Connecticut Tumor Registry, Department of PublicHealth, Hartford, CT, USA.
Cancer Epidemiol. 2013 Oct;37(5):569-74. doi: 10.1016/j.canep.2013.05.004. Epub 2013 Jun 15.
For myelodysplastic syndromes (MDS) (formerly known as preleukemia), a diverse group of myeloid neoplasms usually involving anemia in elderly persons, trends in U.S. death rates apparently have not been reported.
Trends in annual age-standardized rates per 100,000 from 1999 to 2009 were examined for MDS using multiple causes vs. underlying cause alone, coded on death certificates for U.S. residents.
The death rate (all ages combined) for MDS increased from 1999 to 2009, from 1.62 to 1.84 using underlying cause alone and from 2.89 to 3.27 using multiple causes. Rates using multiple causes were about 80% higher than those based on underlying cause alone. From 2001 to 2004 the rate for MDS using underlying cause alone (but not using multiple causes) declined, accompanied by an increase in the rate for deaths from leukemia as underlying cause with mention of MDS; this trend coincided with the advent of the 2001 World Health Organization's reclassification of certain MDS as leukemia. The MDS rate for age 65+ years increased after 2005, whereas the rate for age 25-64 years was low but declined from 2001 to 2003 and then stabilized. For deaths with MDS coded as other than underlying cause, rates did not decline for deaths from each of the two most common causes (i.e., cardiovascular diseases and leukemia).
Evidence for decreases in MDS-related mortality rates was limited; the increase at age 65+ years is consistent with increases in incidence rates reported from cancer registries. Using multiple causes of death vs. only the underlying cause results in substantially higher MDS-related death rates, shows the impact of changes in the classification of myeloid neoplasms and emphasizes the importance of reducing cardiovascular disease mortality in MDS patients.
对于骨髓增生异常综合征（MDS）（以前称为白血病前期），这是一组异质性髓系肿瘤，通常涉及老年人贫血，目前尚未报告美国死亡率趋势。
使用多种死因与仅使用根本死因，对美国居民死亡证明上编码的 MDS 进行分析，研究了 1999 年至 2009 年每年每 10 万人年龄标准化率的趋势。
MDS 的死亡率（所有年龄组合并）从 1999 年至 2009 年增加，单独使用根本死因时从 1.62 增至 1.84，而使用多种死因时从 2.89 增至 3.27。使用多种死因的比率比单独使用根本死因的比率高约 80%。从 2001 年至 2004 年，单独使用根本死因（但不使用多种死因）的 MDS 率下降，同时伴有作为根本死因的白血病死亡率上升，同时提及 MDS；这一趋势与 2001 年世界卫生组织（WHO）将某些 MDS 重新分类为白血病相符。2005 年后，65 岁以上人群的 MDS 发病率增加，而 25-64 岁人群的发病率较低，但从 2001 年至 2003 年下降，然后稳定。对于以其他原因而非根本原因编码的 MDS 死亡，两种最常见死因（即心血管疾病和白血病）的死亡率并未下降。
MDS 相关死亡率下降的证据有限；65 岁以上人群的增加与癌症登记处报告的发病率增加一致。与仅使用根本死因相比，使用多种死因会导致 MDS 相关死亡率显著升高，这表明髓系肿瘤分类变化的影响，并强调降低 MDS 患者心血管疾病死亡率的重要性。
