Survival and cure trends for European children, adolescents and young adults diagnosed with acute lymphoblastic leukemia from 1982 to 2002.

Background. Proportion cured is a potentially more informative cancer outcome measure than five‐year survival. We present population‐based cured estimates for young patients diagnosed with acute lymphoblastic leukemia in Europe from 1982 to 2002. Design and Methods. Thirty‐five European cancer registries provided data. Survival was estimated by age, period of diagnosis and European region, and used as input for parametric cure models, which assume cured patients have the same mortality as the general population. Results. For acute lymphoblastic leukemia diagnosed in 1‐14 year‐olds in 2000‐2002, over 77% were estimated cured. The proportion cured improved significantly over the study period: an impressive 26% to 58% in infants (up to 1 year), 70% to 90% in 1‐4 year‐olds, 63% to 86% in 5‐9 year‐olds, 52% to 77% in 10‐14 year‐olds, and 44% to 50% in 15‐24 year‐olds. Regional variations in proportion cured reduced over time for 1‐14 year‐olds, but persisted in infants and 15‐24 year‐olds. Five‐year survival was always slightly higher than proportion cured. Conclusions. Considerable proportions of young patients were estimated cured of acute lymphoblastic leukemia, nevertheless a small excess risk of dying persisted beyond five years after diagnosis when patients remained at risk for late treatment effects, late relapses and second primaries.