Trends of incidence and survival of patients with chronic myelomonocytic leukemia between 1999 and 2014: A comparison between Swiss and American population-based cancer registries.


Journal

Cancer epidemiology
ISSN: 1877-783X
Titre abrégé: Cancer Epidemiol
Pays: Netherlands
ID NLM: 101508793

Informations de publication

Date de publication:
04 2019
Historique:
received: 15 11 2018
revised: 31 12 2018
accepted: 04 01 2019
pubmed: 29 1 2019
medline: 12 2 2020
entrez: 29 1 2019
Statut: ppublish

Résumé

Chronic myelomonocytic leukemia (CMML) is a rare hematopoietic malignancy. Treatment with hypomethylating agents (HMA) was introduced between 2004 and 2006 but its impact on population-based survival remains controversial. The aim of this study was to investigate epidemiological characteristics and survival before and after introduction of HMA treatment. We performed a population-based analysis of CMML cases reported to the Cantonal Cancer Registries in Switzerland (SWISS) and the Surveillance, Epidemiology, and End Results (SEER) Program from the United States for 1999-2006 (before HMA) and 2007-2014 (after HMA). Time trends were compared for these two time periods. 423 and 4144 new CMML cases were reported to the SWISS and SEER registries, respectively. We observed an increasing proportion of older patients ≥75 years in the SWISS (50.3%-62.3%) compared to a decreasing one in the SEER population (59.1%-55.1%). Age standardized incidence-rates were similar and remained stable in both countries (0.32-0.38 per 100'000 py). Relative survival (RS) improved significantly in the SEER (3 years 27%-37%; 5 years 19%-23%; p < 0.001 for both) but remained stable in the SWISS population (3 years 48% to 40%; 5 years 34% to 26%; n.s. for both). With the exception of opposing age-trends, epidemiologic characteristics are similar in both countries and comparable to other population-based registries. RS remains poor and different time trends of population-based survival cannot be faithfully explained by HMA but most likely by changes in diagnostic accuracy within prognostically distinct age-groups.

Sections du résumé

BACKGROUND
Chronic myelomonocytic leukemia (CMML) is a rare hematopoietic malignancy. Treatment with hypomethylating agents (HMA) was introduced between 2004 and 2006 but its impact on population-based survival remains controversial. The aim of this study was to investigate epidemiological characteristics and survival before and after introduction of HMA treatment.
METHODS
We performed a population-based analysis of CMML cases reported to the Cantonal Cancer Registries in Switzerland (SWISS) and the Surveillance, Epidemiology, and End Results (SEER) Program from the United States for 1999-2006 (before HMA) and 2007-2014 (after HMA). Time trends were compared for these two time periods.
RESULTS
423 and 4144 new CMML cases were reported to the SWISS and SEER registries, respectively. We observed an increasing proportion of older patients ≥75 years in the SWISS (50.3%-62.3%) compared to a decreasing one in the SEER population (59.1%-55.1%). Age standardized incidence-rates were similar and remained stable in both countries (0.32-0.38 per 100'000 py). Relative survival (RS) improved significantly in the SEER (3 years 27%-37%; 5 years 19%-23%; p < 0.001 for both) but remained stable in the SWISS population (3 years 48% to 40%; 5 years 34% to 26%; n.s. for both).
CONCLUSIONS
With the exception of opposing age-trends, epidemiologic characteristics are similar in both countries and comparable to other population-based registries. RS remains poor and different time trends of population-based survival cannot be faithfully explained by HMA but most likely by changes in diagnostic accuracy within prognostically distinct age-groups.

Identifiants

pubmed: 30690330
pii: S1877-7821(18)30650-7
doi: 10.1016/j.canep.2019.01.003
pii:
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

51-57

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

Sonia Benzarti (S)

Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Switzerland.

Michael Daskalakis (M)

Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Switzerland.

Anita Feller (A)

Foundation National Institute for Cancer Epidemiology and Registration (NICER) c/o University of Zurich, Switzerland.

Vera Ulrike Bacher (VU)

Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Switzerland.

Annatina Schnegg-Kaufmann (A)

Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Switzerland; Department for BioMedical Research, University of Bern, Switzerland.

Axel Rüfer (A)

Division of Hematology and Central Hematology Laboratory, Cantonal Hospital Lucerne, Switzerland.

Andreas Holbro (A)

Divisions of Hematology, Department of Medicine, University Hospital Basel, Switzerland.

Adrian Schmidt (A)

Clinic of Medical Oncology and Hematology, City Hospital Triemli Zurich, Switzerland.

Rudolf Benz (R)

Clinic of Oncology/Hematology, Cantonal Hospital Muensterlingen, Switzerland.

Max Solenthaler (M)

Clinic of Oncology/Hematology, Cantonal Hospital Thun, Switzerland.

Georg Stussi (G)

Clinic of Hematology, Oncology Institute of Southern Switzerland, Switzerland.

Volker Arndt (V)

Foundation National Institute for Cancer Epidemiology and Registration (NICER) c/o University of Zurich, Switzerland; Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.

Nicolas Bonadies (N)

Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Switzerland; Department for BioMedical Research, University of Bern, Switzerland. Electronic address: Nicolas.Bonadies@insel.ch.

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