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. 2012 Jan 5;119(1):34-43.
doi: 10.1182/blood-2011-04-347872. Epub 2011 Nov 15.

Acute leukemia incidence and patient survival among children and adults in the United States, 2001-2007

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Acute leukemia incidence and patient survival among children and adults in the United States, 2001-2007

Graça M Dores et al. Blood. .

Abstract

Since 2001, the World Health Organization classification for hematopoietic and lymphoid neoplasms has provided a framework for defining acute leukemia (AL) subtypes, although few population-based studies have assessed incidence patterns and patient survival accordingly. We assessed AL incidence rates (IRs), IR ratios (IRRs), and relative survival in the United States (2001-2007) in one of the first population-based, comprehensive assessments. Most subtypes of acute myeloid leukemia (AML) and acute lymphoblastic leukemia/lymphoma (ALL/L) predominated among males, from twice higher incidence of T-cell ALL/L among males than among females (IRR = 2.20) to nearly equal IRs of acute promyelocytic leukemia (APL; IRR = 1.08). Compared with non-Hispanic whites, Hispanics had significantly higher incidence of B-cell ALL/L (IRR = 1.64) and APL (IRR = 1.28); blacks had lower IRs of nearly all AL subtypes. All ALL/L but only some AML subtypes were associated with a bimodal age pattern. Among AML subtypes, survival was highest for APL and AML with inv(16). B-cell ALL/L had more favorable survival than T-cell ALL/L among the young; the converse occurred at older ages. Limitations of cancer registry data must be acknowledged, but the distinct AL incidence and survival patterns based on the World Health Organization classification support biologic diversity that should facilitate etiologic discovery, prognostication, and treatment advances.

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Figures

Figure 1
Figure 1
Age-specific IRs of AML and ALL/L. Age-specific IRs of AML and ALL/L according to sex and race/ethnicity, SEER-17, 2001 to 2007.
Figure 2
Figure 2
Age-specific IRs of AML, ALL/L, and AL. Age-specific IRs of AML, ALL/L, and AL of ambiguous lineage according to subtype, SEER-17, 2001 to 2007.
Figure 3
Figure 3
RS of AML, ALL/L, and AL. RS of AML, ALL/L, and AL of ambiguous lineage according to subtype and age among individuals diagnosed in SEER-17 during 2001 to 2006 and followed through 2007.

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