Childhood ALL: Survival rates are continuing to improve over the past 3 decades

This study examined changes in survival rates in children with acute lymphoblastic leukemia (ALL) over the past 3 decades. Researchers reported marked improvements in survival rates over each decade studied in children with ALL.

ALL is a cancer of the blood and bone marrow. It is the most common type of childhood cancer. Advances in treatment have improved survival for ALL patients over the past few decades. The 5-year survival rate is reported to have increased from 80.2% between 1990 and 1994 to 87.5% in 2000 to 2004. Whether this trend in improved survival has continued over the past decade is still being studied.

The aim of this study was to assess survival rates in children with ALL over the past 3 decades.

The records of 12,096 children diagnosed with ALL between 1981 and 2010 in 18 separate treatment centers were analyzed. All children were aged 15 years or younger at the time of diagnosis. Incidence rates and treatment outcomes were compared between 3 decades: 1981 to 1990, 1991 to 2000, and 2001 to 2010.

The number of children diagnosed with ALL increased by more than 25% over the 3 decades. It was 1,693 between 1981 and 1990, 1,942 between 1991 and 2000, and 2,131 between 2001 and 2010. This increase was particularly pronounced for children aged 1 to 4 years.

More boys than girls were diagnosed with ALL. The incidence rate of ALL for boys was 3.6 per 100,000 in 1981 to 1990, 3.7 per 100,000 in 1991 to 2001, and 4.1 per 100,000 in 2001 to 2010. It was 3.1 (1981 to 1990), 3.1 (1991 to 2000), and 3.3 (2001 to 2010) per 100,000 for girls. Incidence rates were consistently highest for Caucasian children.

5-year survival rates improved each decade from 74.8% to 84.5% to 88.6%. 10-year survival rates similarly improved from 69.3% to 80.9% to 85.5%. Children aged between 10 and 14 years at diagnosis showed the greatest survival improvements. Over the 3 decades, 10-year survival rates improved from 54.1% to 69.4% to 75.3% for patients aged 10 to 14 years. Infant patients showed no significant improvements in survival over the 3 decades. 10-year survival was similar in 1991 to 2000 (55.8%) and in 2001 to 2010 (54.7%).

Improvements in survival rates were observed in both genders, but survival rates were higher in girls than in boys. The 10-year survival rates were 67.6% (1981 to 1990), 79.7% (1991 to 2000), and 83.6% (2001 to 2010) in boys. They were 71.4%, 82.5%, and 87.8% in girls.

Researchers concluded that survival rates in children with ALL continued to improve over the past 3 decades. Researchers also suggested that they are likely to continue to rise with ongoing advances in therapies.