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New and noteworthy research from the
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Improved Survival for AML Patients Enrolled in
Clinical Trials
Given the lack of large population-based studies of patients with acute myeloid leukemia
(AML), long-term data on the therapies these
patients receive and long-term outcome are
scarce. In a recent paper in Leukemia, Avinash
G. Dinmohamed, MSc, BASc, from Erasmus
MC Cancer Institute in Rotterdam, Netherlands, and colleagues conducted a nationwide
population-based study of adult patients with
AML to assess patterns of primary treatment,
trial participation, and survival rates.
The researchers identified a total of 12,032
patients in the Netherlands who were diagnosed with AML between 1989 and 2012 (median age = 66 years; 54% male), as well as 585
patients with acute promyelocytic leukemia
(APL; median age = 52 years; 47% male).
All patients were then categorized into
four calendar periods (1989-1994, 1995-2000,
2001-2006, and 2007-2012) and four age
groups (18-40, 41-60, 61-70, and >70 years
of age) to determine if trial participation and
survival changed according to age and time of
diagnosis.
Data on the primary treatment for individual patients (including supportive care
only, chemotherapy, and hematopoietic cell
transplantation [HCT]) were taken from the
Netherlands Cancer Registry.
The overall age-standardized incidence
of AML and APL
remained stable
over time (3.0 per
100,000 and 0.15
per 100,000, respectively), the authors
noted. Treatment
including allogeneic
HCT increased over
time among nonAPL AML patients
younger than 70
while, for APL, the
use of chemotherapy
increased across all
age groups over time
(TABLE 1). Among patients older than 70,
treatment remained
conservative, with higher rates of supportive
care only, the authors pointed out.
Allogeneic HCT was used more frequently
than autologous HCT over time in patients
with non-APL AML <70 years, with autologous HCT being applied in ~10 percent and
allogenic HCT in 50 percent of patients. This
increase was most pronounced among patients
41 to 60 years old, increasing from 8 to 46
percent from