Abstract 3591

Background:

AML is the common acute leukemia in adults, accounting for approximately 90% of all acute leukemias in those over the age of 18 years. Overall survival remains poor, with <50% 5-year survival in patients under 45 years and <5% in those over 65 years. We examined whether there has been improvement in survival over three successive decades for subsets of geriatric AML patients. Methods: Examining data from the Surveillance, Epidemiology and End Results (SEER) database, we determined relative overall survival (+/− standard error) of patients with AML 65–74, 75–84 and 85+ years of age between 1977–86, 1987–96 and 1997–2006. Results: Survival for both males and females at 12, 24 and 36 months post-diagnosis is shown below. Between 1977–1986 and 1987–1996, 12-month, 24-month and 36-month survival rates increased from 20% to 25%, 10% to 13.1%, and 5.5 to 8.4%, respectively, in the 65–74 year age group. Between 1987–1996 and 1997–2006, 12-month, 24-month and 36-month survival rates increased from 25% to 30%, 13% to 17% and 8.4% to 11.7%, respectively, in the same age group. Survival rates increased over each decade in patients younger than 75 years of age, but did not improve significantly in patients 75 years and older. Female patients exhibited better survival up to 24 months than males in all age categories. The oldest-old (85+ years) had the lowest survival rates, with no apparent improvement over the past 3 decades for either gender. Conclusions: Analysis of a large data-set demonstrated that overall survival remains unsatisfactory over a 3-decade period among older patients, but has in fact improved in the young-old (65–74 year age group). Neither standard nor newly developed chemotherapy regimens have favorably impacted survival for the oldest-old AML patients, and intervention in this age group is best undertaken on a clinical trial.

Table:

Relative Survival Rates for Acute Myeloid Leukemia

Survival ± Standard Error % (Male)
Survival ± Standard Error % (Female)
Age (yrs)12 months24 months36 months12 months24 months36 months
 Year (1977 to 1986) Year (1977 to 1986) 
All 29.1±0.90 (n=2973) 16.1±0.7 11.4±0.6 31.3±1.0 (n=2420) 18.7±0.8 14.3±0.8 
65 to 74 20.1±1.5 (n=727) 10.0±1.2 5.5±0.9 16.3±1.7 (n=490) 9.6±1.4 5.5±1.1 
75 to 84 10.3±1.3 (n=584) 3.3±0.8 2.3±0.7 14.9±1.6 (n=531) 7.8±1.2 5.0±1 
≥85 10.6±2.7 (n=160) 7.0±2.4 4.4±2.2 9.3±2.1 (n=224) 5.3±1.7 3.4±1.5 
 Year (1987 to 1996) Year (1987 to 1996) 
All 34.8±0.8 (n=3360) 20.7±0.7 16.5±0.7 36.0±0.9 (n=2861) 24.1±0.8 19.9±0.8 
65 to 74 25.1±1.5 (n=913) 12.3±1.1 7.5±0.9 26.1±1.8 (n=607) 14.0±1.4 9.4±1.2 
75 to 84 11±0±1.3 (n=660) 4.1±0.8 2.7±0.7 11.6±1.3 (n=608) 6.2±1.0 3.9±0.9 
≥85 6.8±2.2 (n=159) 1.7±1.2 0.0±0 4.8±1.4 (n=264) 1.9±0.9 1.1±0.8 
 Year (1997 to 2006) Year (1997 to 2006) 
All 39.1±0.8 (n=4078) 27.4±0.8 23.7±0.8 40.9±0.9 (n=3480) 30.5±0.9 26.9±0.9 
65 to 74 30.3±1.6 (n=943) 15.8±1.3 9.8±1.1 30.7±1.9(n=662) 18.4±1.6 13.7±1.5 
75 to 84 14.8±1.3 (n=896) 5.0±0.8 3.5±0.8 14.9±1.3(n=831) 6.4±0.9 3.3±0.70 
≥85 7.8±1.8 (n=268) 1.7±1 1.2±0.8 7.3±1.5(n=364) 1.0±0.7 0.6±0.6 
Survival ± Standard Error % (Male)
Survival ± Standard Error % (Female)
Age (yrs)12 months24 months36 months12 months24 months36 months
 Year (1977 to 1986) Year (1977 to 1986) 
All 29.1±0.90 (n=2973) 16.1±0.7 11.4±0.6 31.3±1.0 (n=2420) 18.7±0.8 14.3±0.8 
65 to 74 20.1±1.5 (n=727) 10.0±1.2 5.5±0.9 16.3±1.7 (n=490) 9.6±1.4 5.5±1.1 
75 to 84 10.3±1.3 (n=584) 3.3±0.8 2.3±0.7 14.9±1.6 (n=531) 7.8±1.2 5.0±1 
≥85 10.6±2.7 (n=160) 7.0±2.4 4.4±2.2 9.3±2.1 (n=224) 5.3±1.7 3.4±1.5 
 Year (1987 to 1996) Year (1987 to 1996) 
All 34.8±0.8 (n=3360) 20.7±0.7 16.5±0.7 36.0±0.9 (n=2861) 24.1±0.8 19.9±0.8 
65 to 74 25.1±1.5 (n=913) 12.3±1.1 7.5±0.9 26.1±1.8 (n=607) 14.0±1.4 9.4±1.2 
75 to 84 11±0±1.3 (n=660) 4.1±0.8 2.7±0.7 11.6±1.3 (n=608) 6.2±1.0 3.9±0.9 
≥85 6.8±2.2 (n=159) 1.7±1.2 0.0±0 4.8±1.4 (n=264) 1.9±0.9 1.1±0.8 
 Year (1997 to 2006) Year (1997 to 2006) 
All 39.1±0.8 (n=4078) 27.4±0.8 23.7±0.8 40.9±0.9 (n=3480) 30.5±0.9 26.9±0.9 
65 to 74 30.3±1.6 (n=943) 15.8±1.3 9.8±1.1 30.7±1.9(n=662) 18.4±1.6 13.7±1.5 
75 to 84 14.8±1.3 (n=896) 5.0±0.8 3.5±0.8 14.9±1.3(n=831) 6.4±0.9 3.3±0.70 
≥85 7.8±1.8 (n=268) 1.7±1 1.2±0.8 7.3±1.5(n=364) 1.0±0.7 0.6±0.6 
Disclosures:

No relevant conflicts of interest to declare.

Author notes

*

Asterisk with author names denotes non-ASH members.