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Long-term survival patterns in AML across age groups in Nordic countries

Jul 8, 2024
Learning objective: After reading this article, learners will be able to cite a new clinical development in AML.

Hemminki, et al. published an article in Blood Cancer Journal on age-specific survival in patients with acute myeloid leukemia (AML) across a 50-year time period (19722021), using data from the NORDCAN database, sourced from the cancer registries of Denmark, Finland, Norway, and Sweden. 

Key learnings

1-, 5/1-, and 5-year relative survival in patients with AML improved in all age groups (0–49 years, 50–59 years, 60–69 years, and 70–79 years), apart from the 8089 years group. 

Among the Nordic countries, survival rates were highest in Sweden, with 5-year relative survival rates of 80% in the 049 years, 70% in the 50–59 years, 45% in the 60–69 years, and 20% in the 70–79 years group. 

  • Survival improvements in Sweden and Denmark were attributed to more intensive therapy, novel agents, wider use of transplant, better supportive care, and overall public health. 

The age-related survival gap widened over time; when comparing the 1972–1976 and 20172021 periods, the 5-year relative survival in the 049 years group improved from <10% to 60–80%. This improvement decreased successively in each older age-group (50% in the 50–59 years, 30–40% in the 60–69 years, and 19% in the 70–79 years group) to as low as 0–5% in 80–89 year olds. 

In the 70–79 years age group, 1-year survival increased from 10% to >40%; 5-year survival also improved for this age group, particularly in Sweden, likely due to the introduction of treatment guidelines in 2005 recommending initial intensive therapy with cytarabine and anthracycline. 

However, patients aged over 80 years, in whom survival has not improved much over the past 50 years, may benefit from upfront treatment with venetoclax plus hypomethylating agent combination therapy, although survival studies with population-level verification are needed. 

  1. Hemminki K, Zitricky F, Försti A, et al. Age-specific survival in acute myeloid leukemia in the Nordic countries through a half century. Blood Cancer J. 2024;14(1):44. DOI: 


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