Long-Term Outcomes among Adolescent and Young Adult Survivors of Acute Leukemia: A Surveillance, Epidemiology, and End Results Analysis

Authors

Amy M Berkman
Clark R Andersen
Branko Cuglievan
David C McCall
Philip J Lupo
Susan K Parsons
Courtney D DiNardo
Nicholas J Short
Nitin Jain
Tapan M Kadia
J A Livingston
Michael E Roth

Publication Date

6-1-2022

Journal

Cancer Epidemiology, Biomarkers & Prevention

Abstract

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.

Keywords

Adult, Ethnicity, Female, Humans, Leukemia, Myeloid, Acute, Male, Risk Factors, Social Class, Survivors, Young Adult, Adolescent and Young Adult Oncology, AYA, Acute Lymphoblastic Leukemia, Acute Myeloid Leukemia, ALL, AML, Survival, Disparities

DOI

10.1158/1055-9965.EPI-21-1388

PMID

35553621

PMCID

PMC9179079

PubMedCentral® Posted Date

12-1-2022

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes