Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Aug 19;14(8):e0220864.
doi: 10.1371/journal.pone.0220864. eCollection 2019.

Racial/ethnic, Age and Sex Disparities in Leukemia Survival Among Adults in the United States During 1973-2014 Period

Affiliations
Free PMC article

Racial/ethnic, Age and Sex Disparities in Leukemia Survival Among Adults in the United States During 1973-2014 Period

Ovie Utuama et al. PLoS One. .
Free PMC article

Abstract

There has been marked improvement in leukemia survival, particularly among children in recent time. However, the long-term trends in survival among adult leukemia patients and the associated sex and racial survival disparities are not well understood. We, therefore, evaluated the secular trends in survival improvement of leukemia patients from 1973 through 2014, using Surveillance Epidemiology and End-Result Survey Program (SEER) data. ICD-O-3 morphology codes were used to group leukemia into four types: acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), chronic myeloid leukemia (CML). Survival analysis for each leukemia type stratified by race/ethnicity, age, sex was performed to generate relative survival probability estimates for the baseline time period of 1973 through 1979. Hazard ratios (HR) and respective 95% confidence intervals (CIs) for survival within subsequent 10-year time periods by race, age and sex were calculated using Cox proportional hazard models. Of the 83,255 leukemia patients for the current analysis, the 5-year survival of patients with ALL, AML, CLL, and CML during 1973-1979 were 42.0%, 6.5%, 66.5%, and 20.9%, respectively. Compared to the baseline, there were substantial improvements of leukemia-specific survival in 2010-2014 among African-American (81.0%) and Asian (80.0%) patients with CML and among 20-49 year of age with CLL (96.0%). African-American patients, those with AML and those older than 75 years of age had the lowest survival improvements. Asians experienced some of the largest survival improvements during the study period. Others, including African-American and the elderly, have not benefited as much from advances in leukemia treatment.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Multivariate-adjusted hazard ratios for cancer-specific death associated with year of diagnosis, according to race/ethnicity in 9 SEER registries, 1973–2014.
Fig 2
Fig 2. Multivariate-adjusted hazard ratios for cancer-specific death associated with year of diagnosis, according to age at diagnosis in 9 SEER registries, 1973–2014.
Fig 3
Fig 3. Multivariate-adjusted hazard ratios for cancer-specific death associated with year of diagnosis, according to sex at diagnosis in 9 SEER registries, 1973–2014.

Similar articles

See all similar articles

References

    1. Noone A, Howlader N, Krapcho M, Miller D, Brest A, Yu M, et al. SEER Cancer Statistics Review, 1975–2015, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2015/, based on November 2017 SEER data submission, posted to the SEER web site, April 2018. National Cancer Institute; 2018.
    1. National Cancer Institute. SEER. Surveillance, Epidemiology, and End Results Program: SEER Stat Cancer Fact Sheet. National Cancer Institute; 2018.
    1. Davis AS, Viera AJ, Mead MD. Leukemia: an overview for primary care. Am Fam Physician. 2014;89: 731–738. - PubMed
    1. Hunger SP, Mullighan CG. Acute Lymphoblastic Leukemia in Children. N Engl J Med. 2015;373: 1541–1552. 10.1056/NEJMra1400972 - DOI - PubMed
    1. Döhner H, Weisdorf DJ, Bloomfield CD. Acute Myeloid Leukemia. N Engl J Med. 2015;373: 1136–1152. 10.1056/NEJMra1406184 - DOI - PubMed

Publication types

Feedback