TY - JOUR
T1 - Long-Term Outcomes among Adolescent and Young Adult Survivors of Acute Leukemia
T2 - A Surveillance, Epidemiology, and End Results Analysis
AU - Berkman, Amy M.
AU - Andersen, Clark R.
AU - Cuglievan, Branko
AU - McCall, David C.
AU - Lupo, Philip J.
AU - Parsons, Susan K.
AU - DiNardo, Courtney D.
AU - Short, Nicholas J.
AU - Jain, Nitin
AU - Kadia, Tapan M.
AU - Livingston, J. A.
AU - Roth, Michael E.
N1 - Publisher Copyright:
© 2022 American Association for Cancer Research
PY - 2022/6
Y1 - 2022/6
N2 - Background: There is a growing population of adolescent and young adult (AYA, age 15–39 years) acute leukemia survivors in whom long-term mortality outcomes are largely unknown. Methods: The current study utilized the Surveillance, Epidemiology, and End Results (SEER) registry to assess long-term outcomes of AYA acute leukemia 5-year survivors. The impact of diagnosis age, sex, race/ethnicity, socioeconomic status, and decade of diagnosis on long-term survival were assessed utilizing an accelerated failure time model. Results: A total of 1,938 AYA acute lymphoblastic leukemia (ALL) and 2,350 AYA acute myeloid leukemia (AML) survivors diagnosed between 1980 and 2009 were included with a median follow-up of 12.3 and 12.7 years, respectively. Ten-year survival for ALL and AML survivors was 87% and 89%, respectively, and 99% for the general population. Survival for AYA leukemia survivors remained below that of the age-adjusted general population at up to 30 years of follow-up. Primary cancer mortality was the most common cause of death in early survivorship with noncancer causes of death becoming more prevalent in later decades of follow-up. Male AML survivors had significantly worse survival than females (survival time ratio: 0.61, 95% confidence interval: 0.45–0.82). Conclusions: AYA leukemia survivors have higher mortality rates than the general population that persist for decades after diagnosis. Impact: While there have been improvements in late mortality, long-term survival for AYA leukemia survivors remains below that of the general population. Studies investigating risk factors for mortality and disparities in late effects among long-term AYA leukemia survivors are needed.
AB - Background: There is a growing population of adolescent and young adult (AYA, age 15–39 years) acute leukemia survivors in whom long-term mortality outcomes are largely unknown. Methods: The current study utilized the Surveillance, Epidemiology, and End Results (SEER) registry to assess long-term outcomes of AYA acute leukemia 5-year survivors. The impact of diagnosis age, sex, race/ethnicity, socioeconomic status, and decade of diagnosis on long-term survival were assessed utilizing an accelerated failure time model. Results: A total of 1,938 AYA acute lymphoblastic leukemia (ALL) and 2,350 AYA acute myeloid leukemia (AML) survivors diagnosed between 1980 and 2009 were included with a median follow-up of 12.3 and 12.7 years, respectively. Ten-year survival for ALL and AML survivors was 87% and 89%, respectively, and 99% for the general population. Survival for AYA leukemia survivors remained below that of the age-adjusted general population at up to 30 years of follow-up. Primary cancer mortality was the most common cause of death in early survivorship with noncancer causes of death becoming more prevalent in later decades of follow-up. Male AML survivors had significantly worse survival than females (survival time ratio: 0.61, 95% confidence interval: 0.45–0.82). Conclusions: AYA leukemia survivors have higher mortality rates than the general population that persist for decades after diagnosis. Impact: While there have been improvements in late mortality, long-term survival for AYA leukemia survivors remains below that of the general population. Studies investigating risk factors for mortality and disparities in late effects among long-term AYA leukemia survivors are needed.
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U2 - 10.1158/1055-9965.EPI-21-1388
DO - 10.1158/1055-9965.EPI-21-1388
M3 - Article
C2 - 35553621
AN - SCOPUS:85131223808
SN - 1055-9965
VL - 31
SP - 1176
EP - 1184
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
IS - 6
ER -