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Background: The survival of patients with acute promyelocytic leukemia (APL) has dramatically improved with the use of all‐trans retinoic acid (ATRA) and arsenic trioxide (ATO). However, because of the complexity of the initial management, early mortality (EM) remains a major contributor to treatment failure. It is less known whether advances in treatment, urgent access to specialized care, and broad availability of ATRA/ATO have reduced EM in the last 2 decades. Furthermore, the influence of sociodemographic factors on the risk of EM also remains unclear. Methods: This study used the Surveillance, Epidemiology, and End Results program to characterize the impact of sociodemographic factors on the rates of EM and overall survival (OS) in patients with APL diagnosed between 1992 and 2015. Results: In all, 2224 cases were identified (895 who were younger than 40 years and 1329 who were 40 years old or older); 47.9% had a county‐level median household income of $59,630 or higher, 49.0% belonged to counties where more than 31% of adults held at least a bachelor's degree, and 86.0% resided in urban areas. The rate of EM declined from 31.5% in 1992‐1995 to 15.9% in 2012‐2015 for all patients. It improved for patients younger than 40 years (27.4% in 1992‐1995 vs 5.4% in 2012‐2015; P <.001) and for patients 40 years old or older but not to the same extent (35.2% in 1992‐1995 vs 22.2% in 2012‐2015; P =.02). Importantly, improvements in EM were not seen among patients residing in rural areas, with the rate remaining higher than 20% in 2012‐2015. The 3‐year OS rate was 49.2% for patients with APL diagnosed in 1992‐1995 and 76.4% for patients diagnosed in 2012‐2015. Conclusions: These findings confirm consistent improvements in EM and OS for patients with APL and point to the challenge of further extending these improvements in EM rates to older patients and to those living in rural areas. Early mortality and overall survival continue to improve for patients with acute promyelocytic leukemia over 2 decades. For patients 40 years old or older and those residing in rural areas, the risk of early mortality from acute promyelocytic leukemia remains unacceptably high. [ABSTRACT FROM AUTHOR]

Background: Survival among patients diagnosed with acute promyelocytic leukemia (APL) has significantly improved with the use of all-trans retinoic acid and arsenic trioxide. However, the need for immediate diagnosis and access to specialized care and the cost associated with APL management can potentially act as barriers for disadvantaged patients. The influence of sociodemographic factors on the outcomes of patients with APL remains unclear.Methods: The authors used the National Cancer Institute's Surveillance, Epidemiology, and End Results program to characterize the impact of sociodemographic factors on survival in patients younger than 65 years with APL.Results: The authors identified 1787 cases: 816 who were younger than 40 years and 971 who were 40 years old or older. Insured patients who were younger than 40 years had an improved 5-year overall survival (OS) rate in comparison with patients without insurance. Among patients who were 40 years or older, having insurance (other than Medicaid) was associated with better survival than being a Medicaid beneficiary or being uninsured, whereas patients with Medicaid had improved 5-year OS in comparison with uninsured patients. In a multivariate analysis of patients younger than 40 years, a higher risk of death was associated with being male, being diagnosed in earlier years, and being uninsured. For patients who were 40 years old or older, mortality increased with increasing age and for both Medicaid and uninsured patients in comparison with insured patients.Conclusions: Despite the high cure rate experienced by patients with APL, patients younger than 65 years without insurance and those 40 years old or older with Medicaid are at a significant disadvantage in comparison with patients with insurance. These findings point to an opportunity to improve survival in APL by addressing access to care. [ABSTRACT FROM AUTHOR]

The article presents a study that used data from the National Cancer Institute Surveillance, Epidemiology, and End Results program to determine incidence and overall survival (OS) of paediatric myelodysplastic syndrome (p-MDS) in the U.S. The study showed that p-MDS is a very rare disorder in the nation, with higher incidence among children younger than one year of age.