Trends in 5- and 10-year survival after diagnosis with childhood hematologic malignancies in the United States, 1990-2004.
Level 3 - non-randomized controlled study
Retrospective population-based cohort study analyzing registry survival trends.
PubMed 18780868 · doi:10.1093/jnci/djn276
What was done
The authors used period analysis to assess trends in 5- and 10-year relative survival among US children younger than 15 years diagnosed with four hematologic malignancies: acute lymphoblastic leukemia (ALL), acute non-lymphoblastic leukemia (ANLL), Hodgkin lymphoma, and non-Hodgkin lymphoma (NHL). Data on 6,957 patients from the Surveillance, Epidemiology, and End Results (SEER) database were examined across three 5-year calendar periods (1990–1994, 1995–1999, and 2000–2004), and expected survival for 2005–2009 was modeled from these trends.
What was found
Between 1990–1994 and 2000–2004, 5- and 10-year relative survival rates improved substantially: - ALL: 5-year survival increased from 80.2% to 87.5%; 10-year survival increased from 73.4% to 83.8% (projected 2005–2009 10-year survival: 88.0%). - ANLL: 5-year survival increased from 41.9% to 59.9%; 10-year survival increased from 38.7% to 59.1% (projected 2005–2009 10-year survival: 63.9%). - NHL: 5-year survival increased from 76.6% to 87.7%; 10-year survival increased from 73.0% to 86.9% (projected 2005–2009 10-year survival: 90.6%). - Hodgkin lymphoma: 5- and 10-year survival were 96.1% and 94.4% in 1990–1994 and remained stable (projected 2005–2009 10-year survival: 94.3%).
Why it matters
This study shows ongoing survival gains into the early 2000s for pediatric ALL, ANLL, and NHL in the US population, while Hodgkin lymphoma maintained high overall survival exceeding 94%.
Limits
The analysis relies on retrospective cancer registry data from the US SEER database, which lacks specific treatment details, toxicities, and molecular disease subtypes in the abstract. Projections for 2005–2009 are model-based estimates rather than observed follow-up.
Cited by
- supports Certain childhood leukemias that were previously fatal now have cure rates between 90% and close to 100%.