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美国多发性骨髓瘤发病率及按年龄、种族和族裔划分的生存率的近期趋势。

Recent trends in multiple myeloma incidence and survival by age, race, and ethnicity in the United States.

作者信息

Costa Luciano J, Brill Ilene K, Omel James, Godby Kelly, Kumar Shaji K, Brown Elizabeth E

机构信息

Division of Hematology and Oncology, Department of Medicine, and.

Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.

出版信息

Blood Adv. 2017 Jan 4;1(4):282-287. doi: 10.1182/bloodadvances.2016002493. eCollection 2017 Jan 10.

Abstract

Prior improvements in multiple myeloma (MM) survival were not fully observed in racial and ethnic minorities and older individuals. We hypothesized that improvements in MM management in recent years have reduced these disparities. We used the Surveillance, Epidemiology, and End Results registries to calculate the incidence and relative survival rates (RSRs) of MM in the United States for patients diagnosed from 1993 to 1997 (prethalidomide), 1998 to 2002 (introduction of thalidomide), 2003 to 2007 (bortezomib and lenalidomide), and 2008 to 2012 (upfront bortezomib and lenalidomide, early availability of carfilzomib and pomalidomide). MM incidence increased significantly among non-Hispanic whites (NHWs) and non-Hispanic black (NHB) men, but not among NHB women and Hispanics. Improvement in 5-year RSRs (1993-1997 vs 2008-2012) was seen among patients of all age and race/ethnicity groups. Ten-year RSRs (1993-1997 vs 2003-2007) improved for patients <65 years of age (19.6%-35%; < .001), but not for patients ≥75 years of age (7.8%-9.3%; = .3). Among patients 65 to 74 years of age, 10-year RSRs improved for NHWs (11.3% vs 20.5%; < .001) and Hispanics (10.6% vs 20.2%; = .02), but not for NHBs (12.6% vs 19.5%; = .06.). These findings confirm consistent improvement in survival for MM patients and point to the challenge of further extending these improvements to older and minority patients.

摘要

多发性骨髓瘤(MM)生存率此前的改善在少数族裔和老年人中并未得到充分体现。我们推测近年来MM管理方面的改善已经缩小了这些差距。我们利用监测、流行病学和最终结果登记系统来计算1993年至1997年(沙利度胺前)、1998年至2002年(沙利度胺引入)、2003年至2007年(硼替佐米和来那度胺)以及2008年至2012年(前期硼替佐米和来那度胺、卡非佐米和泊马度胺早期可用)在美国被诊断为MM的患者的发病率和相对生存率(RSR)。非西班牙裔白人(NHW)和非西班牙裔黑人(NHB)男性的MM发病率显著增加,但NHB女性和西班牙裔人群中未出现这种情况。所有年龄和种族/族裔组的患者5年RSR(1993 - 1997年与2008 - 2012年)均有所改善。65岁以下患者的10年RSR(1993 - 1997年与2003 - 2007年)有所改善(从19.6%提高到35%;P <.001),但75岁及以上患者未改善(从7.8%提高到9.3%;P =.3)。在65至74岁的患者中,NHW(从11.3%提高到20.5%;P <.001)和西班牙裔(从10.6%提高到20.2%;P =.02)的10年RSR有所改善,但NHB未改善(从12.6%提高到19.5%;P =.06)。这些发现证实了MM患者生存率的持续改善,并指出了将这些改善进一步扩展到老年患者和少数族裔患者面临的挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34fc/5727774/41c786cad8d8/advances002493absf1.jpg

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