Chronic Myeloid Leukemia Survival in Older Population in Pre- and Post- Imatinib Era in the United States

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4237-4237 ◽  
Author(s):  
Krishna B Ghimire ◽  
Binay K. Shah
Keyword(s):  
Randomized Clinical Trials ◽  
Conflicts Of Interest ◽  
Survival Rates ◽  
Age Groups ◽  
Relative Survival ◽  
The United States ◽  
Published Data ◽  
Gender And Age ◽  
Z Value ◽  
Improvement In Survival

Abstract Abstract 4237 Background: Median age at diagnosis for CML is 64 years of age. CML survival in elderly population is not well studied. This study was conducted to evaluate the relative survival rates among CML patients older than 50 years in pre- (1991–2000) and post- (2001– 2009) imatinib era. Methods: We analyzed the Surveillance, Epidemiology, and End Results (SEER*Stat) 18 registry database to compare 3-year and 5-year relative survival rates among CML patients by gender and age groups (50–69, ≥70) from the pre- (1991–2000) to post- imatinib eras (2001–2009). We used Z-test in the SEER*Stat program to calculate the differences in relative survival rates among different cohorts. Results: The 3-year and 5-year relative survival rates for CML patients age ≥50 years in pre- (n=3,848) vs post- (n=6,501) imatinib era were: 44.1±0.9% vs 55.9±0.8%, p=<0.0001, Z-value=10.179 at 3-years and 31.4±0.9% vs 46.9±0.9%, p=<0.0001, Z-value=12.361 at 5-years. The 3-year and 5-year relative survival rates for old (50–69) patients in pre- (n=1,723) vs post- (n=3011) imatinib era were: 57.7 ± 1.2% vs 72.3 ±1.0%, p=<0.0001, Z-value=9.454 at 3 years and 44.8±1.3% vs 64.3±1.2%, P=<0.0001, Z-value= 11.365 at 5 years. The survival rates for elderly (≥70) patients in pre (n= 2,125) and post (n=3,490) imatinib era were: 32.4±1.2% and 41.3±1.1%, p=<0.0001, Z-value=5.806 at 3 years and 19.3±1.1% and 31.2±1.2%, P=<0.0001, Z-value=7.135 at 5 years respectively. Table 1 shows CML survival rates by age and sex in patients older than 50 years of age. Conclusions: This study showed significant increase in 3 year and 5 year relative survival rates in post- imatinib era among CML patients older than 50 in all cohorts examined. However, the improvement in survival rates is modest compared to published data from randomized clinical trials. Disclosures: No relevant conflicts of interest to declare.

Survival trends among patients with metastatic bladder cancer in the United States.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 306-306
Author(s):  
Binay Kumar Shah ◽  
Rakesh Mandal
Keyword(s):  
United States ◽  
Bladder Cancer ◽  
Survival Rates ◽  
Age Groups ◽  
Stage Iv ◽  
Relative Survival ◽  
The United States ◽  
Ajcc Stage ◽  
Metastatic Bladder Cancer ◽  
Z Value

306 Background: The chemotherapy regimens for metastatic bladder cancer (MBC) have evolved over the last two decades. Due to favorable toxicity profile, a combination of cisplatin and gemcitabine is widely used for the treatment of MBC since 2000. It is unclear if the survival trend in MBC has changed over last two decades. This study was conducted to evaluate the relative survival rates for patients with MBC in the United States during 1991-1999 and 2000-2008. Methods: We used the Surveillance, Epidemiology, and End Results (SEER*Stat) program to analyze 6-month and 12-month relative survival rates of AJCC stage-IV bladder cancer patients included in the SEER database. We used Z-test in the SEER*Stat program to compare relative survival rates among cohorts of patients categorized by race, gender, and age groups (<60 and ≥60 years). Results: The dataset comprised 9,819 and 986 patients with AJCC stage-IV bladder cancer among Caucasians and African Americans (AA), respectively. Among Caucasian men (<60 years), 6-month survival rates were 85.4±1.7% (n=442) and 77.9±1.3% (n=1,117) for 1991-1999 and 2000-2008, respectively. Similarly, 12-month survival rates in this group were 68.6±2.2% (n=442) and 60.4±1.5% (n=1,117) for 1991-1999 and 2000-2008, respectively. Thus, both 6-month and 12-month survival rates in 2000-2008 were lower among young Caucasians; and the differences were statistically significant when compared to 1991-1999 (6-month: Z-value = -3.205, p=0.001; 12-month: Z-value= -2.984, p=0.003). The survival rates among AA were not statistically significant. Conclusions: In young Caucasian patients (<60 years) with MBC, 6- month and 12-month relative survival rates were lower for the period 2000-2008 compared to 1991-1999. Further studies may be required to evaluate factors responsible for decreased survival rates among this population.

