Survival and ‘Cure’ of Acute Myeloid Leukaemia (AML) in Children, Adolescents and Young Adults in England


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Mae-Yen Tan1,Aimilia Exarchakou2,Sara Benitez Majano2
1University of Glasgow,2London School of Hygiene & Tropical Medicine

Abstract

Background

Acute Myeloid Leukaemia (AML) is one of the most common malignancies among children and young adults. In England, five-year net survival of patients with AML aged 15-24 years increased from 7% to 53% during 1971-2006. The ‘cured’ proportion of these patients also increased substantially during this time period. This study aims to investigate the trends in survival and ‘proportion cured’ for children (aged 0-14), adolescents (aged 15-19) and young adults (aged 20-39) diagnosed with AML in England between 2006 and 2014. 

Method

We report 1- and 5-year net survival using the Pohar-Perme estimator for children, adolescents and young adults between 2006 and 2014. Cure modelling was used to estimate the proportion of patients “cured” during 2006-2014. This is the proportion of patients with no excess mortality compared to the general population.

Results

Between 2006 and 2014, 2216 patients aged 0-39 were diagnosed with AML in England and 855 deaths occurred. Young adults (aged 20-39) had the most dramatic increase in five-year net survival; 10% from the period 2006-2010 to 2011-2014. Adolescents' (aged 15-19) 1- and 5-year net survival decreased by 6% and 3% respectively. Young adults had the highest increase in proportion ‘cured’ (13.6%) and the largest improvement in median survival of the ‘uncured’ proportion (0.34 years) between 2006 and 2014. Children (aged 0-14) had the highest proportion ‘cured’, and the highest 1- and 5-year net survival in both time periods.

Conclusion

AML in children, adolescents and young adults still remains an elusive disease with hardly any improvement in the last decade. What is of concern is the decrease in net survival among adolescents over the last decade. More research on paediatric AML is needed to discover risk factors and novel treatments to improve outcomes for the children, adolescents and young adults.