Changes in long term survival after diagnosis with common hematologic malignancies in the early 21st century

Abstract

Five-year survival has increased for many hematologic malignancies in the 21st century. However, whether this has translated into greater long-term survival is unknown. Here, we examine 10- and 20-year survival for patients with multiple myeloma (MM), acute lymphoblastic leukemia (ALL), acute myeloblastic leukemia (AML), chronic lymphoid leukemia (CLL), chronic myeloid leukemia (CML), non-Hodgkin lymphoma (NHL), and Hodgkin lymphoma (HL). Data were extracted from the Surveillance, Epidemiology, and End Results-9 database. Patients age 15+ with the above malignancies were included. The newly developed boomerang method was used to examine 10- and 20-year relative survival (RS) for patients in 2002-2006 and 2012-16. Ten and 20-year RS increased for each malignancy examined, with increases ranging from +4.4% units for 20-year RS for AML to +23.1% units for 10-year RS for CML. Ten year RS was >50% in 2012-16 for patients with CLL, CML, HL, NHL, and DLBCL, at 77.1%, 62.1%, 63.9%, 64.5%, and 63.0%, respectively. Survival dropped between 10 and 20 years after diagnosis for most malignancies. Long-term survival is increasing for common hematologic malignancies, but late mortality is an ongoing issue. Further study of long-term outcomes in curable malignancies to determine the reason for these later decreases in survival is indicated.

Fig. 1. Age-adjusted and age-specific long term relative survival for patients with multiple myeloma.

a Age-adjusted 0–20 relative survival for 2002–2006 (dashed line) and 2012–2016 (solid line.) b Age-specific 0–20-year relative survival for patients age 15–64 2002–2006 (black dashed line), 15–64 2012–2016 (black solid line), 65+ 2002–2006 (gray dashed line) and 2012–2016 (gray solid line).

Fig. 2. Age-adjusted and age-specific long term relative survival for patients with acute leukemia.

a Age-adjusted relative survival for patients with ALL in 2002–2006 (dashed line) and 2012–2016 (solid line). b Relative survival for patients age 15–64 with ALL in 2002–2006 (dashed line) and 2012–2016 (solid line). c Age-adjusted 0–20-year survival for patients with AML in 2002–2006 (dashed line) and 2012–2016 (solid line). d Age-specific 0–20-year relative survival for patients with AML age 15–64 2002–2006 (black dashed line) and 2012–2016 (black solid line) and for patients age 65+ in 2002–2006 (gray dashed line) and 2012–2016 (gray solid line).

Fig. 3. Age-adjusted and age-specific long term relative survival for patients with chronic leukemia.

a Age-adjusted 0–20 relative survival for patients with CLL in 2002–2006 (dashed line) and 2012–2016 (solid line). b Age-specific 0–20-year relative survival for patients with CLL age 15–64 in 2002–2006 (black dashed line) and 2012–2016 (black solid line) and for patients age 65+ in 2002–2006 (gray dashed line) and 2012–2016 (gray solid line). c Age-adjusted 0–20-year survival for patients with CML in 2002–2006 (dashed line) and 2012–2016 (solid line). d Age-specific 0–10-year relative survival for patients with CML age 15–64 in 2002–2006 (black dashed line) and 2012–2016 (black solid line) and for patients age 65+ in 2002–2006 (gray dashed line) and 2012–2016 (gray solid line).

Fig. 4. Age-adjusted and age-specific long term relative survival for patients with HL and NHL.

a Relative survival for patients with HL in 2001–2005 (dashed line) and 2012–2016 (solid line). b Relative survival for patients age 15–64 with HL in 2002–2006 (dashed line) and 2012–2016 (solid line). c Age-adjusted 0–20 year survival for patients with NHL in 2002–2006 (dashed line) and 2012–2016 (solid line). d Age-specific 0–20-year relative survival for patients with NHL age 15–64 in 2002–2006 (black dashed line) and 2012–2016 (black solid line) and for patients age 65+ in 2002–2006 (gray dashed line) and 2012–2016 (gray solid line). e Age-adjusted 0–20-year survival for patients with DLBCL in 2002–2006 (dashed line) and 2012–2016 (solid line). f Age-specific 0–20-year relative survival for patients with DLBCL age 15–64 in 2002–2006 (black dashed line) and 2012–2016 (black solid line) and for patients age 65+ in 2002–2006 (gray dashed line) and 2012–2016 (gray solid line).