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Acute myeloid leukemia in the real world: why population-based registries are needed

Gunnar Juliusson, Vladimir Lazarevic, Ann-Sofi Hörstedt, Oskar Hagberg and Martin Höglund for the Swedish Acute Leukemia Registry Group

Data supplements

Article Figures & Data

Figures

  • Figure 1

    Yearly incidence of AML per 100 000 inhabitants according to age and sex in Sweden 1997 to 2006, in the SEER registry (whites, 2004-2008),24 and in the United Kingdom.25 United Kingdom data were given for 20-year age intervals (20-39, 40-59, 60-79, and 80+ years).

  • Figure 2

    Proportion of secondary AML (non-APL, secondary to previous hematologic disease and/or cytotoxic therapy) according to age in the Swedish Registry (1997-2006). Total number of patients is given below graph.

  • Figure 3

    OS according to age for AML (non-APL) patients diagnosed in 1997 to 2006, with follow-up in December 2008.31,41 Nine patients were younger than 20 years.

  • Figure 4

    Projected relative 5-year survival in AML according to age and time period, with follow-up on December 31, 2006. Point estimates are from Derolf et al.3

  • Figure 5

    OS in days from diagnosis for patients 70 to 79 years of age with AML (non-APL) diagnosed in 1997 to 2006 according to palliative versus intensive intention and WHO/ECOG PS. (A) PS 0-I. (B) PS II. (C) PS III-IV. Note the logarithmic scale on x-axis to emphasize early deaths. Survival < 1 day was set to 1.

  • Figure 6

    Screen shot from Web-based dynamic graph showing 2-year OS (OS2 years) and percentage intensive treatment (TX_rate) according to PS (blue represents PS 0; turquoise, PS I; yellow, PS II; and orange, PS III-IV) for AML non-APL patients 65 to 85 years of age. The full view requires Web connection http://www.ocsyd.se/SwedishAMLRegistry1997_2006/AML_who.html and shows overall 2-year and 3-year survival, early death rate by 8 weeks, proportion receiving intensive treatment, CR rate, and SCT rate by age and PS in patients from the Swedish national acute leukemia registry diagnosed in 1997 to 2006 (AML non-APL; supplemental data, available on the Blood Web site; see the Supplemental Materials link at the top of the online article).

  • Figure 7

    OS in years from diagnosis for AML (non-APL) patients 40 to 59 years of age according to geographic region (Southeast vs others, P = .005). In Southeast region, 46% received allogeneic transplantation compared with 22% (range, 20%-29%) in other regions (P < .01).

  • Figure 8

    OS in days from diagnosis for patients with APL diagnosed 2000 to 2006 according to age. Note logarithmic scale on x-axis to emphasize early deaths. Survival < 1 day was set to 1.

Tables

  • Table 1

    OS with AML, non-APL, 1997 to 2006 (n = 2511)

    Age, yAML (non-APL), unselected, %AML (non-APL), selected de novo, intensive treatment, PS 0-II, %Ratio of selected/unselected
    n2-year5-yearMedian daysn2-year5-yearMedian daysn2-year5-yearMedian
    < 30656560> 4000447263> 40000.681.111.05
    30-44171574917471207260> 40000.701.261.22
    45-5426654439341707059> 40000.641.301.37
    55-644233623396208583610220.491.611.572.58
    65-69308221226313243266550.431.952.172.49
    70-7441916517413434134470.322.132.602.57
    75-79448921081431762480.321.892.30
    80-844114181123841110.301.37
    • — indicates not applicable.

  • Table 2

    Characteristics and outcome of Swedish AML patients 60 to 84 years of age diagnosed 2007 to 2010,49 according to performance status (PS) and treatment intensity compared with patients in high-dose lenalidomide study by Fehniger et al51

    PatientsNMedian age, yPerformance status 0/I/II, %De novo AML, %Death rate at 30 d, %Median OS, moOS, 1 y, %OS, 3 y, %
    Sweden 60-84 y
        PS 0-II5117221/63/166210104421
        PS 010769100/0/0695176435
        PS I320710/100/06310104418
        PS II84770/0/100491532212
        PS 0-I4277125/75/0648124922
            Intensive2846829/71/0705155827
            Palliative1297716/84/0501653012
    Lenalidomide study337149/39/1270244300