Epidemiology, survival, and treatment of acute myeloid and lymphoblastic leukaemia in Germany: a nationwide population-based registry analysis

David Baden; Nadine Wolgast; Philipp M Altrock; Sophie Steinhäuser; Jakob Voran; Thomas Beder; Manuel Hecht; Cornelia Baden; Lorenz Bastian; Cécile Ronckers; Jacqueline Müller-Nordhorn; Soo-Zin Kim-Wanner; Martin Neumann; Lars Fransecky; Gunnar Cario; Christoph Röllig; Alexander Katalinic; Claudia D Baldus

Epidemiology, survival, and treatment of acute myeloid and lymphoblastic leukaemia in Germany: a nationwide population-based registry analysis

David Baden, Nadine Wolgast, Philipp M Altrock, Sophie Steinhäuser, Jakob Voran, Thomas Beder, Manuel Hecht, Cornelia Baden, Lorenz Bastian, Cécile Ronckers, Jacqueline Müller-Nordhorn, Soo-Zin Kim-Wanner, Martin Neumann, Lars Fransecky, Gunnar Cario, Christoph Röllig, Alexander Katalinic, Claudia D Baldus

Abstract

BACKGROUND: Acute leukaemias are rare but highly aggressive malignancies, but only limited population-level data are available for Germany. We aimed to describe epidemiology, survival, and therapies of acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL) in Germany using nationwide cancer registry data.

METHODS: We conducted a population-based analysis of all incident cases of AML and ALL in Germany, identified via ICD codes from mandatory cancer registry reporting, to assess incidence, treatment, and survival outcomes.

FINDINGS: We identified 25,788 patients with AML and 6480 patients with ALL diagnosed between 2016 and 2021 aged 0-101 years. The age-standardized incidence rate was 4.72/100,000 for AML (median age 72.8 years, IQR 61.0-80.3) and 1.36/100,000 for ALL (median age 19.4 years, IQR 5.2-58.6). The three- and five-year overall survival was 29.0% (95% CI: 28.3-29.7) and 23.8% (95% CI: 23.1-24.7) in AML, and 64% (95% CI: 62.2-65.9) and 58% (95% CI: 55.7-60.2) in ALL. Survival was highly dependent on age, with children (0-18 years) showing the highest three-year survival rates in AML (76.4%, 95% CI: 70.2-83.2) and ALL (91.9%, 95% CI: 89.8-94.1) compared to older adults. Moreover, area-based income and social deprivation were linked to survival, with three-year survival reduced by up to 4% in lower-income counties. Based on German federal population estimates, AML cases are expected to rise by 14.6%, while ALL cases will decline by 2.3% between 2020 and 2050.

INTERPRETATION: We provide incidence and survival data to inform future clinical trials, guide resource allocation, and support healthcare planning to improve real-world outcomes and address disparities in acute leukaemia.

FUNDING: German Research Foundation (DFG).

Original language	English
Article number	101503
Journal	The Lancet regional health. Europe
Volume	59
Pages (from-to)	101503
ISSN	2666-7762
Publication status	Published - 12.2025

Funding

Funders	Funder number
Clinician Scientist Program of the medical faculty of the Christian-Albrechts-University Kiel
national German Childhood Cancer Registry
Christian-Albrechts-Universität zu Kiel
Deutsche Forschungsgemeinschaft	413490537
DFG	525136051

Research Areas and Centers

Research Area: Center for Population Medicine and Public Health (ZBV)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Cite this

Baden, D., Wolgast, N., Altrock, P. M., Steinhäuser, S., Voran, J., Beder, T., Hecht, M., Baden, C., Bastian, L., Ronckers, C., Müller-Nordhorn, J., Kim-Wanner, S.-Z., Neumann, M., Fransecky, L., Cario, G., Röllig, C., Katalinic, A., & Baldus, C. D. (2025). Epidemiology, survival, and treatment of acute myeloid and lymphoblastic leukaemia in Germany: a nationwide population-based registry analysis. The Lancet regional health. Europe, 59, 101503. Article 101503.

