For many hematological malignancies (HMs) survival among older patients is compromised. We want to test the most up-to-date age-group-specific survival differences in five hematological malignancies, Hodgkin lymphoma (HL), multiple myeloma (MM), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML) and myeloproliferative diseases (MPD) in Sweden (SE) and compared these to Denmark, Finland and Norway. For analysis we apply a recently published metric for comparing and visualizing age-group-specific relative survival differences using data from the NORDCAN database between 1972 and 2021. Periodic changes in age-related deviation in SE survival showed increasing differences for AML and MM while for the other HMs the differences declined in the course of time. Country-specific differences were observed, for Finnish male CLL and female MPD deviations were larger than those for the other countries, both of which were explained by the deviant survival of the oldest patients. Age-related deviations in 5-year survival increased for AML and MM for which survival improvements have been achieved through intense treatment regimens but these are not offered to old patients because of risk of complications. Paradoxically, improving overall survival in AML and MM has contributed to the widening of the age gaps. For the remaining HMs, age-related deviations declined with time as even old patients benefitted from the survival improvements; most notably female MPD and CLL patients had hardly any age gaps. Age disparities are an issue in hematological malignancies, and an intense search for novel treatments also includes old patients with an example of success as a novel drug venetoclax.

• Keywords
• Cancer registry, Periodic survival, Prognosis, Treatment,
• MeSH
• Adult MeSH
• Hematologic Neoplasms * mortality   diagnosis   epidemiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Survival Rate trends   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Age Factors MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Comparative Study MeSH
• Geographicals
• Denmark epidemiology   MeSH
• Finland epidemiology   MeSH
• Norway epidemiology   MeSH
• Sweden epidemiology   MeSH

• MeSH
• Humans MeSH
• Multiple Myeloma * epidemiology   therapy   MeSH
• Risk Factors MeSH
• Age Factors MeSH
• Check Tag
• Humans MeSH
• Publication type
• Letter MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Scandinavian and Nordic Countries epidemiology   MeSH

Studies of survival in hematological malignancies (HMs) have generally shown an improvement over time, although most of these studies are limited by a short follow-up period. Using the NORDCAN database with data from Denmark, Finland, Norway and Sweden, we follow periodic increases in relative survival in seven HMs through half a century up to 2015-2019. Five-year survival improved in all seven HMs, reaching 90% for Hodgkin lymphoma (HL), myeloproliferative neoplasias and chronic lymphocytic leukemia (CLL), 60% for multiple myeloma (MM) and chronic myeloid leukemias (CMLs), 50% for the myelodysplastic syndromes and 30% for acute myeloid leukemia (AML). Improvements in survival over 50 years ranged from 20% to more than 50% units across the different HMs. The likely reasons for such progress include earlier diagnoses, improved risk stratification and advances in treatment. We observed differing temporal trends in improvements in survival. The gradual increases observed in HL, CLL and AML highlight the impact of optimization of existing therapies and improvements in diagnostics and risk stratification, whereas the rapid increases observed in the CMLs and MM highlight the impact of novel therapies. Recent therapeutic advances may further improve survival in HMs where survival remains low such as in AML.

• MeSH
• Leukemia, Myeloid, Acute * therapy   MeSH
• Leukemia, Lymphocytic, Chronic, B-Cell * MeSH
• Hematologic Neoplasms * epidemiology   therapy   MeSH
• Hodgkin Disease * MeSH
• Humans MeSH
• Multiple Myeloma * epidemiology   therapy   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Scandinavian and Nordic Countries epidemiology   MeSH

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• MeSH
• Hematologic Neoplasms * epidemiology   therapy   MeSH
• Incidence MeSH
• Humans MeSH
• Registries MeSH
• Age Distribution MeSH
• Check Tag
• Humans MeSH
• Publication type
• Letter MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Scandinavian and Nordic Countries epidemiology   MeSH