Division of Hematology-Oncology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea.
Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea.
Cancer Med. 2020 Aug;9(15):5335-5344. doi: 10.1002/cam4.3179. Epub 2020 Jun 3.
We analyzed the patterns of diagnosis, treatment, and prognoses of acute myeloid leukemia (AML) patients with and without disabilities. The data were collected from the National Disability Database, the Korean Central Cancer Registry, and the Korean National Health Insurance claim database. We built a cohort of 2 776 450 people with disabilities and a nondisabled cohort of 8 329 350 people who were selected at a ratio of 1:3 by matching age and sex. From this population, adult patients who were diagnosed with AML were analyzed. The number of patients with AML were 26.74 per 100 000 in people without disabilities and 20.39 per 100 000 in those with disabilities (P < .0001). The proportion of AML patients receiving chemotherapy and those of patients receiving transplants were significantly lower in the disabled population than that of nondisabled populations (71.2% vs 77.1%, P = .0031, and 17.5% vs 26.9%, P = .002). This trend was more pronounced in subgroups of communication disability and major internal organ disorder. The median survival was 10.8 months for patients with disabilities, which was significantly shorter than 17.1 months for those without a disability (P = .002). Individuals with disabilities have a low diagnosis rate of AML and undergo less active treatment, which results in inferior prognosis.
我们分析了有无残疾的急性髓系白血病 (AML) 患者的诊断、治疗和预后模式。这些数据来自国家残疾数据库、韩国中央癌症登记处和韩国国家健康保险索赔数据库。我们构建了一个由 2776450 名残疾人和 8329350 名非残疾者组成的队列,这些非残疾者是通过年龄和性别匹配选择的,比例为 1:3。从这个人群中,我们分析了成年 AML 患者。在非残疾人群中,AML 患者的人数为每 100000 人 26.74 人,而在残疾人群中为每 100000 人 20.39 人(P<.0001)。在残疾人群中,接受化疗和接受移植的 AML 患者比例明显低于非残疾人群(71.2%比 77.1%,P=.0031,和 17.5%比 26.9%,P=.002)。这种趋势在沟通障碍和主要内部器官障碍亚组中更为明显。残疾患者的中位生存期为 10.8 个月,明显短于非残疾患者的 17.1 个月(P=.002)。有残疾的个体 AML 诊断率较低,接受的治疗不那么积极,因此预后较差。