title: Acute lymphoblastic leukemia: an assessment of international incidence, survival, and disease burden.
abstract: OBJECTIVE
  Acute lymphoblastic leukemia (ALL) is a rare hematological malignancy. With the recent introduction of a classification system for hematopoietic and lymphoid neoplasms, more comprehensive assessment of ALL epidemiology is now possible. In this study, we describe recent international incidence of ALL and project the annual number of diagnoses to 2025. We also estimate relative survival and average potential years of life lost (AYLL) to assess the societal burden of ALL.
  
  
  METHODS
  Age-specific incidence data for ALL from select cancer registries in different geographies were obtained from the International Agency for Research on Cancer's Cancer Incidence in Five Continents Database. Country-specific age-standardized rates were calculated to allow for direct comparisons between countries. ALL-specific mortality and relative survival data were only available from the United States (US) National Cancer Institute's Surveillance, Epidemiology, and End Results program; mortality rates were estimated for other countries.
  
  
  RESULTS
  The age-standardized incidence rate of ALL during 2003-2007 ranged from 1.08 to 2.12 per 100,000 person-years in selected countries. Incidence was generally higher in the Americas and Oceania and lower in Asia and Eastern Europe. In most countries, the incidence rate of ALL in children was approximately four times that in adults. Survival was particularly poor among adults. In selected countries, the estimated AYLL ranged from 30 to 48 years for all ages and from 23 to 39 years for adults.
  
  
  CONCLUSIONS
  Although a rare disease, ALL presents a significant public health burden given poor survival outcomes among adults, AYLL, and its importance as the most common pediatric cancer.
authors.affiliation: Center for Observational Research, Amgen Inc., One Amgen Center Drive, 24-2-A, Thousand Oaks, CA, 91320, USA. katza@amgen.com.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Katz
authors.affiliation: Center for Observational Research, Amgen Inc., One Amgen Center Drive, 24-2-A, Thousand Oaks, CA, 91320, USA.
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Chia
authors.affiliation: Center for Observational Research, Amgen Ltd., 1 Uxbridge Business Park, Sanderson Road, Uxbridge, Middlesex, UK.
authors.forename: Wilma M
authors.initials: WM
authors.lastname: Schoonen
authors.affiliation: Center for Observational Research, Amgen Inc., One Amgen Center Drive, 24-2-A, Thousand Oaks, CA, 91320, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kelsh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D054547:National Cancer Institute (U.S.); D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology* / Q000401:mortality; D011634:Public Health; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Acute lymphoblastic leukemia; Incidence; International; Potential years of life lost; Projections; Survival