Survival differences in childhood and young adult acute myeloid leukemia: A cross-national study using US and England data
| Autor: | Jobayer Hossain, Sherlly Xie |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine Oncology Cancer Research medicine.medical_specialty Adolescent Survival Epidemiology Population Disease Article Young Adult 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases Internal medicine medicine Risk of mortality Humans Registries Young adult Child education Proportional Hazards Models education.field_of_study business.industry Hazard ratio Infant Newborn Infant Prognosis United States Confidence interval Leukemia Myeloid Acute 030104 developmental biology England Child Preschool 030220 oncology & carcinogenesis Etiology Female business SEER Program |
| Zdroj: | Cancer Epidemiology. 54:19-24 |
| ISSN: | 1877-7821 |
| DOI: | 10.1016/j.canep.2018.03.001 |
| Popis: | Background Acute myeloid leukemia (AML) is a serious disease with complex etiology and marked variation in survival. Known prognostic factors include AML subtypes, age at diagnosis and sex. However, survival outcomes may vary across healthcare systems. In this study, we evaluated the survival patterns in individuals diagnosed with AML at ages 0–24 years in the US and England between prognostic features and across countries. Methods We obtained data on 4387 and 2194 subjects from the US Surveillance Epidemiology and End Result registries and UK National Cancer Data Repository. Subjects were diagnosed and followed in 1995–2014. Kaplan-Meier curve and stratified Cox proportional hazards regression were used in the analysis. Results Overall risk of mortality was 23% lower in English patients compared to that in the US patients (adjusted hazard ratio (aHR), 95% confidence Interval (CI): 0.77, 0.71–0.84). Survival difference of similar extent was observed in subgroups of sex and age at diagnosis. However, mortality risks between two countries varied substantially across AML subtypes, especially in AML inv(16) (1.81, 0.61–5.34), AML with minimal differentiation (0.54, 0.25–1.17), AML without maturation (0.38, 0.20–0.74) and AML with maturation (0.52, 0.31–0.86). Conclusions Similar to the population trend, mortality risk across sex, age at diagnosis, and most AML subtypes was lower in England. Survival outcome for AML with and without maturation in England was better than the population trend, while that for AML inv(16) was worse. Our findings suggest that future etiologic and policy research may uncover the underlying mechanisms and contribute to closing these morality gaps. |
| Databáze: | OpenAIRE |
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