Recent trends in multiple myeloma incidence and survival by age, race, and ethnicity in the United States
Recent trends in multiple myeloma incidence and survival by age, race, and ethnicity in the United States
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DOI：
10.1182/bloodadvances.2016002493
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发表时间：
2017-01-10
期刊：
影响因子：
7.5
通讯作者：
Brown, Elizabeth E.
中科院分区：
文献类型：
--
作者：
Costa, Luciano J.;Brill, Ilene K.;Brown, Elizabeth E.
在少数民族和老年人中，没有充分观察到多发性骨髓瘤（MM）生存率的改善。我们假设近年来MM管理的改善减少了这些差异。我们使用监测、流行病学和最终结果登记来计算美国1993年至1997年确诊的MM患者的发病率和相对生存率（RSRs（prethalidomide），1998年至2002年（沙利度胺的引入），2003年至2007年（硼替佐米和来那度胺），以及2008年至2012年（硼替佐米和来那度胺的前期，卡非佐米和泊马度胺的早期可用性）。MM发病率在非西班牙裔白人（NHW）和非西班牙裔黑人（NHB）男性中显著增加，但在NHB女性和西班牙裔中没有增加。在所有年龄和人种/种族组的患者中均观察到5年RSRs（1993-1997 vs 2008-2012）改善。< 65岁患者的10年RSRs（1993-1997 vs 2003 - 2007）改善（19.6%-35%; P <0.001），但>= 75岁患者无改善（7.8%-9.3%; P = 0.3）。在65至74岁的患者中，NHWs（11.3% vs 20.5%; P <0.001）和西班牙裔（10.6% vs 20.2%; P = 0.02）的10年RSRs有所改善，但NHB（12.6% vs 19.5%; P = 0.06）没有改善。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和少数民族患者的挑战。
Prior improvements inmultiplemyeloma (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 20032007) improved for patientS < 65 years of age (19.6%-35%; P < .001), but not for patients >= 75 years of age (7.8%-9.3%; P = .3). Among patients 65 to 74 years of age, 10-year RSRs improved for NHWs (11.3% vs 20.5%; P < .001) and Hispanics (10.6% vs 20.2%; P = .02), but not for NHBs (12.6% vs 19.5%; P = .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.