Improved 1-Year Survival in AML Patients Aged ‚â•75 After 2018: A SEER-Based Population Study
Introduction/Background/Significance: Older adults with acute myeloid leukemia (AML) historically experience poor outcomes, particularly those aged ≥75. The introduction of venetoclax-based regimens in 2018 may have contributed to improved survival in this population. We examined 1-year survival trends in this group using a national cancer registry.
Materials and Methods/Case Presentation/Objective: We used SEER data (2000–2022) to identify patients aged ≥75 with newly diagnosed AML. Patients were grouped by diagnosis period: 2000–2007, 2008–2017, and 2018–2022. The primary outcome was 1-year overall survival. Multivariable logistic regression was used to estimate adjusted odds of 1-year survival, with subgroup analyses by sex, race/ethnicity, and rural-urban residence.
Results/Description/Main Outcome Measures: A total of 26,221 patients aged ≥75 were included. One-year survival increased from 11.4% (2000–2007) to 25.4% (2018–2022). Diagnosis in 2018–2022 was associated with higher odds of 1-year survival compared to 2000–2007 (OR 1.55, 95% CI 1.41–1.71, p < 0.001). Male patients had slightly higher odds of survival (OR 1.10, 95% CI 1.03–1.18, p = 0.007). No significant differences were observed by race. Patients in small metro and non-metro areas had lower 1-year survival than those in large metropolitan areas.
Conclusions: One-year survival in AML patients aged ≥75 has more than doubled since 2000, with the most significant gains seen after 2018. These improvements coincide with the introduction of venetoclax-based therapies, though treatment-level data were not available. No racial disparities were observed, but rural-urban gaps persist. These findings highlight the real-world impact of novel therapies in older AML patients and suggest a need to address persistent geographic barriers to care.
