Recent trends in survival of adult patients with acute leukemia: overall improvements, but persistent and partly increasing disparity in survival of minority patients

Background: Survival has improved for younger patients with acute leukemia in the early 21st century, but it is unknown whether people of all ethnic and racial backgrounds have benefited equally. Methods: Using cancer registry data from the Surveillance, Epidemiology and End Results Program, we assessed trends in 5-year relative survival for patients age 15+ with acute lymphoblastic leukemia and acute myeloblastic leukemia by racial and ethnic group, including non-Hispanic whites, African-Americans, Hispanics, and Asian-Pacific Islanders in the 1990s and the early 21st century. Modelled period analysis was used to obtain the most up-to-date estimates of survival. Results: Overall, 5-year survival increased from 31.6% in 1997-2002 to 39.0% in 2003-08 for acute lymphoblastic leukemia patients and from 15.5% in 1991-96 to 22.5% in 2003-08 for acute myeloblastic leukemia patients. Nevertheless, for acute lymphoblastic leukemia, age-adjusted 5-year relative survival rates remained lower for African-Americans and Hispanics than for non-Hispanic whites. In acute myeloblastic leukemia, the increase in survival was strongest (from 32.6% in to 47.1% in 2003-08) for younger patients (15-54 years), and this increase was more pronounced for nHw (+16.4% units) than for other patients (+10.8% units). Conclusions: Increases in survival are observed in all ethnic or racial groups. Nevertheless, disparities in survival persist for patients with acute leukemias between non-Hispanic white and people of other ethnic or racial groups. Disparities are increasing in younger patients with acute myeloblastic leukemia. Improvements in access to treatment, especially for minority patients, may improve outcomes.