title: Temporal trends in the proportion cured among adults diagnosed with acute myeloid leukaemia in Sweden 1973-2001, a population-based study.
abstract: Large age-dependent 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 < or =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.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. therese.m-l.andersson@ki.se
authors.forename: Therese M-L
authors.initials: TM
authors.lastname: Andersson
authors.forename: Paul C
authors.initials: PC
authors.lastname: Lambert
authors.forename: Asa Rangert
authors.initials: AR
authors.lastname: Derolf
authors.forename: Sigurdur Yngvi
authors.initials: SY
authors.lastname: Kristinsson
authors.forename: Sandra
authors.initials: S
authors.lastname: Eloranta
authors.forename: Ola
authors.initials: O
authors.lastname: Landgren
authors.forename: Magnus
authors.initials: M
authors.lastname: Björkholm
authors.forename: Paul W
authors.initials: PW
authors.lastname: Dickman
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D012042:Registries; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult