Survival of Older Blood Cancer Patients Improved in 21st Century

The early 21^st century has brought with it significant improvements in survival from most common hematologic malignancies for patients aged 65 years or older, but these increases still lag behind those of 50- to 59-year-olds, a new study has found.

“In general, survival decreases with age for patients with cancer and particularly hematologic malignancies. In addition, in the past, older patients with common hematologic malignancies did not have the same increases in survival observed in younger patients,” wrote Dianne Pulte, MD, of the German Cancer Research Center, and colleagues in Cancer. “Our current results suggest that this may no longer be true for some hematologic malignancies, and although age-related disparities were observed for all malignancies examined, the disparity was decreasing for selected hematologic malignancies.”

According to background information in the study, there has been an overall increase in survival from hematologic malignancies in the 21^st century, but there are few data on whether this improvement in survival extends to older patients.

Pulte and colleagues used data from SEER to look at survival for 355,972 patients aged 65 and older diagnosed with the most common hematologic malignancies between 1992 and 2012. They included acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), chronic myeloid leukemia (CML), Hodgkin lymphoma, non-Hodgkin lymphoma, and multiple myeloma.

Data showed that the 5-year relative survival had increased for all of the conditions examined except for AML in patients aged 75 and older, where there was no change.

“This finding is consistent with the findings of other population-based studies of AML,” the researchers wrote. “Most studies suggest that medically fit older patients who receive curative-intent chemotherapy or, in select cases, a hematopoietic stem cell transplant have better outcomes than those treated with supportive care only, and age per se may not be an independent predictor of outcome for AML after treatment.”

Among patients with CML there was a strong increase in 5-year relative survival for all age groups between 1997–2000 and 2001–2004 except those aged 65–69. This age group had their significant increase from 2001–2004 to 2005–2008. In contrast, patients aged 50 to 59 years had significant increase in every time period.

Only small changes in survival were seen for patient with ALL. The only age group that had statistically significant increases in survival were those aged 65 to 74 for the time between 2001–2004 and 2005–2008.

For myeloma, there were increases in the 5-year relative survival in all ages and time periods except among those aged 85 or older where there was a significant decrease in survival from 2005–2008 to 2009–2012.

There were strong improvements in 5-year relative survival in patients with CLL and non-Hodgkin lymphoma. Among those patients aged 85 and older there was a 31.5% increase in the 5-year relative survival for patients with CLL, and a 39.6% increase for patients with non-Hodgkin lymphoma between 1997–2000 and 2009–2012.

“Our results demonstrate that survival has been improving for older patients with the most common hematologic malignancies,” the researchers wrote. “The acute leukemias are a partial exception to this general statement, with little change being observed for patients who were 75 years old or older.”