Comparison of Age at Diagnosis, Cytogenetic Risk, and Overall Survival Between Acute Myeloid Leukemia Patients of White and South Asian Race/Ethnicity in the United States

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3753-3753
Author(s):  
Tao Zou ◽  
Ashley M. Perry ◽  
Andrew M. Brunner ◽  
Chepsy C Philip ◽  
Donna S. Neuberg ◽  
...  
Keyword(s):  
Old Age ◽  
South Asian ◽  
South Asians ◽  
Age Distribution ◽  
Age At Diagnosis ◽  
Age Group ◽  
Asian Populations ◽  
Younger Age ◽  
The Us ◽  
Race Ethnicity

Abstract Introduction: Acute myeloid leukemia (AML) is more frequent among older patients in the United States (US), with a median age at diagnosis of 67 years old. A recent case series of AML patients from India reported a median age at diagnosis of 40 years old, suggesting that the pathogenesis of AML may differ between these populations (British Journal of Haematology 2015;170:110). In this study, we examined whether differences exist in the age at diagnosis, cytogenetic risk, and overall survival (OS) of White and South Asian patients diagnosed with AML in the US. Methods: We used the 1973-2012 Surveillance, Epidemiology, and End Results Program (SEER) database to identify adults, age 20 years or older, diagnosed with AML between 2000 and 2012. We included patients with documented race/ethnicity and known age at diagnosis. We compared age at diagnosis, cytogenetic risk, and OS according to White or South Asian race/ethnicity, based on patient surname as defined by SEER. We stratified age at diagnosis into age groups, defined as 20-24, 25-34, 35-44, 45-54, 55-64, and >65 years old, to compare the White and South Asian populations. Using the 2012 US Census population age distributions, we directly standardized the distribution of age at diagnosis of AML in SEER, weighted according to the age distribution of the total White and South Asian populations in the US. We categorized SEER-reported cytogenetic profiles as having favorable or adverse prognosis based on accepted definitions. We compared cytogenetic risk and OS between White and South Asian populations according to stratified age group at diagnosis. Differences in age at diagnosis were calculated using the Mann-Whitney test. OS was compared by the Log-rank test and estimated by the method of Kaplan and Meier. P-values <0.05 were considered significant. Results: 39,192 patients, age 20 years old and above, were diagnosed with AML from 2000 to 2012 and had documented race/ethnicity at diagnosis in the SEER database. South Asian patients in the US were diagnosed with AML at a significantly younger age compared to White patients (Figure 1A, median age at diagnosis of 57 vs. 69.5 years old for South Asians (n=265) vs. Whites (n=33,419), p=<0.0001). Along with younger age at diagnosis, South Asians had a greater reported frequency of favorable cytogenetic risk (17.7% vs. 9.7% favorable cytogenetic risk for South Asians vs. Whites). Analysis of the demographics of the US population also showed that the South Asian population was significantly younger than the White population (median age of 40 vs. 50 years old for South Asians (n=2,447,009) vs. Whites (n=172,366,410), p=<0.0001). Direct standardization of the age at AML diagnosis with the age distributions of White and South Asian census populations in the US abrogated the differences in age at diagnosis between these groups (Figure 1B, p=0.8718). Standardization by age distribution also narrowed the difference in favorable cytogenetic risk between Whites and South Asians (17.9 vs. 19.1 cases per one million people, respectively). OS was not different between Whites and South Asians in the 20-49 year old age group (median OS: 46 vs. 60 months for Whites (n=5,272) vs. South Asians (n=96), p=0.4986), the 50-64 year old age group (median OS: 13.5 vs. 16 months for Whites (n=6,066) vs. South Asians (n=62), p=0.5088), or the >65 year old age group (median OS: 3 vs. 4.5 months for Whites (n=13,692) vs. South Asians (n=66), p=0.8491). Conclusions: In the US, AML patients of South Asian descent are diagnosed at a younger age and have more favorable cytogenetic risk profiles as compared to their White counterparts, which is of epidemiologic importance. Nevertheless, these findings appear to reflect the younger age distribution of the entire South Asian population as compared to the total White population in the US, rather than a difference in the inherent biology or pathogenesis of AML. These data highlight the importance of directly standardizing age distributions in population outcomes research. Disclosures Fathi: Agios Pharmaceuticals: Other: Advisory Board participation; Merck: Other: Advisory Board participation; Seattle Genetics: Other: Advisory Board participation, Research Funding.

