Marital status, where you live, and if you have health insurance may play a role in survival following a diagnosis of acute myeloid leukemia (AML), say researchers from the University of California Davis School of Medicine in Sacramento, California.
In a study published in the British Journal of Haematology, researchers found patients who were unmarried, lived in less affluent neighborhoods, or did not have health insurance, were more likely to die within 60 days of diagnosis than their peers who were married, lived in more affluent areas, or had private insurance.1
The overall 5-year survival rate for AML is about 27%, but this was not the case for those who fell into the aforementioned categories.2
“Although sociodemographic factors are well known to be important for long-term survival for patients with chronic illness and other cancers, this is the first study to find that they also play a significant role in outcomes of hospitalized patients with acute myeloid leukemia, when presumably everyone is treated similarly,” lead author Gwendolyn Ho, MD, said in a release. Ho is a hematologist-oncologist at the UC Davis Comprehensive Cancer Center, and researcher with the Center for Oncology Hematology Outcomes Research and Training (COHORT).3
Using data collected from the California Cancer Registry, Ho and her colleagues looked at 6,359 patients 15 years old or older who had received inpatient treatment for AML from 1999 to 2012. The researchers assessed the association of complications with early mortality, adjusting for sociodemographic factors, comorbidities, and hospital type.
The results showed that those who were married were about 25% more likely to survive than patients who were single. People who lived in more affluent neighborhoods were 20% more likely to survive, while those who were not insured were nearly 2.5 times more likely to die than those patients who had private health insurance.
Early mortality associated with major bleeding, liver failure, renal failure, respiratory failure, and cardiac arrest decreased from 25.3% in 1999 to 2000 to 16.8% in 2011 to 2012 for all patients, the researchers wrote, but was higher in older patients:
- Fifteen to 39 years: 6.9%;
- Forty to 54 years: 11.4%;
- Fifty-five to 65 years: 18.6%; and
- Over 65 years: 35.8%.
The researchers also found that patients who underwent treatment at a National Cancer Institute-designated cancer center had about half the risk of dying compared to patients at all other hospital types and across all age groups.
“Understanding the factors that affect early mortality can help identify targets for improvement,” said Ho. “We expect that further study of the trends will lead to interventions to improve early survival of cancer.”
- Ho G, Jonas BA, Li Q, et al. Early mortality and complications in hospitalized adult Californians with acute myeloid leukaemia. Br J Haematol. 2017 Apr 17.
- Cancer.Net. Leukemia - Acute Myeloid - AML: Statistics. 2016 Jan.
- UC Davis Comprehensive Cancer Center. Early cancer deaths linked to being single, living in a poor neighborhood. 2017 Apr 25.