Continued improvement in survival of acute myeloid leukemia patients: an application of the loss in expectation of life.
Continued improvement in survival of acute myeloid leukemia patients: an application of the loss in expectation of life.
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DOI：
10.1038/bcj.2016.3
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发表时间：
2016-02-05
影响因子：
12.8
通讯作者：
Derolf ÅR
中科院分区：
文献类型：
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作者：
Bower H;Andersson TM;Björkholm M;Dickman PW;Lambert PC;Derolf ÅR
我们使用相对生存率（RSRs）和一种称为预期寿命损失（LEL）的指标评估了1973年至2011年诊断的瑞典急性髓性白血病（AML）患者的生存时间趋势。在第一个日历期间，诊断时<60岁的患者的RSR增加最多，但在1997-2005年和2006-2011年期间，诊断时年龄在61-70岁的患者增加最明显; RSR从0.16（95%置信区间（CI）：0.13-0.19）至0.28（95% CI：0.23-0.33）。1975年诊断时35岁男性的LEL为41.0（95% CI：40.1-41.8）岁，2011年为19.5（95% CI：16.4-22.5）岁。对于65岁的男性，相应数字为13.8（95% CI：13.7-14.0）和12.0（95% CI：11.3-12.8）。条件LEL估计表明，诊断后存活5年的患者的剩余寿命比一般人群短。预期寿命损失的比例（PELL）表明，2005年65岁的男性患者预期寿命损失了75%，如果他们在2011年被诊断为66%。生存率持续增加到2011年，诊断时年龄在61-70岁的患者改善更大。LEL和PELL是直观的测量方法，可能有助于向患者、临床医生和医疗保健提供者传达生存统计数据。
We evaluated temporal trends in survival of Swedish acute myeloid leukemia (AML) patients diagnosed between 1973 and 2011 using relative survival ratios (RSRs) and a measure called the loss in expectation of life (LEL). RSRs increased most for patients <60 years at diagnosis during the first calendar periods, but between 1997–2005 and 2006–2011 the most pronounced increase was for those aged 61–70 years at diagnosis; RSR changed from 0.16 (95% confidence interval (CI): 0.13–0.19) to 0.28 (95% CI: 0.23–0.33), respectively. The LEL for males aged 35 years at diagnosis was 41.0 (95% CI: 40.1–41.8) years in 1975 and 19.5 (95% CI: 16.4–22.5) years in 2011. For males aged 65 years, the corresponding figures were 13.8 (95% CI: 13.7–14.0) and 12.0 (95% CI: 11.3–12.8). Conditional LEL estimates suggested that patients who survive 5 years postdiagnosis have shorter remaining lifespan than the general population. The proportion of expected life lost (PELL) suggested that male 65-year-old patients lost 75% of their life expectancy in 2005 and 66% if they were diagnosed in 2011. Survival continued to increase to 2011, with larger improvements in those aged 61–70 years at diagnosis. The LEL and PELL are intuitive measures that may be useful in communicating survival statistics to patients, clinicians and health-care providers.