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慢性髓性白血病患者的预期寿命接近普通人群。

Life Expectancy of Patients With Chronic Myeloid Leukemia Approaches the Life Expectancy of the General Population.

机构信息

Hannah Bower, Magnus Björkholm, Paul W. Dickman, Paul C. Lambert, and Therese M.-L. Andersson, Karolinska Institutet; Magnus Björkholm, Karolinska University Hospital Solna, Stockholm; Martin Höglund, University Hospital Uppsala, Uppsala, Sweden; Paul C. Lambert, University of Leicester, Leicester, United Kingdom; and Therese M.-L. Andersson, Danish Cancer Society, Copenhagen, Denmark.

出版信息

J Clin Oncol. 2016 Aug 20;34(24):2851-7. doi: 10.1200/JCO.2015.66.2866. Epub 2016 Jun 20.

Abstract

PURPOSE

A dramatic improvement in the survival of patients with chronic myeloid leukemia (CML) occurred after the introduction of imatinib mesylate, the first tyrosine kinase inhibitor (TKI). We assessed how these changes affected the life expectancy of patients with CML and life-years lost as a result of CML between 1973 and 2013 in Sweden.

MATERIALS AND METHODS

Patients recorded as having CML in the Swedish Cancer Registry from 1973 to 2013 were included in the study and followed until death, censorship, or end of follow-up. The life expectancy and loss in expectation of life were predicted from a flexible parametric relative survival model.

RESULTS

A total of 2,662 patients with CML were diagnosed between 1973 and 2013. Vast improvements in the life expectancy of these patients were seen over the study period; larger improvements were seen in the youngest ages. The great improvements in life expectancy translated into great reductions in the loss in expectation of life. Patients of all ages diagnosed in 2013 will, on average, lose < 3 life-years as a result of CML.

CONCLUSION

Imatinib mesylate and new TKIs along with allogeneic stem cell transplantation and other factors have contributed to the life expectancy in patients with CML approaching that of the general population today. This will be an important message to convey to patients to understand the impact of a CML diagnosis on their life. In addition, the increasing prevalence of patients with CML will have a great effect on future health care costs as long as continuous TKI treatment is required.

摘要

目的

甲磺酸伊马替尼的问世,标志着首个酪氨酸激酶抑制剂(TKI)的诞生,显著改善了慢性髓性白血病(CML)患者的生存状况。本研究旨在评估瑞典在 1973 年至 2013 年间 CML 患者的预期寿命变化以及因 CML 而导致的预期寿命损失。

材料与方法

纳入 1973 年至 2013 年期间在瑞典癌症登记处记录为 CML 的患者,并进行随访直至死亡、删失或随访结束。采用灵活参数相对生存模型预测预期寿命和预期寿命损失。

结果

1973 年至 2013 年间共诊断出 2662 例 CML 患者。研究期间,这些患者的预期寿命显著提高;年龄越小,改善越大。预期寿命的显著提高转化为预期寿命损失的显著减少。2013 年诊断的所有年龄段的患者平均因 CML 而导致的预期寿命损失<3 年。

结论

甲磺酸伊马替尼和新型 TKI 以及异基因干细胞移植和其他因素的应用使 CML 患者的预期寿命接近当今普通人群的水平。这将是一个重要的信息,让患者了解 CML 诊断对其生活的影响。此外,只要需要持续的 TKI 治疗,CML 患者的患病率不断增加,将对未来的医疗保健成本产生重大影响。

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