文章：

急性髓系白血病患者总体生存特征分析：基于SEER数据库46年随访数据的竞争风险模型研究

Characterizing Overall Survival of Patients with Acute Myeloid Leukemia: A Competing Risk Analysis of SEER Data Covering 46 Years

原文发布日期：22 November 2025

DOI: 10.3390/cancers17233735

类型: Article

开放获取: 是

英文摘要：

Background and Methods: We analyzed trends in overall survival after acute myeloid leukemia (AML) using US registry data covering the years 1975 to 2021. Our study utilized unique patient data from the Surveillance, Epidemiology, and End Results Program (SEER), with 37,615 adult patients included. We employed Kaplan–Meier estimates and competing risk analyses to assess overall survival and risks of AML-related death and death from other causes. Results: Our findings indicate a clear and continuous trend of improved survival in AML patients, attributed to decreased AML-related mortality. Patients aged 60 or younger showed continuous improvement over the entire period, while those aged 61 or older demonstrated improvement starting in the early 2000s. Only patients receiving chemotherapy treatment benefited from ongoing research. No sex-specific differences were found. Subgroup analyses revealed age-dependent differences in survival improvement. The delayed onset of improvement in older patients may be due to the availability of hypomethylating agents and increased access to hematological stem cell transplantation. Conclusion: Our analysis showed, on a high level of abstraction, how ongoing research and availability of new treatment options improved survival for AML patients. Furthermore, subgroup analyses revealed age-dependent differences in this respect. While the data did not allow us to conduct in-depth analyses of treatment regimens, we hypothesized that the later onset of a pattern of improvement in older patients was due to the availability of hypomethylating substances and increased availability of hematological stem cells transplantation for elderly patients.

摘要翻译： 

背景与方法：本研究利用美国监测、流行病学和最终结果计划（SEER）数据库中1975年至2021年的独特患者数据，共纳入37,615例成年急性髓系白血病（AML）患者，分析其总体生存趋势。通过Kaplan-Meier估计和竞争风险分析，评估总体生存率、AML相关死亡风险及其他原因死亡风险。结果：研究发现AML患者生存率呈现明确且持续的改善趋势，主要归因于AML相关死亡率下降。60岁及以下患者在整个研究期间持续改善，而61岁及以上患者从2000年代初期开始显现改善。仅接受化疗治疗的患者从持续研究中获益，未发现性别特异性差异。亚组分析显示生存改善存在年龄依赖性差异。老年患者改善延迟可能与去甲基化药物的可及性及造血干细胞移植机会增加有关。结论：本研究在较高抽象层次上揭示了持续研究及新治疗方案的可及性如何改善AML患者生存。亚组分析进一步显示该改善存在年龄依赖性差异。虽然数据未允许对治疗方案进行深入分析，但我们推测老年患者改善模式出现较晚的原因在于去甲基化药物的应用及老年患者造血干细胞移植可及性的提高。

原文链接：

Characterizing Overall Survival of Patients with Acute Myeloid Leukemia: A Competing Risk Analysis of SEER Data Covering 46 Years