@article{f954196798b243ffa15ac3cbdeddd2b9,

title = "Epidemiology, survival, and treatment of acute myeloid and lymphoblastic leukaemia in Germany: a nationwide population-based registry analysis",

abstract = "BACKGROUND: Acute leukaemias are rare but highly aggressive malignancies, but only limited population-level data are available for Germany. We aimed to describe epidemiology, survival, and therapies of acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL) in Germany using nationwide cancer registry data.METHODS: We conducted a population-based analysis of all incident cases of AML and ALL in Germany, identified via ICD codes from mandatory cancer registry reporting, to assess incidence, treatment, and survival outcomes.FINDINGS: We identified 25,788 patients with AML and 6480 patients with ALL diagnosed between 2016 and 2021 aged 0-101 years. The age-standardized incidence rate was 4.72/100,000 for AML (median age 72.8 years, IQR 61.0-80.3) and 1.36/100,000 for ALL (median age 19.4 years, IQR 5.2-58.6). The three- and five-year overall survival was 29.0\% (95\% CI: 28.3-29.7) and 23.8\% (95\% CI: 23.1-24.7) in AML, and 64\% (95\% CI: 62.2-65.9) and 58\% (95\% CI: 55.7-60.2) in ALL. Survival was highly dependent on age, with children (0-18 years) showing the highest three-year survival rates in AML (76.4\%, 95\% CI: 70.2-83.2) and ALL (91.9\%, 95\% CI: 89.8-94.1) compared to older adults. Moreover, area-based income and social deprivation were linked to survival, with three-year survival reduced by up to 4\% in lower-income counties. Based on German federal population estimates, AML cases are expected to rise by 14.6\%, while ALL cases will decline by 2.3\% between 2020 and 2050.INTERPRETATION: We provide incidence and survival data to inform future clinical trials, guide resource allocation, and support healthcare planning to improve real-world outcomes and address disparities in acute leukaemia.FUNDING: German Research Foundation (DFG).",

author = "David Baden and Nadine Wolgast and Altrock, \{Philipp M\} and Sophie Steinh{\"a}user and Jakob Voran and Thomas Beder and Manuel Hecht and Cornelia Baden and Lorenz Bastian and C{\'e}cile Ronckers and Jacqueline M{\"u}ller-Nordhorn and Soo-Zin Kim-Wanner and Martin Neumann and Lars Fransecky and Gunnar Cario and Christoph R{\"o}llig and Alexander Katalinic and Baldus, \{Claudia D\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s)",

year = "2025",

month = dec,

language = "English",

volume = "59",

pages = "101503",

journal = "The Lancet regional health. Europe",

issn = "2666-7762",

publisher = "Elsevier Ltd",

}

Baden, D, Wolgast, N, Altrock, PM, Steinhäuser, S, Voran, J, Beder, T, Hecht, M, Baden, C, Bastian, L, Ronckers, C, Müller-Nordhorn, J, Kim-Wanner, S-Z, Neumann, M, Fransecky, L, Cario, G, Röllig, C, Katalinic, A & Baldus, CD 2025, 'Epidemiology, survival, and treatment of acute myeloid and lymphoblastic leukaemia in Germany: a nationwide population-based registry analysis', The Lancet regional health. Europe, vol. 59, 101503, pp. 101503.

TY - JOUR

T1 - Epidemiology, survival, and treatment of acute myeloid and lymphoblastic leukaemia in Germany

