Trends in long-term survival of patients with chronic lymphocytic leukemia from the 1980s to the early 21st century

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Blood, 15 May 2008, Vol. 111, No. 10, pp. 4916-4921

Trends in long-term survival of patients with chronic lymphocytic leukemia from

the 1980s to the early 21st century

Hermann Brenner1, Adam Gondos1, and Dianne Pulte1,2

1 Division of Clinical Epidemiology and Aging Research, German Cancer Research

Center, Heidelberg, Germany; and 2 Weill Cornell Medical Center, New York, NY

Although chronic lymphocytic leukemia (CLL) has remained incurable with standard

treatments, newer therapeutic approaches, such as chemoimmunotherapy or stem

cell transplantation, bear the potential for prolonged survival. We estimated

trends in age-specific 5- and 10-year absolute and relative survival of CLL

patients in the United States between 1980-1984 and 2000-2004 from the 1973 to

2004 database of the Surveillance, Epidemiology, and End Results Program. Period

analysis was used to disclose recent developments with minimum delay. Overall,

5- and 10-year absolute survival from diagnosis increased from 54.2% to 60.2%

(+6 percentage points; P < .0001) and from 27.8% to 34.8% (+7 percentage points;

P < .0001), respectively. Despite a strong age gradient in prognosis, increases

in 5-year absolute and relative survival over time were rather homogeneous

across age groups. In contrast, increases in 10-year absolute and relative

survival close to or well above 10% units were observed for all patients younger

than 80 years of age at diagnosis compared with no increase at all for older

patients. Long-term survival expectations of patients with CLL have

substantially improved over the past 2 decades except for patients 80 years of

age or older at the time of diagnosis. Future studies are needed to confirm and

expand our findings.