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Progress in the treatment of childhood acute leukemia: a review
Insights
Survival rates for childhood acute lymphocytic leukemia (ALL) significantly improved from the 1960s onward, while acute nonlymphocytic leukemia (ANLL) survival remained lower. Mortality rates for childhood leukemia decreased by 45% between 1950 and 1976.
Area of Science:
- Pediatric Oncology
- Epidemiology
- Cancer Survival Analysis
Background:
- Childhood leukemia survival rates have seen dramatic improvements over recent decades.
- Understanding trends in acute lymphocytic leukemia (ALL) and acute nonlymphocytic leukemia (ANLL) is crucial for pediatric cancer care.
Purpose of the Study:
- To analyze survival experience improvements for children diagnosed with acute leukemia between 1950 and 1973.
- To compare survival rate trends for ALL versus ANLL in pediatric patients.
Main Methods:
- Utilized data from the National Cancer Institute's End Results Group Program (1950-1973).
- Analyzed survival rates (3-year and 5-year) for pediatric leukemia cohorts.
- Examined age-adjusted incidence and mortality rates for childhood leukemia.
Main Results:
- Children with ALL showed significantly better survival rates than ANLL, particularly from the 1960s onwards.
- For the 1970-1973 cohort, 3-year survival was 49% for ALL and 20% for ANLL; 5-year survival was 34% for ALL and 12% for ANLL.
- Childhood leukemia mortality rates decreased by approximately 45% from 1950 to 1976.
Conclusions:
- Significant therapeutic advancements have disproportionately benefited children with ALL.
- While overall childhood leukemia mortality has declined, disparities in survival between ALL and ANLL persist.
- Continued research is needed to improve outcomes for ANLL and all childhood leukemias.
Abstract:
The dramatic improvements in the survival experience for children diagnosed with acute leukemia are analyzed using data collected through hospitals participating in the National Cancer Institute's End Results Group Program between 1950 and 1973. Children under 15 years of age who were diagnosed with both acute lymphocytic leukemia (ALL) and acute nonlymphocytic leukemia (ANLL) showed moderate improvements in the 1950s, but beginning in the 1960s those with ALL did far better. Statistically significant differences at the 0.05 level were noted between their three-year survival rates for all cohorts analyzed between 1960 and 1973. For the 1970-1973 cohort, three-year survival rates were 49% and 20% for ALL and ANLL, respectively, and five-year survival rates were 34% and 12%. Between 1950 and 1976 the age-adjusted incidence rate for all childhood leukemias remained relatively stable in a sample of five geographic areas, changing from 4.6 per 100,000 children under 15 years of age to 4.3 per 100,000. In contrast, the corresponding age-adjusted mortality rate fell approximately 45% over the same period, from 4.4 per 100,000 to 2.4 per 100,000.