Life Years Saved: Why This Metric Better Reflects Progress in Blood Cancer

"Life years saved" is emerging as a more meaningful way to track progress in blood cancer care than the five-year survival rates typically reported in clinical trials. In this interview, E. Anders Kolb, MD, a pediatric hematologist-oncologist and researcher who serves as president and CEO of Blood Cancer United, explains why population-based mortality rates, the standard measure of cancer progress in the United States, can be misleading for hematologic malignancies such as leukemia, lymphoma, and multiple myeloma.

Since 1991, overall cancer mortality in the US has declined steadily, but most of that improvement comes from screening and prevention programs, including mammography, Pap smears, and lung and colon cancer screening, along with reduced smoking rates. Blood cancers do not benefit from these tools in the same way. Incidence is rising as the population ages, and survival gains depend almost entirely on the development of new, innovative therapies rather than early detection.

Dr. Kolb also unpacks the limitations of the five-year survival benchmark, which does not account for relapse, long-term treatment toxicity, or the reality that a normal lifespan, not necessarily a cure, is often the true goal of therapy, using chronic myeloid leukemia and Gleevec as the clearest example.

Looking back at decades of data reveals clear inflection points where new treatments changed the trajectory of survival: multi-agent chemotherapy for Hodgkin lymphoma in the 1960s, CNS-directed therapy for acute lymphoblastic leukemia, rituximab for non-Hodgkin lymphoma, and targeted therapy for chronic myeloid leukemia. Chronic lymphocytic leukemia and multiple myeloma show more gradual, incremental gains, while acute myeloid leukemia remains an area of urgent unmet need.

For community oncologists, the conversation is a reminder that continued progress against blood cancers is not guaranteed. It depends on sustained research funding, a strong drug development pipeline, and equitable patient access to innovative therapies.