Improved patient survival for acute myeloid leukemia: a population-based study of 9729 patients diagnosed in Sweden between 1973 and 2005
Improved patient survival for acute myeloid leukemia: a population-based study of 9729 patients diagnosed in Sweden between 1973 and 2005
复制标题
DOI：
10.1182/blood-2008-09-179341
复制
发表时间：
2009-04-16
期刊：
影响因子：
20.3
通讯作者：
Bjorkholm, Magnus
中科院分区：
文献类型：
--
作者：
Derolf, Asa Rangert;Kristinsson, Sigurdur Yngvi;Bjorkholm, Magnus
我们评估了1973年至2005年在瑞典确诊的所有登记的急性髓系白血病(AML)患者的生存模式(N=9729；中位年龄69岁)。患者被分成6个年龄组和4个历期(1973-1980年、1981-1988年、1989-1996年和1997-2005年)。计算相对存活率作为患者存活率的衡量标准。随着时间的推移，所有年龄组的一年生存率都有所提高，而除了80岁以上的患者外，所有年龄组的5年和10年生存率都有所改善。0~18岁、19~40岁、41~60岁、61~70岁、71~80岁、80岁以上5年相对生存率分别为0.65、0.58、0.36、0.15、0.05、0.01。强化化疗、支持性护理的持续改进和异基因干细胞移植可能是导致这一发现的最重要因素。相比之下，在1993-2005年间，有骨髓增生异常综合征诊断的AML患者的存活率没有改善(n=219)。总而言之，在过去的几十年里，AML的存活率有所提高。然而，大多数AML患者死于他们的疾病和年龄仍然是一个重要的预后预测因素。需要具有更有利毒性的新的有效药物来提高存活率，特别是在老年人中。(血。2009；113：3666-3672)
We evaluated survival patterns for all registered acute myeloid leukemia (AML) patients diagnosed in Sweden in 1973 to 2005 (N = 9729; median age, 69 years). Patients were categorized into 6 age groups and 4 calendar periods (1973-1980, 1981-1988, 1989-1996, and 1997-2005). Relative survival ratios were computed as measures of patient survival. One-year survival improved over time in all age groups, whereas 5- and 10-year survival improved in all age groups, except for patients 80+ years. The 5-year relative survival ratios in the last calendar period were 0.65, 0.58, 0.36, 0.15, 0.05, and 0.01 for the age groups 0 to 18, 19 to 40, 41 to 60, 61 to 70, 71 to 80, and 80+ years, respectively. Intensified chemotherapy, a continuous improvement in supportive care, and allogeneic stem cell transplantation are probably the most important factors contributing to this finding. In contrast, there was no improvement in survival in AML patients with a prior diagnosis of a myelodysplastic syndrome during 1993 to 2005 (n = 219). In conclusion, AML survival has improved during the last decades. However, the majority of AML patients die of their disease and age remains an important predictor of prognosis. New effective agents with a more favorable toxicity profile are needed to improve survival, particularly in the elderly. (Blood. 2009; 113: 3666-3672)