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慢性髓性白血病的发病率、生存率及酪氨酸激酶抑制剂的可及性:基于立陶宛2000 - 2013年血液疾病登记处人群报告

Chronic myeloid leukemia incidence, survival and accessibility of tyrosine kinase inhibitors: a report from population-based Lithuanian haematological disease registry 2000-2013.

作者信息

Beinortas Tumas, Tavorienė Ilma, Žvirblis Tadas, Gerbutavičius Rolandas, Jurgutis Mindaugas, Griškevičius Laimonas

机构信息

Clinical Medical School, University of Oxford, Oxford, UK.

Centre for Evidence-Based Medicine, Clinics of Internal, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania.

出版信息

BMC Cancer. 2016 Mar 8;16:198. doi: 10.1186/s12885-016-2238-9.

Abstract

BACKGROUND

Currently available chronic myeloid leukaemia (CML) survival reports have originated from more affluent countries. Herein we report the entire country data on incidence and survival of CML, as well as penetrance of tyrosine kinase inhibitors (TKIs) in Lithuania.

METHODS

We analyzed all patients (N = 601) from the national haematological disease monitoring system who were diagnosed with CML between 2000 and 2013. Crude (CR) and age-standardized (weighted) (ASW(R)) incidence and mortality rates, as well as 1-, 5-, and 10-year relative survival rates (RSR) were calculated. Information on TKI penetration is also reported.

RESULTS

Throughout the entire 2000-2013 period the median age at diagnosis of CML patients was 62 years. The respective incidence and mortality CRs were 1.28 and 0.78, both characterized by decreasing trends over the observation period. A 5-year RSR increased from 0.33 [95 % CI, 0.27-0.40] in 2000-2004 to 0.55 [95 % CI, 0.47-0.63] in 2005-2009. However, the respective 5-year RSRs for patients aged 65-74 and ≥75 were only 0.33 [95 % CI, 0.24-0.42] and 0.18 [95 % CI 0.07-0.23] during the entire study period. TKI penetrance for CML patients grew from 1.5 % in 2000-2004 to 30.6 % in 2005-2009 and 69.1 % in 2010-2013. TKI penetrance was low in the older age groups (60 % for the 65-74 and 19 % for the ≥75 patient group, in 2010-2013).

CONCLUSION

Relative CML survival in Lithuania steadily improved and paralleled the increase in TKI treatment availability. Patients above 64 years rarely received TKIs and their relative survival remained low throughout the observation period. The latency of TKI availability may have influenced the survival trends.

摘要

背景

目前可用的慢性髓性白血病(CML)生存报告来自较富裕的国家。在此,我们报告立陶宛CML的发病率、生存率以及酪氨酸激酶抑制剂(TKIs)的普及率的全国数据。

方法

我们分析了国家血液系统疾病监测系统中2000年至2013年间诊断为CML的所有患者(N = 601)。计算了粗发病率(CR)和年龄标准化(加权)发病率(ASW(R))、死亡率以及1年、5年和10年相对生存率(RSR)。还报告了TKI普及率的信息。

结果

在整个2000 - 2013年期间,CML患者诊断时的中位年龄为62岁。相应的发病率和死亡率粗率分别为1.28和0.78,两者在观察期内均呈下降趋势。5年相对生存率从2000 - 2004年的0.33[95%置信区间,0.27 - 0.40]增加到2005 - 2009年的0.55[95%置信区间,0.47 - 0.63]。然而,在整个研究期间,65 - 74岁和≥75岁患者的5年相对生存率分别仅为0.33[95%置信区间,0.24 - 0.42]和0.18[95%置信区间0.07 - 0.23]。CML患者的TKI普及率从2000 - 2004年的1.5%增长到2005 - 2009年的30.6%和2010 - 2013年的69.1%。在老年组中TKI普及率较低(2010 - 2013年,65 - 74岁患者组为60%,≥75岁患者组为19%)。

结论

立陶宛CML患者的相对生存率稳步提高,与TKI治疗可用性的增加并行。64岁以上患者很少接受TKI治疗,并且在整个观察期内他们的相对生存率仍然较低。TKI可用性的延迟可能影响了生存趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d16/4782571/35189b8f50ff/12885_2016_2238_Fig1_HTML.jpg

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