Population-based survival trends for leukaemia in East Anglia, United Kingdom

Over the last 25 years clinical trials have reported improvement in the management of leukaemia leading to improved survival. In this paper we present the population-based survival patterns of leukaemia over the last two decades from East Anglia.

Data on leukaemia from the East Anglian cancer registry were analysed to study survival based on age and time period at diagnosis. Kaplan-Meier survival was calculated for children (ages 0-14) and for adults (ages 15+) separately, for the main leukaemia sub-types.

A total of 2044 males and 1524 females with leukaemia were registered between 1971 and 1990, of whom 158 (7.7 per cent) and 123 (8.1 per cent) were aged less than 15 years at diagnosis. In children, five-year survival was significantly better for females for all leukaemias (p = 0.02) and for acute lymphoid leukaemia (ALL) (p < 0.01). Infants and older children had the worst prognosis as compared with children aged 2-9 years. Analysis by quinquennium of diagnosis showed a highly significant improvement in survival (p < 0.00001) for children with ALL in the later decade (1981-1990). In adults, patients with lymphoid leukaemia survived better as compared with the myeloid subtypes (p < 0.0001). Analysis by year of diagnosis in five-year calendar period showed a significant improvement in survival for acute myeloid leukaemia (p < 0.01), chronic myeloid leukaemia (p < 0.05), chronic lymphoid leukaemia (p < 0.05) and for the four types together (p < 0.001). Survival decreased with age for each subtype.

Age is an important predictor of survival. There was a significant improvement in survival with time for all subtypes except ALL in adults.