Background. Making a research on incidence and survival of myeloid malignancies we realised that few well documented population-based studies exist on epidemiology of myelodisplastic syndromes (MDS) and chronic myeloproliferative disorders (CMPD). Aims. The goal of our population-based study was to add and improve information about epidemiology of myeloid malignancies. In collaboration with Modena Cancer Registry (MCR) we focalized our attention above all on those haematological malignancies which until few years ago were not recorded in cancer registry because not considered neoplastic. Methods. We examined all new cases of AML, MDS, chronic myeloid leukemia (CML) and CMPD diagnosed in the Province of Modena (population 633.993 at 2001 Census) between 1997 and 2006. Death certificate, cytology and histology report, both local and national reports of hospital admission, ICD-9 code reported in medical records were used as sources for identifying new cases and their outcome. All cases were checked and validated by a haematologist (AB) and a pathologist (GB) by a review of the original pathology report. Clinical and follow-up data were retrieved by active search of discharge letters, review of hospital records and interview of general practitioners. Information on vital status was achieved from official population registries. Age-Standardized Rates (ASR) were calculated according to the World Standard population (Doll et al., 1966). The dates of diagnosis and death or the closing date of study (January 2008) were used to estimate survival. Relative survival was calculated according to Hakulinen approach. Results. A total of 1102 myeloid malignancies were identified of which 304 AML, 238 MDS, 29 CMML, 417 CMPD and 114 CML. The ASR (per 100,000 people) was calculated as 2.4 for AML, 1.3 for MDS, 0.1 for CMML, 3.2 for CMPD and 1 for CML. When reported to European Standard Population the incidence was 3.2 for AML, 2 for MDS, 0.2 for CMML, 4.4 for CMPD and 1.3 for CML. Compared with reports from other European countries our series seems to be characterized by a higher incidence of CMPD, by a lower incidence of MDS and similar incidence of AML. After a median follow-up of 55 months (range 7-128) the median survival for AML was 5 months, for MDS 23 months, for CMML 26 months; median survival for CMPD and CML was not reached. Relevant differences were observed among median survival of different subtypes of AML, MDS and CMPD. The 5-year relative survival for AML was 20% (for AML M3 74%), for MDS 27%, for CMML 23%, for CMPD 87% and for CML 53% (for CML Ph1+ 80%). Conclusions. Our population-based study provides the first analysis of incidence, survival and subtypes distribution of myeloid malignancies performed in Northern Italy. Our results may contribute to better understand the true epidemiology of these diseases, avoiding bias related to referral pattern to myeloid malignancy registries and due to recruiting patients into clinical trials. In the time of emerging innovative treatments the availability of precise epidemiological data could help clinicians in choosing the most appropriate and cost-effectiveness treatment.

INCIDENCE AND SURVIVAL OF MYELOID MALIGNANCIES IN 1102 PATIENTS IN PROVINCE OF MODENA, NORTHERN ITALY / Bari, Alessia; I., Rashid; Marcheselli, Raffaella; G., Bonacorsi; G., Leonardi; Marasca, Roberto; P., Zucchini; F., Giacobbi; Federico, Massimo; Sacchi, Stefano. - In: HAEMATOLOGICA. - ISSN 1592-8721. - ELETTRONICO. - 93:(2008), pp. 304-304. (Intervento presentato al convegno nd tenutosi a Copenhagen, Denmark nel June 12-15, 2008).

INCIDENCE AND SURVIVAL OF MYELOID MALIGNANCIES IN 1102 PATIENTS IN PROVINCE OF MODENA, NORTHERN ITALY

BARI, Alessia;MARCHESELLI, Raffaella;MARASCA, Roberto;FEDERICO, Massimo;SACCHI, Stefano
2008

Abstract

Background. Making a research on incidence and survival of myeloid malignancies we realised that few well documented population-based studies exist on epidemiology of myelodisplastic syndromes (MDS) and chronic myeloproliferative disorders (CMPD). Aims. The goal of our population-based study was to add and improve information about epidemiology of myeloid malignancies. In collaboration with Modena Cancer Registry (MCR) we focalized our attention above all on those haematological malignancies which until few years ago were not recorded in cancer registry because not considered neoplastic. Methods. We examined all new cases of AML, MDS, chronic myeloid leukemia (CML) and CMPD diagnosed in the Province of Modena (population 633.993 at 2001 Census) between 1997 and 2006. Death certificate, cytology and histology report, both local and national reports of hospital admission, ICD-9 code reported in medical records were used as sources for identifying new cases and their outcome. All cases were checked and validated by a haematologist (AB) and a pathologist (GB) by a review of the original pathology report. Clinical and follow-up data were retrieved by active search of discharge letters, review of hospital records and interview of general practitioners. Information on vital status was achieved from official population registries. Age-Standardized Rates (ASR) were calculated according to the World Standard population (Doll et al., 1966). The dates of diagnosis and death or the closing date of study (January 2008) were used to estimate survival. Relative survival was calculated according to Hakulinen approach. Results. A total of 1102 myeloid malignancies were identified of which 304 AML, 238 MDS, 29 CMML, 417 CMPD and 114 CML. The ASR (per 100,000 people) was calculated as 2.4 for AML, 1.3 for MDS, 0.1 for CMML, 3.2 for CMPD and 1 for CML. When reported to European Standard Population the incidence was 3.2 for AML, 2 for MDS, 0.2 for CMML, 4.4 for CMPD and 1.3 for CML. Compared with reports from other European countries our series seems to be characterized by a higher incidence of CMPD, by a lower incidence of MDS and similar incidence of AML. After a median follow-up of 55 months (range 7-128) the median survival for AML was 5 months, for MDS 23 months, for CMML 26 months; median survival for CMPD and CML was not reached. Relevant differences were observed among median survival of different subtypes of AML, MDS and CMPD. The 5-year relative survival for AML was 20% (for AML M3 74%), for MDS 27%, for CMML 23%, for CMPD 87% and for CML 53% (for CML Ph1+ 80%). Conclusions. Our population-based study provides the first analysis of incidence, survival and subtypes distribution of myeloid malignancies performed in Northern Italy. Our results may contribute to better understand the true epidemiology of these diseases, avoiding bias related to referral pattern to myeloid malignancy registries and due to recruiting patients into clinical trials. In the time of emerging innovative treatments the availability of precise epidemiological data could help clinicians in choosing the most appropriate and cost-effectiveness treatment.
2008
93
304
304
Bari, Alessia; I., Rashid; Marcheselli, Raffaella; G., Bonacorsi; G., Leonardi; Marasca, Roberto; P., Zucchini; F., Giacobbi; Federico, Massimo; Sacchi, Stefano
INCIDENCE AND SURVIVAL OF MYELOID MALIGNANCIES IN 1102 PATIENTS IN PROVINCE OF MODENA, NORTHERN ITALY / Bari, Alessia; I., Rashid; Marcheselli, Raffaella; G., Bonacorsi; G., Leonardi; Marasca, Roberto; P., Zucchini; F., Giacobbi; Federico, Massimo; Sacchi, Stefano. - In: HAEMATOLOGICA. - ISSN 1592-8721. - ELETTRONICO. - 93:(2008), pp. 304-304. (Intervento presentato al convegno nd tenutosi a Copenhagen, Denmark nel June 12-15, 2008).
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