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20世纪80年代至21世纪初慢性淋巴细胞白血病患者的长期生存趋势。

Trends in long-term survival of patients with chronic lymphocytic leukemia from the 1980s to the early 21st century.

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, Heidelberg, Germany.

出版信息

Blood. 2008 May 15;111(10):4916-21. doi: 10.1182/blood-2007-12-129379. Epub 2008 Feb 28.

Abstract

Although chronic lymphocytic leukemia (CLL) has remained incurable with standard treatments, newer therapeutic approaches, such as chemoimmunotherapy or stem cell transplantation, bear the potential for prolonged survival. We estimated trends in age-specific 5- and 10-year absolute and relative survival of CLL patients in the United States between 1980-1984 and 2000-2004 from the 1973 to 2004 database of the Surveillance, Epidemiology, and End Results Program. Period analysis was used to disclose recent developments with minimum delay. Overall, 5- and 10-year absolute survival from diagnosis increased from 54.2% to 60.2% (+6 percentage points; P < .0001) and from 27.8% to 34.8% (+7 percentage points; P < .0001), respectively. Despite a strong age gradient in prognosis, increases in 5-year absolute and relative survival over time were rather homogeneous across age groups. In contrast, increases in 10-year absolute and relative survival close to or well above 10% units were observed for all patients younger than 80 years of age at diagnosis compared with no increase at all for older patients. Long-term survival expectations of patients with CLL have substantially improved over the past 2 decades except for patients 80 years of age or older at the time of diagnosis. Future studies are needed to confirm and expand our findings.

摘要

尽管慢性淋巴细胞白血病(CLL)的标准治疗方法仍无法治愈,但化疗免疫疗法或干细胞移植等新的治疗方法有望延长患者生存期。我们从监测、流行病学和最终结果计划1973年至2004年的数据库中估计了1980 - 1984年至2000 - 2004年美国CLL患者特定年龄的5年和10年绝对及相对生存率趋势。采用时期分析以最快速度揭示近期进展。总体而言,从诊断开始计算的5年和10年绝对生存率分别从54.2%提高到60.2%(增加6个百分点;P <.0001)和从27.8%提高到34.8%(增加7个百分点;P <.000)。尽管预后存在明显的年龄梯度,但随着时间推移,5年绝对和相对生存率的提高在各年龄组中较为一致。相比之下,诊断时年龄小于80岁的所有患者10年绝对和相对生存率提高接近或远高于10个百分点,而老年患者则完全没有提高。在过去20年中,CLL患者的长期生存预期有了显著改善,但诊断时年龄在80岁及以上的患者除外。需要未来的研究来证实并扩展我们的发现。

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