Improvement In Survival of Patients with Multiple Myeloma: An Update of Population Based Survival Trends

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1510-1510
Author(s):  
Dianne Pulte ◽  
Adam Gondos ◽  
Hermann Brenner
Keyword(s):  
Multiple Myeloma ◽  
Conflicts Of Interest ◽  
Treatment Options ◽  
Age Groups ◽  
Relative Survival ◽  
Population Level ◽  
Published Data ◽  
Period Analysis ◽  
Survival Expectations ◽  
Improvement In Survival

Abstract Abstract 1510 Background: Treatment options for multiple myeloma have changed significantly over the past decade with new treatment options demonstrating improved survival in multiple clinical trials. We have previously published data demonstrating that survival has improved on the population level (Brenner et al Blood 2008) and projections of survival expectations for patients recently diagnosed with multiple myeloma which predicted continued improvement in survival for patients diagnosed in the years 2006-10 (Brenner et al Haematologica 2009). Here, we provide updated estimates of survival in myeloma and compare the results to projected survival. Methods: Period analysis was used to calculate 5- and 10-year relative survival for patients diagnosed with multiple myeloma from 1997-01 and 2002-06, using data from the Surveillance, Epidemiology, and End Results (SEER) database. Survival estimates for single years were calculated as well to determine whether changes in survival were ongoing throughout the 2002-06 period. Results: Five and 10-year relative survival in 2002-06 was significantly higher than in earlier time periods and was similar to survival predicted for patients diagnosed 2006–2010 (see table). When individual years between 2002 and 2006 were evaluated, survival was higher in 2005 and 2006 as compared to 2002-4. Survival was higher for all age groups as compared to survival previously calculated by period analysis for 1997–2001 (see table). Conclusions: Survival for patients diagnosed with multiple myeloma is improving for all age groups at a rate faster than predicted by previous models of survival. This implies a greater than linear increase in survival over the early part of the 21st century. Disclosures: No relevant conflicts of interest to declare.

Ethnic Disparities in Survival of Chronic Myeloid Leukemia

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1272-1272
Author(s):  
Krishna B Ghimire ◽  
Binay K. Shah
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Kinase Inhibitors ◽  
Conflicts Of Interest ◽  
Survival Rates ◽  
Ethnic Disparities ◽  
Relative Survival ◽  
Ethnic Disparity ◽  
Z Value ◽  
Improvement In Survival

Introduction: Development of tyrosine kinase inhibitors has led to significant improvement in survival of chronic myeloid leukemia (CML) patients. We conducted this study to evaluate any ethnic disparity in CML survival. Methods: We analyzed surveillance, Epidemiology, and End Results, SEER 18 registry to compare 1 and 3 years relative survival rates of CML patients diagnosed between 2001- 2008 by ethnicity - Caucasian, African American (AA), Others (O). We analyzed survival rates by age (≤65, >65), and time periods: (2001-2004) and (2005-2008). We used SEER*Stat software to calculate Z value. Results: There were 6,306 CML patients during (2001-2008); 3,111 during (2001-2004) and 3,195 during (2005-2008). The 1-year relative survival rates among Caucasians (n=6,306), AA (n=790), and Others (n=532) were 80.0±0.5%, 83.8 ±1.4%, and 84.0±1.7% [Z value 2.43 (AA vs Caucasian), 2.15 (O vs Caucasian)] respectively. The 3 years RS rates were 65.6±0.7%, 70.2±1.8%, and 70.9 ±2.1% respectively with Z value 2.49 (AA vs Caucasian) and 2.42 (Caucasian vs O). Among younger patients (age ≤65 years, n=4,245) Caucasians had better RS compared to AA (83.1±0.7% vs 78.7±1.8%, Z value 2.24) at 3 years. There was no difference survival at 1and 3 years in older patients (age >65 years, n= 3,383). The survival rates of patients diagnosed during 2001-2004 were similar for all ethnic groups. Among patients diagnosed during 2005-2008, survival rates were significantly higher for AA versus Caucasians (1 year RS 86.6±1.8% vs 81.3±0.7%, Z value 2.45, and 3 year RS 73.8±2.4% vs 68.3±0.9%, Z value 2.20). Others also had better RS compared to Caucasians (87.1±2.1% vs 81.3±0.7%, Z value 2.22) at 1 year. There was no racial disparity in survival rates when analyzed by age (≤65 and >65) and sex at 1 and 3 years during 2001-2004 and 2005-2008. Conclusions: Our study showed that there is ethnic disparity in CML survival. Among CML patients diagnosed during 2005-2008, AA and Other races had superior survival rates compared to Caucasians. Disclosures No relevant conflicts of interest to declare.

