title: Myeloid leukaemia treatment and survival--the South Australian experience, 1977 to 2002.
abstract: OBJECTIVE
  To evaluate trends in survival and treatment for myeloid leukaemia in South Australia during 1977-2002, using population-based survival data plus data on survival and treatment of patients at three teaching hospitals.
  
  
  METHODS
  Population data were analysed using relative survival methods and hospital registry data using disease-specific survival. Univariate and multivariable analyses were undertaken. Multiple logistic regression analysis was used to investigate factors associated with first-line chemotherapy.
  
  
  RESULTS
  South Australia recorded 1,572 new cases of acute myeloid leukaemia (AML) in 1977-2002, together with 536 cases of chronic myeloid leukaemia (CML). Of these cases, 42.6% were recorded in teaching hospital registries. The five-year survival for AML at the teaching hospitals of 14.5% was similar to the corresponding 12.0% for South Australia as a whole. The five-year survival for CML at these hospitals was higher, however, at 48.1% compared with 37.5% for all South Australian cases. Younger patients had higher survivals, both for AML and CML. An increase in survival was evident for more recently diagnosed cases for both leukaemia types, after adjusting for age. This increase in survival was accompanied by an increase over time in the proportion of patients at teaching hospitals having a primary course of chemotherapy. Cytarabine in combination with other agents was the most common induction therapy for AML. While hydroxyurea was the most common first-line treatment of CML, there were changes in clinical policies towards higher-dose treatments, plus trials of new agents and combination therapies.
  
  
  CONCLUSIONS
  Secular gains in survival have occurred from AML and CML in association with an increased use of chemotherapy.
authors.affiliation: Epidemiology Branch, Department of Health, Adelaide, SA.
authors.forename: Colin
authors.initials: C
authors.lastname: Luke
authors.forename: Anh-Minh Azhar
authors.initials: AM
authors.lastname: Nguyen
authors.forename: Bik
authors.initials: B
authors.lastname: To
authors.forename: Ram
authors.initials: R
authors.lastname: Seshadri
authors.forename: Tim
authors.initials: T
authors.lastname: Hughes
authors.forename: Peter
authors.initials: P
authors.lastname: Bardy
authors.forename: Margaret
authors.initials: M
authors.lastname: Colbeck
authors.forename: Dianne
authors.initials: D
authors.lastname: Buranyi-Trevarton
authors.forename: Maureen
authors.initials: M
authors.lastname: McMellon
authors.forename: David
authors.initials: D
authors.lastname: Roder
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006784:Hospitals, Teaching; D006801:Humans; D007951:Leukemia, Myeloid / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008875:Middle Aged; D012042:Registries; D012959:Socioeconomic Factors; D013021:South Australia / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome