Gatta G, Luksch R, Coleman M P, Corazziari I
Istituto Nazionale per lo Studio e la Cura e dei Tumori, Divisione di Epidemiologia, Via Venezian,1, 20133 Milan, Italy.
Eur J Cancer. 2001 Apr;37(6):695-702. doi: 10.1016/s0959-8049(01)00045-4.
We used data supplied by population-based cancer registries, collected and quality controlled using a common protocol, to analyse survival from acute non-lymphocytic leukaemia (ANLL) and chronic myeloid leukaemia (CML) among children in 17 European countries. Variations in survival in relation to age, country, histologic subtype and period of diagnosis (1978--1992) were examined. These are rare malignancies and survival can be studied reliably only by examination of data from a very large population (in this case EUROCARE). 5 years after diagnosis, overall survival was 44% (95% CI 33--55) for CML and 37% (95% CI 32--43) for ANLL. For both types of leukaemia, survival was slightly better for girls and worse in children under 5 years of age. Consistent with clinical literature, the ANLL subtypes with poorer prognosis were monocytic, megakaryocytic and erythroleukaemia. For ANLL, 5-year survival was better in Finland, the UK, The Netherlands and Germany (> or =40%); for CML, 5-year survival was highest in Italy, although the 95% CI were wide. The risk of death from ANLL and CML fell by 7% per year and 5% per year, respectively, after adjustment for age, gender and country. Since these rare childhood malignancies were virtually untreatable until 1970, these are very welcome trends.
我们使用了基于人群的癌症登记处提供的数据，这些数据通过通用方案收集并进行了质量控制，以分析17个欧洲国家儿童急性非淋巴细胞白血病（ANLL）和慢性粒细胞白血病（CML）的生存率。研究了生存率在年龄、国家、组织学亚型和诊断时期（1978 - 1992年）方面的差异。这些是罕见的恶性肿瘤，只有通过检查来自非常大的人群的数据（在本研究中为EUROCARE）才能可靠地研究生存率。诊断后5年，CML的总生存率为44%（95%可信区间33 - 55），ANLL为37%（95%可信区间32 - 43）。对于这两种白血病，女孩的生存率略高，5岁以下儿童的生存率较低。与临床文献一致，预后较差的ANLL亚型为单核细胞型、巨核细胞型和红白血病。对于ANLL，芬兰、英国、荷兰和德国的5年生存率较好（≥40%）；对于CML，意大利的5年生存率最高，尽管95%可信区间较宽。在对年龄、性别和国家进行调整后，ANLL和CML的死亡风险分别每年下降7%和5%。由于这些儿童期罕见恶性肿瘤在1970年前几乎无法治疗，这些趋势非常令人欣慰。