Improvement in survival in younger patients with acute lymphoblastic leukemia from the 1980s to the early 21st century

Blood ◽  
2009 ◽  
Vol 113 (7) ◽  
pp. 1408-1411 ◽  
Author(s):  
Dianne Pulte ◽  
Adam Gondos ◽  
Hermann Brenner
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Age Groups ◽  
Relative Survival ◽  
The United States ◽  
Period Analysis ◽  
Early 21St Century ◽  
Time Period ◽  
Improvement In Survival ◽  
Difficult Issue

Abstract Acute lymphoblastic leukemia (ALL) is an uncommon but highly fatal disease in adults. We used period analysis to data from the Surveillance, Epidemiology, and End Results (SEER) database to disclose changes in outcomes for patients diagnosed with ALL in the United States in the 2 decades between 1980–1984 and 2000–2004. Major improvement in survival was observed for patients less than 60 years of age. Improvement in survival was greater for women than for men, but was significant for both genders. The greatest improvement was seen in patients aged 15 to 19, in whom 5-year relative survival improved from 41.0% to 61.1%, and 10-year survival improved from 33.0% to 60.4%. Lesser but significant improvements were seen for age groups 20–29, 30–44, and 45–59. Survival for patients aged 60 and over remained essentially unchanged at levels around or below 10%, respectively. Survival has improved for patients with ALL over the time period studied, but treatment of older patients remains a difficult issue.

Survival trends among patients with advanced hepatocellular carcinoma in the United States.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 329-329
Author(s):  
Krishna Bilas Ghimire ◽  
Binay Kumar Shah ◽  
Barsha Nepal
Keyword(s):  
Survival Rates ◽  
Age Groups ◽  
Stage Iv ◽  
Relative Survival ◽  
The United States ◽  
P Value ◽  
Advanced Hepatocellular Carcinoma ◽  
Z Score ◽  
Significant Difference ◽  
End Results

329 Background: Sorafenib was approved by FDA for treatment of HCC in 2007. This study was conducted to evaluate survival outcome in advanced HCC during 2005-2006 and 2008-2009 using U.S. Surveillance, Epidemiology, and End Results (SEER) cancer registry database.Methods: We analyzed the Surveillance, Epidemiology, and End Results (SEER*Stat) database: Incidence - SEER 18 Regs Research Data + Hurricane Katrina Impacted Louisiana Cases, Nov 2011 Sub (1973-2009 varying) using MP-SIR session. We analysed 1 year relative survival rates among stage IV HCC patients between pre- sorafenib (2005- 2006) and post- sorafenib (2008- 2009) eras. We used seer Z test to compare relative survival rates among cohorts of patients categorized by gender and age groups (<50 and >50 years). Results: There were 2,497 (1,180 in pre-sorafenib era and 1,317 in post-sorafenib era) stage IV HCC patients reported in seer database. Overall 1 year relative survival rates ± standard error (SE) were: 12.5±0.7% (12.5±1% in pre sorafenib era vs 13.1±1.1% in post sorafenib era, Z score= 0.481, p value=0.63). Overall Relative survival rates among men and women were 12.9±0.8% (12.7±1.1% in pre vs 13.4±1.2 in post sorafenib era, Z score=0.254, p value=0.79) and 11.8±1.6% (11.7±2.2% in pre vs 11.5±2.5 post sorafenib era, Z score=0.469, p value=0.63) respectively. There was no significant differences between 1 year relative survival rates by age groups (<50 and >50 years). Conclusions: This study showed no significant difference in 1-year relative survival rates during 2008-2009 as compared to 2005-2006. More studies are required to find out why the findings of SHARP trial have not translated to population-based settings.[Table: see text]

