Journal
LEUKEMIA & LYMPHOMA
Volume 55, Issue 11, Pages 2549-2555Publisher
TAYLOR & FRANCIS LTD
DOI: 10.3109/10428194.2014.885517
Keywords
Acute myeloid leukemia; treatment; survival; patterns of care
Categories
Funding
- National Cancer Institute [N01-PC-35133, N01-PC-35135, N01-PC-35141, N01-PC-35136, N01-PC-35137, N01-PC-35138, N01-PC-35139, N01-PC-35142, N01-PC-35143, N01-PC-35145, N01-PC-54402, N01-PC-54403, N01-PC-54404, N01-PC-54405]
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Few US studies have examined patterns of care (POC) for acute myeloid leukemia (AML) in community settings. We examined treatment and survival in 978 adults with AML sampled from Surveillance, Epidemiology, and End Results (SEER) registries through the POC program. Logistic regression was used to evaluate the association between patient/hospital characteristics and receipt of chemotherapy and allogeneic transplant. Survival was examined using proportional hazards models. Treatment with cytarabine/anthracycline occurred in >80% of patients without acute promeyelocytic leukemia (non-APL) <60, but only about one-third of older non-APL patients. Ultimately, 27% of those <60 received an allogeneic transplant. Thirty-seven percent of those <40 and 4% of those >= 80 were alive at the end of follow-up. About three-quarters of patients with APL received all-trans retinoic acid (ATRA) and either an anthracycline or arsenic trioxide, with 71% surviving. Age and APL diagnosis were the strongest predictors of treatment and survival. Trends in dissemination of novel diagnostic tests and treatments and in survival will be monitored by POC in future years.
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