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年轻多发性骨髓瘤患者长期生存率近期有显著改善。

Recent major improvement in long-term survival of younger patients with multiple myeloma.

作者信息

Brenner Hermann, Gondos Adam, Pulte Dianne

机构信息

Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Bergheimer Strasse 20, Heidelberg, Germany.

出版信息

Blood. 2008 Mar 1;111(5):2521-6. doi: 10.1182/blood-2007-08-104984. Epub 2007 Sep 27.

Abstract

In the past, most patients with multiple myeloma (MM) died within 5 to 10 years after diagnosis. Within the past decade, several new therapeutic interventions have been introduced, including autologous stem-cell transplantation, thalidomide, lenalidomide, and bortezomib. We estimated trends in age-specific 5- and 10-year relative survival of patients with MM in the United States from 1990-1992 to 2002-2004 from the 1973-2004 database of the Surveillance, Epidemiology, and End Results (SEER) Program. Techniques of period analysis were used to show most recent developments. Overall, 5-year relative survival increased from 28.8% to 34.7% (P < .001), and 10-year relative survival increased from 11.1% to 17.4% (P < .001) between 1990-1992 and 2002-2004. Much stronger increases were seen in the age group younger than 50 years, leading to 5- and 10-year relative survival of 56.7% and 41.3% in 2002-2004, and in the age group 50 to 59 years, leading to 5- and 10-year relative survival of 48.2% and 28.6% in 200-2004. By contrast, only moderate improvement was seen in the age group 60 to 69 years, and essentially no improvement was achieved among older patients. Our period analysis discloses a major increase in long-term survival of younger patients with MM in recent years, which most likely reflects the effect of recent advances in therapy and their dissemination in clinical practice.

摘要

过去,大多数多发性骨髓瘤(MM)患者在确诊后5至10年内死亡。在过去十年中,引入了几种新的治疗干预措施,包括自体干细胞移植、沙利度胺、来那度胺和硼替佐米。我们根据监测、流行病学和最终结果(SEER)计划1973 - 2004年数据库,估算了1990 - 1992年至2002 - 2004年美国MM患者年龄特异性5年和10年相对生存率的趋势。采用时期分析技术来展示最新进展。总体而言,1990 - 1992年至2002 - 2004年间,5年相对生存率从28.8%增至34.7%(P <.001),10年相对生存率从11.1%增至17.4%(P <.001)。年龄小于50岁的人群生存率提升更为显著,2002 - 2004年其5年和10年相对生存率分别为56.7%和41.3%;年龄在50至59岁的人群中,2002 - 2004年其5年和10年相对生存率分别为48.2%和28.6%。相比之下,60至69岁年龄组仅有适度改善,老年患者基本未实现改善。我们的时期分析揭示,近年来年轻MM患者的长期生存率大幅提高,这很可能反映了近期治疗进展及其在临床实践中的推广效果。

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