Survival In Adult Acute Lymphoblastic Leukemia Survival By Age, Gender and Ethnicity

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1696-1696 ◽  
Author(s):  
Krishna B Ghimire ◽  
Binay K. Shah
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Conflicts Of Interest ◽  
Lymphoblastic Leukemia ◽  
Survival Rates ◽  
Relative Survival ◽  
Younger Patients ◽  
Adult Acute Lymphoblastic Leukemia ◽  
Time Periods ◽  
Improvement In Survival ◽  
End Results

Abstract Background Studies have shown improvement in survival in adult acute lymphoblastic leukemia (ALL) with the use of risk-directed therapy pediatric-inspired regimens. We analyzed US Surveillance, Epidemiology and End Results (SEER) cancer registry database to evaluate whether survival of adult ALL patients has improved in general population. Methods We analyzed US Surveillance, Epidemiology and End Results (SEER) 18 registries using survival session to calculate relative survival rates (RS) during 1973-1989, 1990-1999 and 2000-2009 among adult (≥20 years) ALL patients. We used Z-test in the SEER*Stat software to compare the relative survival rates in several cohorts categorized by race, gender, and age groups (20-39, ≥ 40 years). Results There were 7,435 adult ALL patients reported in SEER 18 registries during 1973-2009. The majority of patients were Caucasian (85%) and Male (57%). The relative survival rates for adult ALL patients between 1973-2009 were 55.8±0.6% and 25.0±0.5% at 1 year and 5 years respectively. The relative survival rates improved significantly for each successive time periods, with an improvement from 45.4%, to 51.6%, to 60.6% at 1 year and, from 15.3%, to 23.7%, to 29.0% at 5 years for time periods 1973-1989, 1990-1999 and 2000-2009 respectively. For younger patients (age 20-39 years), 1- and 5-year RS rates improved from 1973-1989 to 1990-1999 but not from 1990-1999 to 2000-2009. For older patients (age ≥40 years) RS improved for each successive time periods. The 1- and 5- year relative survival rates improved significantly for both male and female patients during successive time periods. Interestingly, although there was significant improvement in survival rates at 1- and 5- years for Caucasians, improvement was not seen for AA adult ALL patients during subsequent time periods examined. Conclusions Although adult ALL survival rates have improved for most cohorts examined, the survival of African American patients has not improved. Similarly, survival rates of younger patients (20-39 years) has not improved from 1990-1999 to 2000-2009. Disclosures: No relevant conflicts of interest to declare.

Acute Myeloid Leukemia Survival In Elderly Patients In The United States

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1690-1690
Author(s):  
Binay K. Shah ◽  
Krishna B Ghimire
Keyword(s):  
United States ◽  
Acute Myeloid Leukemia ◽  
Elderly Patients ◽  
Myeloid Leukemia ◽  
Survival Rates ◽  
Relative Survival ◽  
The United States ◽  
Very Elderly ◽  
Z Value ◽  
Acute Myeloid

Abstract Background Survival in Acute myeloid leukemia (AML) has improved in younger patients over the last decade. Though chemotherapy has not changed significantly, better patient care may have improved survival in AML patients. This study was conducted to evaluate the relative survival rates in older AML patients over two decades in the United States. Methods Newly diagnosed AML (first primary only) in older (age≥75 years) patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database. We analyzed SEER 18 registry database to evaluate relative survival rate in older (≥75 years) AML population diagnosed during 1992-2000. We selected AML patients from 13 SEER registries to compare RS during 1992-2000 and 2001-2009. The relative survival rates at 1 and 5 year were analyzed for various cohorts categorized by race (White, African-Americans (AA) & other), gender & age (≥75-84 and ≥85 years). The relative survival rates accompany standard error (SE). We used SEER-Stat, statistical software provided by NCI for statistical analysis. Results The relative survival rates improved significantly during 2001-2009 compared to 1992-2000 for all age groups, sex. For young elderly patients (≥75-84 years) RS increased from 13.1±0.8% to 17.4±0.9% at 1 year Z value=3.98, P<0.0001 and from 2.0±0.4 to 2.6±0.5%, Z value= 3.61, P<0.0005 at 5 years with improvement in median relative survival from 2.41 to 2.75 months. Similarly, for very elderly (≥85 years) patients RS increased from 5.3±1.0% to 8.0±1.0%, Z value=3.03, P<0.005 at 1 year, 0.7±0.4% to 1.3±0.5% at 3 years Z value= 2.81, P=0.005, but no improvement seen at 5 years. There was significant improvement in RS from 1992-2000 to 2001-2009 in both sexes, caucasian and other races. There was no improvement in RS at 1 year and 5 year for older AA population. (Table) Conclusion The relative survival in elderly AML has increased significantly during 2001-2009 compared to 1992-2000. The RS improved both at 1 year and 5 years for young elderly patients. Improvement in RS was observed at 1 year and 3 years for very elderly (>85 years) AML patients. Disclosures: No relevant conflicts of interest to declare.

