Predictors of early death and survival among children, adolescents and young adults with acute myeloid leukaemia in California, 1988–2011: a population-based study

Details

• Alternative Title:
  Br J Haematol
• Personal Author:
  Abrahão, R ; Keogh, RH ; Lichtensztajn, DY ; Marcos-Gragera, R ; Medeiros, BC ; Coleman, MP ; Ribeiro, RC ; Keegan, THM
• Description:
  A better understanding of factors associated with early death and survival among children, adolescents and young adults with acute myeloid leukaemia (AML) may guide health policy aimed at improving outcomes in these patients. We examined trends in early death and survival among 3935 patients aged 0-39 years with de novo AML in California during 1988-2011 and investigated the associations between sociodemographic and selected clinical factors and outcomes. Early death declined from 9·7% in 1988-1995 to 7·1% in 2004-2011 (P = 0·062), and survival improved substantially over time. However, 5-year survival was still only 50% (95% confidence interval 47-53%) even in the most recent treatment period (2004-2011). Overall, the main factors associated with poor outcomes were older age at diagnosis, treatment at hospitals not affiliated with National Cancer Institute-designated cancer centres, and black race/ethnicity. For patients diagnosed during 1996-2011, survival was lower among those who lacked health insurance compared to those with public or private insurance. We conclude that mortality after AML remained strikingly high in California and increased with age. Possible strategies to improve outcomes include wider insurance coverage and treatment at specialized cancer centres.
• Keywords:
  Acute Myeloid Leukaemia Adolescent Adult Age Of Onset California Child Child, Preschool Early Death Epidemiologic Methods Female Humans Infant Infant, Newborn Leukemia, Myeloid, Acute Male Population-based Socioeconomic Factors Survival Young Adult

  More +
• Source:
  Br J Haematol. 173(2):292-302
• Pubmed ID:
  26847024
• Pubmed Central ID:
  PMC4833652
• Document Type:
  Journal Article
• Funding:
  U58DP003862-01/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201000140C/CA/NCI NIH HHSUnited States/ ; HHSN261201000035C/CA/NCI NIH HHSUnited States/ ; P30 CA021765/CA/NCI NIH HHSUnited States/ ; HHSN261201000035I/CA/NCI NIH HHSUnited States/ ; HHSN261201000034C/CA/NCI NIH HHSUnited States/ ; U58 DP003862/DP/NCCDPHP CDC HHSUnited States/ ; P30 CA021765-30/CA/NCI NIH HHSUnited States/
• Volume:
  173
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e1cd76e17872f01670c5716f452bcad12bc60ea7b629c6ebdacdf674de4a6054
• Download URL:
  https://stacks.cdc.gov/view/cdc/40883/cdc_40883_DS1.pdf
• File Type:
  [PDF - 321.75 KB ]