SURVIVAL TRENDS IN CHILDHOOD HEMATOLOGICAL MALIGNANCIES

Survival of patients with childhood hematological malignancies has increased markedly in the past decades. To examine the fine-scale details of how this progress has occurred, we carried out Kaplan-Meier cause-specific survival analysis using the Surveillance Epidemiology and End Results (SEER) dataset for patients with childhood hematological malignancies - Hodgkin's Lymphoma, Non-Hodgkin's Lymphoma, Lymphoblastic Leukemia and Myeloid Leukemia - diagnosed in five eras: 1983-1987; 1988-1992; 1993-1997; 1998-2002 and 2003-2007. We generated Kaplan-Meier estimates of survival for each of the first 24 years after diagnosis. These figures agree with previously reported five- and ten-year values and attest to the remarkable increase in survival that has occurred over the past three decades of medical progress. The trend towards progressively increasing survival shows no sign of slowing, suggesting that we may expect further increases in survival in the years ahead. Most of the increase in survival for childhood hematological malignancies has occurred by reducing the risk of death in the first two years after diagnosis. This may be largely explained by the fact that this is the time period when patients are at highest risk of death.