Impact of Chemotherapy and Demographic Factors on Survival in Adult (21-64-Year-Old) with Acute Lymphoblastic Leukemia: A SEER Database 10-Year Cohort Study
Author(s)
N M Mahmudul Alam Bhuiya1, Lorenzo Villa Zapata, PharmD, PhD2.
1PhD Student, Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens, GA, USA, 2University of Georgia, Athens, GA, USA.
1PhD Student, Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens, GA, USA, 2University of Georgia, Athens, GA, USA.
Presentation Documents
OBJECTIVES: To assess the 10-year survival probability and the influence of chemotherapy, age, sex, and race on survival duration in adults with acute lymphoblastic leukemia (ALL).
METHODS: This prospective cohort study employed SEER data from 2012-2021 combined with the U.S. Mortality dataset spanning 2000-2021. Adult patients (aged 21-64 years) with ALL were included. Age at diagnosis was classified into 20-29, 30-39, 40-49, and 50-59 categories. Race was categorized as White, Black, Asian/Pacific Islander, and American Indian/Alaska Native. All-cause mortality was the primary outcome. Kaplan-Meier survival analysis was utilized to evaluate all-cause mortality over time and adjusted Cox regression analysis calculated hazard ratios (HRs) with a log-rank p value=0.05 and 95% confidence intervals (CIs) using SAS 9.4 (TS1M6. The Cox proportional hazards assumption was validated using a graphical log-log plot.
RESULTS: Among 4,256 patients, 94.27% (4,012) received chemotherapy, while 5.73% (244) did not. Chemotherapy use varied by age and race but not by sex. Younger patients had a higher likelihood of receiving chemotherapy, with the highest percentage observed in the 20-29 age group (95.17%). Overall, 60.77% of patients were censored, indicating a higher percentage survived beyond the observation period. Chemotherapy significantly reduced mortality risk (HR = 0.362, p < 0.0001). Older age (50-59 years: HR=2.024, p<0.0001) and Black race (HR=1.231, p=0.012) were associated with increased mortality, while Asian/Pacific Islanders demonstrated a lower risk (HR=0.768, p=0.003). After adjusting for covariates, chemotherapy continued to reduce mortality risk significantly (aHR=0.383, p < 0.001). Increased mortality was observed for the 50-59 age group (aHR=1.972, p < 0.001), with Asian/Pacific Islanders exhibiting a reduced risk (aHR=0.772, p=0.0035).
CONCLUSIONS: This study highlights the critical role of chemotherapy in improving survival outcomes in adults with ALL and demonstrates how age and race influence treatment efficacy. These findings underscore the importance of tailored and equitable interventions to address disparities in treatment outcomes.
METHODS: This prospective cohort study employed SEER data from 2012-2021 combined with the U.S. Mortality dataset spanning 2000-2021. Adult patients (aged 21-64 years) with ALL were included. Age at diagnosis was classified into 20-29, 30-39, 40-49, and 50-59 categories. Race was categorized as White, Black, Asian/Pacific Islander, and American Indian/Alaska Native. All-cause mortality was the primary outcome. Kaplan-Meier survival analysis was utilized to evaluate all-cause mortality over time and adjusted Cox regression analysis calculated hazard ratios (HRs) with a log-rank p value=0.05 and 95% confidence intervals (CIs) using SAS 9.4 (TS1M6. The Cox proportional hazards assumption was validated using a graphical log-log plot.
RESULTS: Among 4,256 patients, 94.27% (4,012) received chemotherapy, while 5.73% (244) did not. Chemotherapy use varied by age and race but not by sex. Younger patients had a higher likelihood of receiving chemotherapy, with the highest percentage observed in the 20-29 age group (95.17%). Overall, 60.77% of patients were censored, indicating a higher percentage survived beyond the observation period. Chemotherapy significantly reduced mortality risk (HR = 0.362, p < 0.0001). Older age (50-59 years: HR=2.024, p<0.0001) and Black race (HR=1.231, p=0.012) were associated with increased mortality, while Asian/Pacific Islanders demonstrated a lower risk (HR=0.768, p=0.003). After adjusting for covariates, chemotherapy continued to reduce mortality risk significantly (aHR=0.383, p < 0.001). Increased mortality was observed for the 50-59 age group (aHR=1.972, p < 0.001), with Asian/Pacific Islanders exhibiting a reduced risk (aHR=0.772, p=0.0035).
CONCLUSIONS: This study highlights the critical role of chemotherapy in improving survival outcomes in adults with ALL and demonstrates how age and race influence treatment efficacy. These findings underscore the importance of tailored and equitable interventions to address disparities in treatment outcomes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
CO115
Topic
Clinical Outcomes
Topic Subcategory
Clinician Reported Outcomes
Disease
SDC: Oncology