T2 - a nationwide population-based registry analysis

AU - Baden, David

AU - Wolgast, Nadine

AU - Altrock, Philipp M

AU - Steinhäuser, Sophie

AU - Voran, Jakob

AU - Beder, Thomas

AU - Hecht, Manuel

AU - Baden, Cornelia

AU - Bastian, Lorenz

AU - Ronckers, Cécile

AU - Müller-Nordhorn, Jacqueline

AU - Kim-Wanner, Soo-Zin

AU - Neumann, Martin

AU - Fransecky, Lars

AU - Cario, Gunnar

AU - Röllig, Christoph

AU - Katalinic, Alexander

AU - Baldus, Claudia D

PY - 2025/12

Y1 - 2025/12

N2 - BACKGROUND: Acute leukaemias are rare but highly aggressive malignancies, but only limited population-level data are available for Germany. We aimed to describe epidemiology, survival, and therapies of acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL) in Germany using nationwide cancer registry data.METHODS: We conducted a population-based analysis of all incident cases of AML and ALL in Germany, identified via ICD codes from mandatory cancer registry reporting, to assess incidence, treatment, and survival outcomes.FINDINGS: We identified 25,788 patients with AML and 6480 patients with ALL diagnosed between 2016 and 2021 aged 0-101 years. The age-standardized incidence rate was 4.72/100,000 for AML (median age 72.8 years, IQR 61.0-80.3) and 1.36/100,000 for ALL (median age 19.4 years, IQR 5.2-58.6). The three- and five-year overall survival was 29.0% (95% CI: 28.3-29.7) and 23.8% (95% CI: 23.1-24.7) in AML, and 64% (95% CI: 62.2-65.9) and 58% (95% CI: 55.7-60.2) in ALL. Survival was highly dependent on age, with children (0-18 years) showing the highest three-year survival rates in AML (76.4%, 95% CI: 70.2-83.2) and ALL (91.9%, 95% CI: 89.8-94.1) compared to older adults. Moreover, area-based income and social deprivation were linked to survival, with three-year survival reduced by up to 4% in lower-income counties. Based on German federal population estimates, AML cases are expected to rise by 14.6%, while ALL cases will decline by 2.3% between 2020 and 2050.INTERPRETATION: We provide incidence and survival data to inform future clinical trials, guide resource allocation, and support healthcare planning to improve real-world outcomes and address disparities in acute leukaemia.FUNDING: German Research Foundation (DFG).

AB - BACKGROUND: Acute leukaemias are rare but highly aggressive malignancies, but only limited population-level data are available for Germany. We aimed to describe epidemiology, survival, and therapies of acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL) in Germany using nationwide cancer registry data.METHODS: We conducted a population-based analysis of all incident cases of AML and ALL in Germany, identified via ICD codes from mandatory cancer registry reporting, to assess incidence, treatment, and survival outcomes.FINDINGS: We identified 25,788 patients with AML and 6480 patients with ALL diagnosed between 2016 and 2021 aged 0-101 years. The age-standardized incidence rate was 4.72/100,000 for AML (median age 72.8 years, IQR 61.0-80.3) and 1.36/100,000 for ALL (median age 19.4 years, IQR 5.2-58.6). The three- and five-year overall survival was 29.0% (95% CI: 28.3-29.7) and 23.8% (95% CI: 23.1-24.7) in AML, and 64% (95% CI: 62.2-65.9) and 58% (95% CI: 55.7-60.2) in ALL. Survival was highly dependent on age, with children (0-18 years) showing the highest three-year survival rates in AML (76.4%, 95% CI: 70.2-83.2) and ALL (91.9%, 95% CI: 89.8-94.1) compared to older adults. Moreover, area-based income and social deprivation were linked to survival, with three-year survival reduced by up to 4% in lower-income counties. Based on German federal population estimates, AML cases are expected to rise by 14.6%, while ALL cases will decline by 2.3% between 2020 and 2050.INTERPRETATION: We provide incidence and survival data to inform future clinical trials, guide resource allocation, and support healthcare planning to improve real-world outcomes and address disparities in acute leukaemia.FUNDING: German Research Foundation (DFG).

UR - https://www.scopus.com/pages/publications/105019083915

UR - https://www.mendeley.com/catalogue/4fce5faf-82cc-33b4-a894-ea317fe0d8d4/

M3 - Journal articles

C2 - 41158418

SN - 2666-7762

VL - 59

SP - 101503

JO - The Lancet regional health. Europe

JF - The Lancet regional health. Europe

M1 - 101503

ER -

Epidemiology, survival, and treatment of acute myeloid and lymphoblastic leukaemia in Germany: a nationwide population-based registry analysis

Abstract

Funding

Research Areas and Centers

UN SDGs

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