Leukemias rarely debut by pleural involvement as the first manifestation of the hematologic malignancy

IRs were being calculated total and in accordance to Idarubicin sex (male, woman), age (< 1, 1-4, 5-19, 20-39, 40-59, 60-74, and ≥ 75 years), race/ethnicity (non-Hispanic whites, Hispanic whites, blacks, Idarubicin Asians/Pacific Islanders [APIs], and other/unspecified), calendar year, and leukemia subtype (specified in Table 2). Age-specific IRs were plotted on a log-linear scale using the midpoint of each specified age group (< 1, 1-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and ≥ 85 years). IRs based on fewer than 10 cases are not shown in the tables and figures, similar to international convention.

To evaluate patient survival after a diagnosis of AL, we restricted the cohort to patients diagnosed during 2001 to 2006 (rather than 2007) and followed them for vital status through 2007 (n = 25 428). We excluded cases of AL diagnosed as a second or later primary cancer (n = 3921) or during July to December 2005 in Louisiana because of population displacement from Hurricane Katrina (n = 93), reported only by death certificate or autopsy (n = 10), with unknown age (n = 1), or with unknown survival time (n = 64). Through active tracing, the SEER Program has been successful in attaining more than 97% follow-up for vital status.

Cause-specific survival is a measure of net survival in the absence of other causes of death observed survival is the probability of surviving all causes of death for a specified interval and relative survival (RS) is the ratio of the proportion of observed to expected survivors in a comparable cohort of the general population. We focused our analysis on RS that is not reliant on a potentially inaccurate cause of death, accounts for the underlying disease process or ensuing associated complications, and provides a basis for comparison in the general population. The actuarial method in the SEER*Stat Survival Session was used to estimate 1- and 5-year RS and 95% CIs using monthly intervals. RS was calculated according to leukemia subtype and 4 age groups (< 20, 20-39, 40-59, and ≥ 60 years). We further divided the younger (< 1, 1-4, 5-19 years, or < 5, 5-19 years) and older (40-49, 50-59, 60-69, 70-79, and ≥ 80 years) age groups when the number of cases allowed. According to SEER Program convention, RS estimates based on fewer than 25 cases are not shown.

Overall AL patterns by sex, race, and age.

During 2001 to 2007, 29 682 individuals (IR = 57.2 per 1 000 000 person-years) were diagnosed with AL in SEER-17. Overall, AML accounted for 65.7% of cases (n = 19 497 IR = 38.0) ALL/L, 31.0% (n = 9,188 IR = 17.3) and AL of ambiguous lineage, 3.4% (n = 997 IR = 2.0). AML IRs were remarkably similar among Hispanic whites, blacks, and APIs (IR = 32.0-32.3), with rates for each racial/ethnic subgroup ∼ 20% lower than among non-Hispanic whites (IR = 39.9 Table 1). AML IRs demonstrated a bimodal age pattern, with an initial peak among infants (< 1 year, IR = 19.9), a decline in childhood, and then an exponential rise in IR with advancing age beginning in young adulthood (Table 1 Figure 1).