Characterizing Overall Survival of Patients with Acute Myeloid Leukemia: A Competing Risk Analysis of SEER Data Covering 46 Years.

[BACKGROUND AND METHODS] We analyzed trends in overall survival after acute myeloid leukemia (AML) using US registry data covering the years 1975 to 2021. Our study utilized unique patient data from the Surveillance, Epidemiology, and End Results Program (SEER), with 37,615 adult patients included. We employed Kaplan-Meier estimates and competing risk analyses to assess overall survival and risks of AML-related death and death from other causes.

[RESULTS] Our findings indicate a clear and continuous trend of improved survival in AML patients, attributed to decreased AML-related mortality. Patients aged 60 or younger showed continuous improvement over the entire period, while those aged 61 or older demonstrated improvement starting in the early 2000s. Only patients receiving chemotherapy treatment benefited from ongoing research. No sex-specific differences were found. Subgroup analyses revealed age-dependent differences in survival improvement. The delayed onset of improvement in older patients may be due to the availability of hypomethylating agents and increased access to hematological stem cell transplantation.

[CONCLUSION] Our analysis showed, on a high level of abstraction, how ongoing research and availability of new treatment options improved survival for AML patients. Furthermore, subgroup analyses revealed age-dependent differences in this respect. While the data did not allow us to conduct in-depth analyses of treatment regimens, we hypothesized that the later onset of a pattern of improvement in older patients was due to the availability of hypomethylating substances and increased availability of hematological stem cells transplantation for elderly patients.