Pathology Queensland, Woolloongabba, Queensland, Australia.
School of Medicine, University of Queensland, Saint Lucia, Queensland, Australia.
Br J Haematol. 2019 Sep;186(6):829-836. doi: 10.1111/bjh.16000. Epub 2019 May 31.
Published studies on the epidemiology of amyloidosis have relied on death certificate data for case ascertainment. We estimated the incidence and mortality burden of amyloidosis among residents of the Australian state, Queensland, aged ≥20 years for the years 1999-2013 based on case ascertainment from histopathology reports. Information systems for participating laboratories were scrutinised to identify histopathology reports that documented a diagnosis of amyloidosis. Case mortality status was determined via linkage to the National Death Index. A total of 447 cases of amyloidosis were identified, with a median age at diagnosis of 66 years. A plasma cell dyscrasia was identified in 72% of patients who had paraprotein studies performed. The estimated incidence for Queenslanders aged ≥20 years was 12·1 cases per million person years. The median survival was 2·45 years. Age at diagnosis, presence of a paraprotein, earlier year of diagnosis, and inner regional location of residence (compared with residence in a major city) were independently associated with reduced survival. Our data confirms previously reported incidence data for amyloidosis of approximately 10 cases per million patient years and indicates that survival for Queensland patients with amyloidosis is improving, though it remains poor for the elderly and patients with AL amyloidosis.
已有研究利用死亡证明数据来确定淀粉样变性的发病情况。我们根据组织病理学报告确定的病例,对澳大利亚昆士兰州≥20 岁的居民进行了 1999 年至 2013 年的淀粉样变性发病率和死亡率的估算。我们仔细审查了参与实验室的信息系统,以识别记录淀粉样变性诊断的组织病理学报告。通过与国家死亡索引的链接确定病例的死亡状态。共发现 447 例淀粉样变性病例,诊断时的中位年龄为 66 岁。进行了副蛋白研究的患者中,72%的患者存在浆细胞异常。对昆士兰州≥20 岁的人群的估计发病率为每 100 万人年 12.1 例。中位生存期为 2.45 年。诊断时的年龄、存在副蛋白、诊断较早的年份以及居住在内陆地区(与居住在主要城市相比)与生存期缩短独立相关。我们的数据证实了淀粉样变性的发病率约为每 100 万患者年 10 例的先前报道数据,并表明昆士兰州淀粉样变性患者的生存率正在提高,但对于老年人和 AL 淀粉样变性患者,生存率仍然较差。