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

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 (1972–2021), using data from the NORDCAN database, sourced from the cancer registries of Denmark, Finland, Norway, and Sweden. 

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 80–89 years group. 

The age-related survival gap widened over time; when comparing the 1972–1976 and 2017–2021 periods, the 5-year relative survival in the 0–49 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.