Daskalakis Michael, Feller Anita, Noetzli Jasmine, Bonadies Nicolas, Arndt Volker, Baerlocher Gabriela Maria
Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland.
Department of BioMedicalResearch (DMBR), University of Bern, Murtenstrasse 40, 3008 Bern, Switzerland.
Cancers (Basel). 2021 Dec 14;13(24):6269. doi: 10.3390/cancers13246269.
Tyrosine kinase inhibitors (TKI) substantially improved chronic myeloid leukemia (CML) prognosis. We aimed to describe time period- and age-dependent outcomes by reporting real-world data of CML patients from Switzerland.
Population-based incidence, mortality, and survival were assessed for four different study periods and age groups on the basis of aggregated data from Swiss Cantonal Cancer Registries.
A total of 1552 new CML cases were reported from 1995 to 2017. The age-standardized rate (ASR) for the incidence remained stable, while the ASR for mortality decreased by 50-80%, resulting in a five-year RS from 36% to 74% over all four age groups. Importantly, for patients <60 years (yrs), the five-year RS increased only in earlier time periods up to 92%, whereas for older patients (+80 yrs), the five-year RS continued to increase later, however, reaching only 53% until 2017.
This is the first population-based study of CML patients in Switzerland confirming similar data compared to other population-based registries in Europe. The RS increased significantly in all age groups over the last decades after the establishment of TKI therapy. Interestingly, we found a more prominent increase in RS of patients with older age at later observation periods (45%) compared to patients at younger age (10%), implicating a greater benefit from TKI treatment for elderly occurring with delay since the establishment of TKI therapy. Our findings suggest more potential to improve CML therapy, especially for older patients.
酪氨酸激酶抑制剂（TKI）显著改善了慢性髓性白血病（CML）的预后。我们旨在通过报告瑞士CML患者的真实世界数据来描述时间和年龄依赖性结局。
基于瑞士各州癌症登记处的汇总数据，对四个不同研究时期和年龄组的人群发病率、死亡率和生存率进行评估。
1995年至2017年共报告了1552例新的CML病例。发病率的年龄标准化率（ASR）保持稳定，而死亡率的ASR下降了50-80%，导致所有四个年龄组的五年相对生存率从36%提高到74%。重要的是，对于<60岁的患者，五年相对生存率仅在早期时间段增加至92%，而对于老年患者（+80岁），五年相对生存率在后期持续增加，但直到2017年仅达到53%。
这是瑞士第一项基于人群的CML患者研究，与欧洲其他基于人群的登记处相比，证实了类似的数据。在TKI治疗建立后的过去几十年中，所有年龄组的相对生存率均显著提高。有趣的是，我们发现与年轻患者（10%）相比，老年患者在后期观察期的相对生存率增加更为显著（45%），这意味着自TKI治疗建立以来，老年患者从TKI治疗中获得的益处出现延迟。我们的研究结果表明改善CML治疗的潜力更大，尤其是对于老年患者。
