Temporal changes in survival among adult patients with acute lymphoblastic leukaemia diagnosed in the period 1998-2020 – A Danish nationwide population-based cohort study

Daniel Tuyet Kristensen*, Trine Louise Jåtun, Mikkel Runason Simonsen, Nina Toft, Andreja Dimitrijevic, Andreas Due Ørskov, Anne Stidsholt Roug, Tarec Christoffer El-Galaly, Marianne Tang Severinsen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background
Previous studies have shown continuous improved overall survival (OS) up to 2015 for young adults with acute lymphoblastic leukaemia (ALL). However, recently several important advances have been made justifying a more contemporary analysis of outcomes in adult with ALL.

Methods
In this nationwide population-based cohort study, we included patients above 18 years of age diagnosed with ALL between January 1, 1998, and December 31, 2020. Patients were followed until December 31, 2022. By employing flexible parametric survival models, we quantified progress in OS using the key endpoint of 2-year age standardized OS for all patients and clinical subgroups of interest.

Findings
This study includes 657 patients and demonstrates a significant improvement in OS over time with the 2-year age standardized OS increasing from 36·4 % (95 % CI, 27·0–45·8 %) for patients diagnosed in 1998 to 68·6 % (95 % CI, 60·2–76·9)for patients diagnosed in 2020, corresponding to an absolute increase in 2-year OS of 32·2 % points (95 % CI, 19·1–45·2). Stratified analysis revealed improvements for both Philadelphia chromosome positive and negative ALL, across cytogenetic risk groups, and for B- and T-cell ALL, whereas the latter did not reach statistical significance. Improvements were seen across all ages; however, most pronounced for Philadelphia chromosome positive ALL and patients below 60 years of age.

Interpretation
These results show a universal and continuous improvement in the treatment of adult ALL. Currently, novel treatment combination and advances in cellular therapy occur rapidly, and we expect even further improvements in the years to come.
Original languageEnglish
Article number114338
JournalEuropean Journal of Cancer
Volume212
Number of pages8
ISSN0959-8049
DOIs
Publication statusPublished - Nov 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors

Keywords

  • Acute lymphoblastic leukaemia
  • Epidemiology
  • Flexible parametric survival
  • Overall survival
  • Temporal changes

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