Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Dec 1;118(23):5811-8.
doi: 10.1002/cncr.27623. Epub 2012 Jun 15.

Acute promyelocytic leukemia: a population-based study on incidence and survival in the United States, 1975-2008

Yiming Chen  1 , Hagop Kantarjian, Haijun Wang, Jorge Cortes, Farhad Ravandi
Affiliations

Acute promyelocytic leukemia: a population-based study on incidence and survival in the United States, 1975-2008

Yiming Chen et al. Cancer. .

Abstract

Background: With the introduction of all-trans retinoic acid and arsenic trioxide, the management of acute promyelocytic leukemia (APL) has changed dramatically. We performed a population-based study of APL in the United States to determine its incidence and relative survival (RS) during a 34-year period.

Methods: We identified 1397 patients diagnosed with APL between 1975 and 2008 in the Surveillance, Epidemiology, and End Results database. Patients were categorized into 4 age groups and 3 calendar periods. As a comparison, we also reviewed the outcome of APL patients treated at our institution during approximately the same time interval.

Results: The incidences of APL increased with time period and patient age. Short- and long-term RS improved with each calendar period, with the greatest improvement occurring between 1991 and 1999; 5-year RS rates were 0.18 for patients diagnosed in 1975-1990, 0.52 in 1991-1999, and 0.64 in 2000-2008. Age was an important predictor of survival. For example, the 5-year RS rate in patients diagnosed in 2000-2008 was 0.38 for patients aged ≥ 60 years and 0.73 and 0.75 for patients aged <20 years and 20-39 years, respectively. Similar treads of improvements in the survival were observed in APL patients treated at our institution.

Conclusions: The incidence of APL has increased, especially in the last decade. Clinical outcome improved remarkably in patients with APL diagnosed from 1991 to 1999, mainly because of the increased use of all-trans retinoic acid.

PubMed Disclaimer

Figures

Fig 1
Fig 1
(A) Cumulative relative survival of all patients with acute promyelocytic leukemia by calendar period of diagnosis (SEER). (B) Overall survival of patients with acute promyelocytic leukemia by treatment era (MD Anderson Cancer Center). (C) Event-free survival of patients with acute promyelocytic leukemia by treatment era (MD Anderson Cancer Center). AIDA, all-trans retinoic acid plus idarubicin; ATRA, all-trans retinoic acid; GO, gemtuzumab ozogamicin.
Fig 1
Fig 1
(A) Cumulative relative survival of all patients with acute promyelocytic leukemia by calendar period of diagnosis (SEER). (B) Overall survival of patients with acute promyelocytic leukemia by treatment era (MD Anderson Cancer Center). (C) Event-free survival of patients with acute promyelocytic leukemia by treatment era (MD Anderson Cancer Center). AIDA, all-trans retinoic acid plus idarubicin; ATRA, all-trans retinoic acid; GO, gemtuzumab ozogamicin.
Fig 1
Fig 1
(A) Cumulative relative survival of all patients with acute promyelocytic leukemia by calendar period of diagnosis (SEER). (B) Overall survival of patients with acute promyelocytic leukemia by treatment era (MD Anderson Cancer Center). (C) Event-free survival of patients with acute promyelocytic leukemia by treatment era (MD Anderson Cancer Center). AIDA, all-trans retinoic acid plus idarubicin; ATRA, all-trans retinoic acid; GO, gemtuzumab ozogamicin.
Fig 2
Fig 2
Relative survival in patients with acute promyelocytic leukemia by age and calendar period of diagnosis (SEER).
Fig 2
Fig 2
Relative survival in patients with acute promyelocytic leukemia by age and calendar period of diagnosis (SEER).
Fig 3
Fig 3
One-, 5-, and 10-year relative survival in patients with acute promyelocytic leukemia by age group and calendar period of diagnosis (SEER).
See this image and copyright information in PMC

References

    1. Soignet SL, Maslak P, Wang ZG, et al. Complete remission after treatment of acute promyelocytic leukemia with arsenic trioxide. N Engl J Med. 1998;339(19):1341–1348. - PubMed
    1. Yamamoto JF, Goodman MT. Patterns of leukemia incidence in the United States by subtype and demographic characteristics, 1997–2002. Cancer Causes Control. 2008;19(4):379–390. - PubMed
    1. de The H, Chen Z. Acute promyelocytic leukaemia: novel insights into the mechanisms of cure. Nat Rev Cancer. 2010;10(11):775–783. - PubMed
    1. Licht JD. Acute promyelocytic leukemia--weapons of mass differentiation. N Engl J Med. 2009;360(9):928–930. - PubMed
    1. Sanz MA, Lo-Coco F. Modern approaches to treating acute promyelocytic leukemia. J Clin Oncol. 2011;29(5):495–503. - PubMed