Brenner Hermann, Gondos Adam, Pulte Dianne
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Bergheimer Strasse 20, Heidelberg, Germany.
Blood. 2008 Mar 1;111(5):2521-6. doi: 10.1182/blood-2007-08-104984. Epub 2007 Sep 27.
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.
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。