title: Recent trends in survival of adult patients with acute leukemia: overall improvements, but persistent and partly increasing disparity in survival of patients from minority groups.
abstract: The survival of younger patients with acute leukemia has improved in the early 21(st) century, but it is unknown whether people of all ethnic and racial backgrounds have benefited equally. Using cancer registry data from the Surveillance, Epidemiology and End Results Program, we assessed trends in 5-year relative survival for patients aged 15 years or more with acute lymphoblastic leukemia and acute myeloblastic leukemia divided by racial and ethnic group, including non-Hispanic whites, African-Americans, Hispanics, and Asian-Pacific Islanders in the 1990s and the early 21(st) century. Modeled period analysis was used to obtain the most up-to-date estimates of survival. Overall, the 5-year survival increased from 31.6% in 1997-2002 to 39.0% in 2003-2008 for patients with acute lymphoblastic leukemia and from 15.5% in 1991-1996 to 22.5% in 2003-2008 for those with acute myeloblastic leukemia. Nevertheless, among patients with acute lymphoblastic leukemia, age-adjusted 5-year relative survival rates remained lower for African-Americans and Hispanics than for non-Hispanic whites. Among patients with acute myeloblastic leukemia, the increase in survival was greatest (from 32.6% in 1991-1996 to 47.1% in 2003-2008) for younger patients (15-54 years), and was more pronounced for non-Hispanic whites (+16.4% units) than for other patients (+10.8% units). Increases in survival are observed in all ethnic or racial groups. Nevertheless, among patients with acute leukemias, disparities in survival persist between non-Hispanic white people and people of other ethnic or racial groups. Disparities are increasing in younger patients with acute myeloblastic leukemia. Improvements in access to treatment, especially for minority patients, may improve outcomes.
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. pultedi@gmail.com
authors.forename: Dianne
authors.initials: D
authors.lastname: Pulte
authors.forename: Maria Theresa
authors.initials: MT
authors.lastname: Redaniel
authors.forename: Lina
authors.initials: L
authors.lastname: Jansen
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
authors.forename: Mona
authors.initials: M
authors.lastname: Jeffreys
mesh_terms: D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D006801:Humans; D007938:Leukemia / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality; D008875:Middle Aged; D008913:Minority Groups; D054525:Minority Health; D018426:SEER Program; D014481:United States / Q000453:epidemiology; D055815:Young Adult