Survival differences in metastatic bladder cancer by geography.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 314-314
Author(s):  
Rakesh Mandal ◽  
Binay Kumar Shah
Keyword(s):  
Bladder Cancer ◽  
Survival Rates ◽  
Stage Iv ◽  
Relative Survival ◽  
The United States ◽  
The South ◽  
Northern Latitude ◽  
The North ◽  
Caucasian Men ◽  
Z Value

314 Background: It is unknown if there is any geographical variation in survival among patients with bladder cancer. This study was conducted to evaluate the survival rates in the northern (latitude ≥40o) and southern regions (latitude < 40o) in the United States for the period of 2000-2008. Methods: We used Z-test in the Surveillance, Epidemiology, and End Results (SEER*Stat) program to analyze 1-year and 5-year relative survival rates of bladder cancer patients included in SEER database. Several cohorts categorized by race, gender, and age groups (<60 and ≥60 years) were examined to compare the survival rates in the northern and southern regions of the U.S. Based on the counties’ centroid, northern (latitude ≥40o) and southern (latitude < 40o) regions were determined. Results: The dataset comprised 6,501 and 664 patients with AJCC stage-IV bladder cancer among Caucasian and African Americans respectively. Among Caucasian men (<60 years), 1-year survival rates in the northern and southern regions were 66.2± 2.5% (n=372) and 57.5± 1.9% (n= 738) respectively. Similarly, 5-year year survival rates in the northern and southern regions were 27.5± 2.6% (n=372) and 20.1± 1.7% (n= 738) respectively. Thus the survival for this group was lower in the South compared to the North and was statistically significantly (1-year: Z-value = -2.723, p= 0.006; 5-year: Z-value = -2.909, p= 0.003). There was no significant difference in the survival rates among any other cohorts examined. Conclusions: Caucasian men (<60 year) with stage IV bladder cancer had lower 1- or 5-year relative survival rates in the South compared to the North. The survival difference in young Caucasian men with bladder cancer by geography may be due to differences in tumor biology resulting from the differential exposure to environmental carcinogens.

Survival trends in advanced gastrointestinal stromal tumor patients: A population-based study.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 136-136
Author(s):  
Binay Kumar Shah ◽  
Nibash Budhathoki
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Distant Metastasis ◽  
Survival Rates ◽  
Relative Survival ◽  
The United States ◽  
Population Based ◽  
Stromal Tumor ◽  
And Gender ◽  
Improvement In Survival ◽  
Advanced Gist

