Trends in survival after diagnosis with hematologic malignancy in adolescence or young adulthood in the United States, 1981-2005

Abstract

BACKGROUND: There are few population-based studies of long-term survival of adolescents and young adults with hematologic malignancies; most pertain to patients diagnosed in the 1990s or earlier. Period analysis was used to obtain up-to-date information on survival expectations of adolescents and young adults diagnosed with hematologic malignancies through the early 21st century. METHODS: Period analysis was used to calculate 5- and 10-year relative survival for adolescents and young adults diagnosed with Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), acute lymphoblastic leukemia (ALL), acute myeloblastic leukemia (AML), and chronic myelocytic leukemia (CML) for 5 5-year periods from 1981-1985 to 2001-2005, using data from the Surveillance, Epidemiology, and End Results database. RESULTS: Survival strongly improved for each of the 5 hematologic malignancies. Increases in 10-year relative survival between 1981-1985 and 2001-2005 were as follows: HL, from 80.4% to 93.4%; NHL, from 55.6% to 76.2%; ALL, from 30.5% to 52.1%; AML, from 15.2% to 45.1%; CML, from 0 to 74.5% (P < .001 in all cases). However, although survival improved steadily throughout the period examined for the lymphomas and CML, survival was stable during the late 1990s and early 21st century for the acute leukemias. CONCLUSIONS: Survival expectations for adolescents and young adults with hematologic malignancies have strongly improved since the 1980s. However, with the exception of HL, survival rates have not reached the levels observed for children diagnosed with these malignancies, and survival expectations for patients with acute leukemiahave stabilized at relatively low levels. © 2009 American Cancer Society.