scholarly journals Fifteen-year trends and differences in mortality rates across sex, age, and race/ethnicity in patients with brainstem tumors

2021 ◽  
Author(s):  
Yusuke Tomita ◽  
Yoshihiro Tanaka ◽  
Nozomu Takata ◽  
Elizabeth A Hibler ◽  
Rintaro Hashizume ◽  
...  
Keyword(s):  
Racial Differences ◽  
Age Groups ◽  
Mortality Rates ◽  
Older Age ◽  
Age Group ◽  
Younger Age ◽  
The Us ◽  
Brainstem Tumors ◽  
Race Ethnicity ◽  
Adjusted Incidence

Abstract Background Localization of tumors to the brainstem carries a poor prognosis, however, risk factors are poorly understood. We examined secular trends in mortality from brainstem tumors in the US by age, sex, and race/ethnicity. Methods We extracted age-adjusted incidence-based mortality rates of brainstem tumors from the Surveillance, Epidemiology and End Results (SEER) database between 2004 and 2018. Trends in age-adjusted mortality rate (AAMR) were compared by sex and race/ethnicity among the younger age group (0-14 years) and the older age group (&gt;15 years) respectively. Average AAMRs in each 5-year age group were compared by sex. Results This study included 2,039 brainstem tumor-related deaths between 2004 and 2018. Trends in AAMRs were constant during the study period in both age groups, with 3 times higher AAMR in the younger age group compared to the older age group. Males had a significantly higher AAMR in the older age group, while no racial differences were observed. Intriguingly, AAMRs peaked in patients 5-9 years of age (0.57 per 100,000) and in patients 80-84 years of age (0.31 per 100,000), with lower rates among middle-aged individuals. Among 5-9 years of age, the average AAMR for females was significantly higher than that of males (p=0.017), whereas the reverse trend was seen among those 50-79 years of age. Conclusions Overall trends in AAMRs for brainstem tumors were constant during the study period with significant differences by age and sex. Identifying the biological mechanisms of demographic differences in AAMR may help understand this fatal pathology.

Abstract P199: Mean Lipoprotein Levels and Composition in South Asian-Americans Compared to the US Population

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Elena Flowers ◽  
Cesar Molina ◽  
Ashish Mathur ◽  
Bradley Aouizerat ◽  
Mintu Turakhia
Keyword(s):  
South Asian ◽  
South Asians ◽  
Low Density Lipoproteins ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Low Density ◽  
Cvd Risk ◽  
South Asian Americans ◽  
Lowering Therapy ◽  
The Us

Background South Asians have increased disk for cardiovascular disease (CVD) that is not captured by traditional risk factors, including TC and LDL-c. Low-density apolipoprotein-B (apoB) containing lipoproteins are heterogeneous in size and composition, and the particles with the greatest triglyceride content are thought to ultimately be the most atherogenic. Specific composition of low-density lipoproteins is not captured by common lipid measures (i.e. TC, LDL-c). A high proportion of triglyceride-rich low-density lipoproteins could be a mechanism for CVD risk in South Asians. Our objective was to compare mean TC, LDL-c, HDL-c, triglycerides, and apoB-triglyceride ratio (an estimate of low-density lipoprotein content) between South Asian-Americans and the US population. Methods We studied 2,876 South Asian adults living in the United States participating in a wellness program. Demographics were obtained by self-report. Lipoprotein levels were measured after 10-hour fast. US population means were calculated from NHANES (2007-2008, n = 5,113). Individuals on lipid-lowering therapy were excluded (780 (33%) South Asians, 1,194 (19%) NHANES). Results LDL-c (118mg/dL vs 116mg/dL, p<0.05) and triglycerides (139mg/dL vs 131 mg/dL, p<0.05) were higher in South Asians than the US population, whereas TC was lower (192mg/dL vs 197 mg/dL, p<0.05). HDL-c was lower in South Asians (46mg/dL vs 52mg/dL, p<0.05). ApoB was not statistically significantly different (93mg/dL vs 92mg/dL, p = 0.1), however the apoB/triglyceride ratio was lower in South Asians (0.8 vs 0.9, p<0.05). After stratifying for age by decade and gender, we found that South Asians have lower HDL-c until the age of 50, and lower apoB/triglyceride ratio until the age of 60, with no substantial differences between men and women. Conclusions Mean TC, LDL-c, and triglycerides were normal in South Asians, however the apoB/triglyceride ratio was lower in South Asians than in the US population. This finding indicates that a higher proportion of low-density lipoproteins in South Asians are of the triglyceride-rich atherogenic type. This may portend non-HDL-c as a better indicator of CVD risk than LDL-c in South Asians. Further, low apoB/triglyceride ratio and low HDL-c occurs at a young age in South Asians, suggesting that onset of risk is early. The disappearance of these patterns after age 60 may be the result of sample bias (excluding individuals on lipid lowering therapy), and/or survival bias.

