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- Title
Predictors of early death and survival among children, adolescents and young adults with acute myeloid leukaemia in California, 1988-2011: a population-based study.
- Authors
Abrahão, Renata; Keogh, Ruth H.; Lichtensztajn, Daphne Y.; Marcos‐Gragera, Rafael; Medeiros, Bruno C.; Coleman, Michel P.; Ribeiro, Raul C.; Keegan, Theresa H. M.
- Abstract
A better understanding of factors associated with early death and survival among children, adolescents and young adults with acute myeloid leukaemia ( AML) may guide health policy aimed at improving outcomes in these patients. We examined trends in early death and survival among 3935 patients aged 0-39 years with de novo AML in California during 1988-2011 and investigated the associations between sociodemographic and selected clinical factors and outcomes. Early death declined from 9·7% in 1988-1995 to 7·1% in 2004-2011 ( P = 0·062), and survival improved substantially over time. However, 5-year survival was still only 50% (95% confidence interval 47-53%) even in the most recent treatment period (2004-2011). Overall, the main factors associated with poor outcomes were older age at diagnosis, treatment at hospitals not affiliated with National Cancer Institute-designated cancer centres, and black race/ethnicity. For patients diagnosed during 1996-2011, survival was lower among those who lacked health insurance compared to those with public or private insurance. We conclude that mortality after AML remained strikingly high in California and increased with age. Possible strategies to improve outcomes include wider insurance coverage and treatment at specialized cancer centres.
- Subjects
UNITED States; HEALTH status indicators; SURVIVAL analysis (Biometry); JUVENILE diseases; ACUTE myeloid leukemia treatment; PUBLIC health; POPULATION-based case control
- Publication
British Journal of Haematology, 2016, Vol 173, Issue 2, p292
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.13944