Epidemiology of acute lymphoblastic leukemia in a private health insurance population: incidence and characterization

Abstract

Introduction: Acute lymphoblastic leukemia (ALL) is a heterogeneous neoplasm with scarce epidemiologic data from Latin America, particularly in adults. We aimed to describe the epidemiology of ALL among members of a private health system in Argentina. Methods: Dynamic, observational, retrospective cohort (2010–2019) including pediatric and adult patients enrolled in the Hospital Italiano de Buenos Aires Health Plan. Incident cases were validated by chart review and hematopathology. Clinical/laboratory features were described; survival was estimated with Kaplan–Meier, and rates (incidence and mortality) with 95% CIs. Results: Twenty-five ALL cases were identified; median age 47 years; 56% male. B-lineage accounted for 92%, predominantly common B-ALL. One-year survival was 68% (95% CI 46–82) and two-year survival 50% (95% CI 29–68); among adults, 52% at one year (95% CI 27–73), and 24% at two years (95% CI 6–47), while all pediatric patients remained alive at two years. Median overall survival was 2.17 years; 1.02 years in adults; and not reached in pediatric patients. The mortality rate was 17 per 100 person-years (95% CI 10–30). Overall incidence was 1.55 per 100,000 member-years (95% CI 1.01–2.3); pediatric 2.87 (95% CI 1.24–5.66) and adult 1.28 (95% CI 0.74–2.05). Conclusions: In this cohort, ALL showed an age distribution skewed toward adults, with lower survival compared with pediatric patients. Findings highlight the influence of age on incidence and prognosis, and underscore the need for centralized registries and local studies including adults to improve diagnosis and care.