML in young people. The percentage ‘cured’ increased to 68% in patients aged 19–40 years in Sweden in 2000 (Andersson et al , ) compared with 45% of 15–24 year olds and 43% of 25–39 year olds in England. A reanalysis of the Swedish data for the purpose of comparison indicates even greater predicted differences in ‘cure’ for patients diagnosed during 2004–2006 (Fig ).…”

Characterization and analysis of the outcome of adults with acute myeloid leukemia treated in a Brazilian University hospital over three decades

“…This, most probably, reflects a combination of elements related to diagnosis and treatment: effective induction treatment, higher proportion of treated patients, intensive postremission therapy, better management of chemotherapyinduced toxicity, appropriate use of antimicrobial agents, development of autologous and allogeneic transplantation, and progresses in overall supportive care (4,9,18,21).…”