136 Background: In February 2002, imatinib was approved by US FDA for treatment of patients with advanced gastrointestinal stromal tumor (GIST). This study was performed to evaluate survival trends in patients with advanced GIST in pre- (1992-2001) and post- (2002-2008) imatinib era in the United States. Methods: We selected adult patients (≥18 years) with advanced GIST (regional and distant metastasis based on SEER’s LRD staging) from the Surveillance, Epidemiology, and End Results 18 database diagnosed during 1992-2008. We excluded patients diagnosed at autopsy or from death certificate only, or those without survival date. We analyzed 1- and 3- year relative survival (RS) rates of the patients by age (all ages,18-64yrs,64+yrs), race [White, Black and Others (American Indian/AK Native, Asian/Pacific Islander)], and gender in pre-imatinib (1992-2001) and post-imatinib (2002-2008) eras. We used Z-test in SEER*Stat to compare RS rates. Results: There were total of 1,734 cases of advanced GIST (regional and distant metastasis) during the study duration. Of the total population, 744 were females and 990 were males. The 1- and 3- year RS rates were significantly higher for patients diagnosed in post-imatinib era compared to those in pre-imatinib era (83.8±1.1% vs 72.5±2.3%; Z 4.47 at one year and 68.8±1.4% vs 51.0± 2.6%; Z 6.25). The survival rates in younger patients (18-64 years) improved significantly in post-imatinib era compared to pre-imatinib era (88.60±1.2% vs 74.20±2.9%; Z 5.19 at 1 year and 75±1.6% vs 56.1±3.4%; Z 5.81 at 3 years). Among older patients, there was improvement in 3- year survival rate (76.90±2% vs 70.40±3.5%; Z 1.22 at 1 year and 59.80±2.5% vs 44.9±4%; Z 2.82 at 3 years). Survival rates improved for both sexes and for Whites and Blacks (1 year RS: 83.80±1.3% vs 73.40±vs2.6%; Z 3.45 for Whites and 85±2.4% vs 68.80±6%; Z 2.53 for Blacks; 3 year RS: 68.60±1.7% vs 51.20±3.1%; Z 5.02 for Whites and 69.10±3.3% vs 42.6±6.6%; Z 3.76 for Blacks). There was no improvement in survival rates for Others. Conclusions: Overall, survival rates of advanced GIST patients have improved significantly in post-imatinib era compared to pre-imatinib era. There was no improvement in survival rates of Others.

Incidence and Survival Outcomes Of Myelodysplastic Syndrome In The United States: A SEER Analysis 2001 - 2010

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5205-5205
Author(s):  
Hari Prasad Ravipati ◽  
Srinadh Annangi ◽  
Vamsi Kota
Keyword(s):  
United States ◽  
Median Survival ◽  
Conflicts Of Interest ◽  
Large Population ◽  
Survival Rates ◽  
Relative Survival ◽  
The United States ◽  
Incidence Rates ◽  
Significant Difference ◽  
Metropolitan Counties

Abstract Introduction Myelodysplastic syndromes (MDS) are a group of hematological disorders leading to ineffective hematopoiesis and excess blast formation. We aimed to establish the incidence rates and median survival periods in MDS by gender, race and geographic location in a large population cohort. Methods We performed a retrospective analysis of the United States (US) SEER database for MDS cases diagnosed between 2001 and 2010 using ICD-0-3 histology codes 9980/3, 9982/3, 9983/3, 9984/3 and 9986/3. Incidence rates were calculated using the 2000 US standard population. Five-year relative survival rates were measured using the Kaplan-Meier method after excluding cases diagnosed by death certificate and autopsy. Results 14,920 cases were identified of which 87.2 % (n = 13,009) were present in age group sixty years and above. Age-adjusted incidence rates (per 100,000) for males were 14.8, 10.0, and 12.7 for white, black and other races respectively. The rates for females were 7.7, 7.1, and 7.0. On US county wise MDS case analysis, 11296 (86.8%) of cases were diagnosed in metropolitan counties and 1694 (13%) cases in nonmetropolitan counties. Median relative survival for white, black and other males were 27 months, 36 months and 24 months respectively ; 35 months, 38 months and 37 months for females. Five-year relative survival for white, black, and other males were 32.5% (95% CI 30.7- 34.3), 36.1% (95% CI 28.3 - 43.9) and 30% (95% CI 24.2 - 36.0) vs. 36.2% (95%CI 34.1 - 38.3), 41.1% (95% CI 34.4 - 47.8) and 37.3% (95% CI 30.2 - 44.5) for females. Median relative survival for cases from metropolitan and non-metropolitan counties were 31 months and 31 months respectively. Five-year relative survivals were 35.1% (95% CI 33.7-36.5) and 32.6% (95% CI 29.1-36.0) for metropolitan and non-metropolitan counties MDS cases respectively. Conclusion The incidence of MDS was higher in males compared to females with the highest rate in white males. Survival rates were similar in both sexes. No significant difference in survival rates were seen among the racial groups. No significant difference in the median survival and five-year relative survival rates were noticed between metropolitan and non-metropolitan groups. Disclosures: No relevant conflicts of interest to declare.

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