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Acute myeloid leukemia

Improved survival for children and young adolescents with acute myeloid leukemia: a Dutch study on incidence, survival and mortality

Leukemia volume 33, pages 1349–1359 (2019)Cite this article

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Abstract

Variation in survival of pediatric acute myeloid leukemia (pAML) over time and between Western European countries exists. The aim of the current study is to assess the progress made for the Dutch pAML population (0–17 years) during 1990–2015, based on trends in incidence, survival and mortality. Data from the population-based Netherlands Cancer Registry were merged with leukemia-related characteristics and treatment specifics from the Dutch Childhood Leukemia Study Group (Dutch Childhood Oncology Group (DCOG) from 2002 onwards). Mortality data (1980–2016) were obtained from the cause of death registry of Statistics Netherlands. Trend analyses were performed over time and by treatment protocol. Between 1990 and 2015, a total of 635 children aged 0–17 years were diagnosed with AML for an average of 25 patients (range 18–36) per year. There was a slight increase in the incidence at age 1–4 years (average annual percentage change (AAPC) of +2.2% per year (95% CI 0.8–3.5, p < 0.01)). Overall, the 5-year survival significantly improved over the past 26 years and nearly doubled from 40% in the early 1990s to 74% in 2010–2015. Multivariable analysis showed a 49% reduction in risk of death for pAML patients treated according to the latest DB-AML 01 protocol (p = 0.03). The continuing decrease of mortality (AAPC −2.8% per year (95% CI −4.1 to −1.5)) supports the conclusion of true progress against pAML in the Netherlands.

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Acknowledgements

The authors thank the registration team of the Netherlands Comprehensive Cancer Organization (IKNL) for the collection of data for the Netherlands Cancer Registry. We thank the laboratory personnel and the data managers from the Dutch Childhood Oncology Group (DCOG) for collecting the data for the DCOG registry. We thank Dr. Otto Visser (IKNL) and Femke Verwer (DCOG) for the extra data checks they had done for the current study. We thank all our collaborators with whom we have designed and recruited into pAML studies together, especially in the context of the I-BFM-SG, and all pediatric oncologists who treated the patients and entered data in the DCLSG/DCOG collaboration.

Data statement

The datasets generated during and/or analyzed for the current study are not publicly available due to the potential identifiable nature the data. However, fully deidentified data can become available from the corresponding author on reasonable request.

Funding

The current work is funded by Stichting Kinderen Kankervrij (KiKa) (project number 207). The funding source had no role in study design, collection, analysis and interpretation of data, or writing of this manuscript.

Author contributions

Design of the study: AMJR, KK, JWWC, HEK-K, LCK, RP and GJLK. Collecting the data: AMJR. Providing (patient) data: All authors. Analyzing the data: AMJR and KK. Interpretation of results: AMJR, KK, JWWC, HEK-K, CMZ, LCK, RP and GJLK. Writing of the paper: AMJR and KK. All authors reviewed the manuscript critically. All authors approve the final version of the manuscript.

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Author notes

  1. These authors contributed equally to this work: A. M. J. Reedijk, K. Klein, G. J. L. Kaspers, H. E. Karim-Kos.

Authors and Affiliations

  1. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

    A. M. J. Reedijk, L. C. Kremer, V. de Haas, A. B. Versluijs, R. Pieters, C. M. Zwaan & G. J. L. Kaspers

  2. Department of Pediatric Oncology/Hematology, VU University Medical Center, Amsterdam, The Netherlands

    K. Klein & G. J. L. Kaspers

  3. Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands

    J. W. W. Coebergh, A. G. Dinmohamed & H. E. Karim-Kos

  4. Department of Pediatric Oncology, Emma Children’s Hospital/Academic Medical Center, Amsterdam, The Netherlands

    L. C. Kremer

  5. Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands

    A. G. Dinmohamed & H. E. Karim-Kos

  6. Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands

    A. G. Dinmohamed

  7. Dutch Childhood Oncology Group, Utrecht, The Netherlands

    V. de Haas & G. J. L. Kaspers

  8. Department of Hematology, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands

    G. J. Ossenkoppele

  9. Department of Clinical Genetics, Erasmus University Medical Center/Dutch Working Group Hemato-oncological Genome Diagnostics, Rotterdam, The Netherlands

    H. B. Beverloo

  10. Department of Pediatric Oncology/Hematology, Erasmus University Medical Center/Sophia Children’s Hospital, Rotterdam, The Netherlands

    C. M. Zwaan

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  1. A. M. J. Reedijk
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Correspondence to A. M. J. Reedijk.

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Reedijk, A.M.J., Klein, K., Coebergh, J.W.W. et al. Improved survival for children and young adolescents with acute myeloid leukemia: a Dutch study on incidence, survival and mortality. Leukemia 33, 1349–1359 (2019). https://doi.org/10.1038/s41375-018-0314-7

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