Department of Hematology, Moffitt Cancer Center, Tampa, FL.
Department of Biostatistics, Biostatistics Epidemiology Research Design Informatics (BERDI) Core, Rhode Island Hospital, Providence, RI.
Clin Lymphoma Myeloma Leuk. 2024 Nov;24(11):e827-e834.e1. doi: 10.1016/j.clml.2024.07.002. Epub 2024 Jul 8.
With advances in therapeutics and longer survival across different cancer spectrums, the incidence of therapy-related acute myeloid leukemia (tAML) has continued to rise. This study aims to evaluate the trend of survival outcomes and their association with sociodemographic factors in tAML over the last 20 years.
We identified tAML patients between 2000 and 2020 from the Surveillance, Epidemiology, and End Results database. Patients were divided into 4 age groups: 18-39, 40-59, 60-69, and >= 70 years, and 4 diagnostic periods: 2000-2005, 2006-2010, 2011-2015, and 2016-2020. Overall survival (OS) was compared using Kaplan Meier and log-rank methods.
The 1-year (and 5-year) OS in patients with tAML was 59.3% (33.7%), 48.2% (24.8%), 37.2% (11.1%), and 32.9% (5.5%) in age groups 18-39, 40-59, 60-69, and >=70 years, respectively. The 1-year (and 5-year) OS based on the year of diagnosis was 20.9% (13.2%), 36.8% (15.2%), 41.9% (13.88%), and 40.4% (not reached) for 2000-2005, 2006-2010, 2011-2015, and 2016-2020 respectively. Among the youngest cohort aged 18-39 years, 1-year OS was 35.7%, 57.7%, 66.7%, and 59.6%, respectively, in 4 diagnostic periods, whereas 1-year OS was 10.5%, 23.9%, 32.2%, and 36.9%, respectively, in the oldest cohort aged >=70 years. Age, year of diagnosis, and geographic location were independent prognostic markers of OS.
Our study demonstrates a significant improvement in the 1-year OS of tAML patients over the last decade, but the long-term prognosis remains dismal. Older patients continue to show improved survival in recent years with the addition of newer intensive and nonintensive options.
随着治疗方法的进步和不同癌症谱中生存时间的延长，治疗相关急性髓系白血病（tAML）的发病率持续上升。本研究旨在评估过去 20 年中 tAML 患者生存结果的趋势及其与社会人口因素的关系。
我们从监测、流行病学和最终结果数据库中确定了 2000 年至 2020 年间的 tAML 患者。患者分为 4 个年龄组：18-39 岁、40-59 岁、60-69 岁和>=70 岁，4 个诊断期：2000-2005 年、2006-2010 年、2011-2015 年和 2016-2020 年。使用 Kaplan-Meier 和对数秩检验比较总生存率（OS）。
tAML 患者的 1 年（和 5 年）OS 分别为 59.3%（33.7%）、48.2%（24.8%）、37.2%（11.1%）和 32.9%（5.5%），年龄组分别为 18-39 岁、40-59 岁、60-69 岁和>=70 岁。根据诊断年份，2000-2005 年、2006-2010 年、2011-2015 年和 2016-2020 年的 1 年（和 5 年）OS 分别为 20.9%（13.2%）、36.8%（15.2%）、41.9%（13.88%）和 40.4%（未达到）。在年龄最小的 18-39 岁队列中，4 个诊断期的 1 年 OS 分别为 35.7%、57.7%、66.7%和 59.6%，而在年龄最大的>=70 岁队列中，1 年 OS 分别为 10.5%、23.9%、32.2%和 36.9%。年龄、诊断年份和地理位置是 OS 的独立预后标志物。
我们的研究表明，过去十年中 tAML 患者的 1 年 OS 显著提高，但长期预后仍然不佳。近年来，随着新的强化和非强化治疗方案的应用，老年患者的生存状况有所改善。