Promoting allyship among South Asian and Arab Muslims toward Black and Latino/a Muslims in American Islamic centers

2021 ◽  
Author(s):  
Nausheen Pasha-Zaidi ◽  
Meg Aum Warren ◽  
Yvonne Pilar El Ashmawi ◽  
Neneh Kowai-Bell
Keyword(s):  
South Asian ◽  
South Asians ◽  
The United States ◽  
Muslim Americans ◽  
Social Categories ◽  
Islam In America ◽  
The Us ◽  
Racial Dialogue ◽  
Muslim Communities ◽  
Black And Latino

Increased social justice awareness in the United States and shifting demographics are giving birth to a more diverse and egalitarian generation. Improving relations across social categories has been a key topic in di-versity, equity, and inclusion work, but less emphasis has been placed on cross-racial allyship within mi-nority populations. While allyship in racial contexts is often perceived as a White versus non-White issue, this binary position erases the diversity that exists within communities of color. A dichotomous approach to allyship that positions White heterosexual males as the primary holders of privilege does not address the disparities that exist within and across minoritized communities. While Arabs and South Asians are minori-ties in the US on a macrolevel, they often hold privileged positions in Islamic centers and other Muslim spaces—even though Black Americans make up a larger percentage of the Muslim population. Additional-ly, there is an increasing number of Latino/a Muslims in the US, but they are often invisible in larger con-versations about Islam in America as well as in discourse among Muslim Americans. In this chapter, we explore the concept of allyship and how South Asian and Arab Muslims can support and advocate for Black and Latino/a Muslims in American Islamic centers. We also discuss Islamophobia in the US as well as the anti-Blackness and racism that exists within Muslim communities and provide suggestions on how Islamic centers can serve as spaces of allyship and cross-racial dialogue.

Abstract P149: A Large-scale Multi Ethnic Study of a Direct Measure of Insulin Sensitivity Demonstrates That South Asians are the Most Insulin Resistant Ethnic Group in the US

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Monica S Divakaruni ◽  
Fahim Abbasi ◽  
Manisha Desai ◽  
Cynthia A Lamendola ◽  
Latha Palaniappan ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Ethnic Group ◽  
Ethnic Groups ◽  
South Asian ◽  
Large Scale ◽  
South Asians ◽  
Insulin Resistant ◽  
The Us ◽  
Resistant Group ◽  
Direct Measures

