Survival disparities by age and country of diagnosis for patients with acute leukemia

Abstract

Survival for patients with acute leukemias (acute myeloblastic leukemia, AML; acute lymphoblastic leukemia, ALL) decreases with age, but whether the extent of disparity varies by country is unknown. We compared age-related disparities in survival in patients with ALL and AML in the USA and England. Five-year relative survival was calculated using period analysis. Excess mortality modeling was used to determine excess hazard ratios (EHRs). Age inequalities were similar in England and the USA, although survival among younger patients with AML was better in England. Compared to patients aged 30–44 years, people with AML diagnosed age 75 + had higher EHRs in the USA (5.43, 95% confidence interval [CI]: 4.97–5.93) and England (6.22, 95% CI: 5.83–6.64). People with ALL diagnosed age 65 + had higher EHRs in the USA (2.95, 95% CI: 2.56–3.41) and England (2.79, 95% CI: 2.47–3.14). Survival continues to be poor for older patients with acute leukemia, but does not differ markedly between the USA and England.

Keywords::

• Acute myeloblastic leukemia
• acute lymphoblastic leukemia
• period analysis
• survival
• disparities

Potential conflict of interest

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Supplementary material available online

Supplementary Table showing further results