title: Outcome of older patients with acute myeloid leukemia: an analysis of SEER data over 3 decades.
abstract: BACKGROUND
  Acute myeloid leukemia (AML) is the common form of acute leukemia in adults, accounting for over 80% of all acute leukemias in individuals aged >18 years. Overall 5-year survival remains poor in older AML patients; it is <5% in patients aged >65 years. In this study, the authors examined whether survival has improved for subsets of geriatric AML patients over 3 successive decades.
  
  
  METHODS
  Surveillance, Epidemiology and End Results (SEER) data were used to determine trends in relative survival by age among 19,000 patients with AML over 3 successive decades (1977-1986, 1987-1996, and 1997-2006). Relative survival rates (RRs) with 95% confidence intervals (CIs) were calculated as measures of survival.
  
  
  RESULTS
  Overall, the RRs increased for each successive decade (1977-1986, 1987-1996, and 1997-2006) in patients ages 65 to 74 years, with improvements in 12-month survival from 20%, to 25%, to 30%, respectively. Findings were similar for 24-month, 36-month, 48-month, and 60-month survival. However, survival rates did not improve in patients aged ≥75 years. The oldest old patients (aged ≥85 years) had the lowest survival rates, with no apparent improvement.
  
  
  CONCLUSIONS
  This analysis of a large data set demonstrated that, although overall survival remained unsatisfactory among older patients, it improved in the younger old (ages 65-74 years). Survival of older old AML patients has not been favorably impacted by available AML therapies or supportive care, and intervention in this age group is best undertaken on a clinical trial.
authors: Division of Hematology/Oncology, University of Maryland School of Medicine, Baltimore, MD, USA.
authors: Mya S
authors: MS
authors: Thein
authors: William B
authors: WB
authors: Ershler
authors: Ahmedin
authors: A
authors: Jemal
authors: Jerome W
authors: JW
authors: Yates
authors: Maria R
authors: MR
authors: Baer
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D018426:SEER Program; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: Surveillance, Epidemiology and End Results data; acute myeloid leukemia; age; survival
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