Introduction: Insulin resistance (IR) is a known risk factor for heart disease. Few studies have compared race/ethnic differences in IR using ‘gold standard’ direct measures of insulin sensitivity. Methods: A total of 892 non-diabetic subjects (548 White, 106 South Asian, 103 East Asian, 86 Hispanic and 49 Black) underwent a 4-hour insulin suppression test (IST) as a part of various IR related studies at Stanford over the last ∼20 years. We used generalized estimating equations assuming an exchangeable correlation structure to determine the association between race/ethnicity and steady state plasma glucose (SSPG) derived from an IST, accounting for correlation of outcomes among subjects from the same study. We similarly determined whether differences in plasma triglyceride (TG) and high-density lipoprotein (HDL) levels among race/ethnic groups could be explained by differences in SSPG. All analyses were adjusted for age, sex, and BMI. Results: Significant differences among the race/ethnic groups in SSPG were observed (p <0.001). South Asians were the most insulin resistant group with a mean increase in SSPG of 38 mg/dL, compared to whites after controlling for age, sex, and BMI, a difference equivalent to ∼1/2 of the standard deviation of SSPG. East Asians were the next most resistant group (mean +33 mg/dl SSPG compared to whites) followed by Hispanics (+20 mg/dl), Whites, and Blacks (−7 mg/dl). South Asians were the only group with significantly higher TG (mean +1.16 fold, p=0.04) and lower HDL (−3.0 mg/dl, p=0.02) levels compared to whites but these differences were no longer evident after controlling for SSPG. In contrast, Blacks had significantly lower TG (mean 0.8 fold, p = 0.006) compared to whites, but this difference was not at all mitigated after adjusting for SSPG. Blacks also had no significant differences in HDL compared to whites. Conclusions: Direct measures of insulin sensitivity suggest that South Asians are the most insulin resistant race/ethnic group in the US even after adjusting for the principal determinants of IR. IR may be largely responsible for differences in TG and HDL observed between South Asian and other race/ethnic groups. The etiologies behind differences in insulin sensitivity across race/ethnic groups remain to be determined.

Diabetes in South Asians

2011 ◽  
pp. 1799-1803
Author(s):  
A. Ramachandran ◽  
C. Snehalatha
Keyword(s):  
South Asian ◽  
Indian Subcontinent ◽  
South Asians ◽  
Stress Factors ◽  
Rapid Urbanization ◽  
Asian Populations ◽  
Adults And Children ◽  
Diabetic Population

Developing countries, mainly in the Indian subcontinent and China, contribute nearly 80% to the rising global diabetic population. Conservative estimates, based on population growth, ageing of population, and rate of urbanization in Asia, show that India and China will remain the top two countries with the highest number of people with diabetes by 2025: 71 and 38 million, respectively. Two other South Asian countries, Pakistan and Bangladesh, also are in the top ten list. The South Asian populations of Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka are racially heterogeneous, but all have high risk for diabetes and cardiovascular diseases. Type 1 diabetes is relatively less common, and nearly 95% of all diabetic cases in these regions are type 2 diabetes. The steady rise in the prevalence of diabetes seen in last three decades coincides with rapid urbanization and industrialization, and associated sociological and political changes, occurring in these countries (1). Among the populations, physical activity has reduced significantly, intake of energy-dense food has increased, and mental and physical stress factors associated with urban living have also increased. A tilt in the energy balance towards conservation and fat deposition has contributed to the alarming increase in the rate of obesity, both in adults and children.

Higher Incidence of Chronic Myeloid Leukemia (CML) Among Blacks Compared to Whites in the Post-Imatinib Period (2002–2009) Corresponds with Worse Survival Observed within the Surveillance, Epidemiology and End Results 18 Registries

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3773-3773
Author(s):  
Adam Mendizabal ◽  
Paul H Levine
Keyword(s):  
Tyrosine Kinase ◽  
Incidence Rate ◽  
Kinase Inhibitors ◽  
Age Groups ◽  
Incidence Rates ◽  
Age At Diagnosis ◽  
Age Group ◽  
Risk Of Death ◽  
Younger Age ◽  
Adjusted Incidence

Abstract Abstract 3773 Background: Age at diagnosis of CML varies by race in the United States with median occurring around ages 54 and 63 among Black and White patients, respectively. The treatment paradigm shifted when Imatinib was approved in 2001 for treatment of CML. More recently, second generation tyrosine kinase inhibitors (TKI) have also been used for treatment of CML. Differences in outcomes by race have been previously reported prior to the TKI treatment period. We aimed to assess whether the earlier age at diagnosis resulted in differential trends in age-adjusted incidence rates and survival outcomes by race in the post-Imatinib treatment period. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) 18 Registries were extracted for diagnoses between 2002 and 2009 based on the assumption that cases diagnosed after 2002 would be treated with TKI's. CML was defined according to the International Classification of Diseases for Oncology 3rd edition code 9863 (CML-NOS) and 9875 (CML-Philadelphia Chromosome Positive). Cases diagnosed by autopsy or death certificate only were excluded. Incidence rates are expressed per 100,000 person-years and age-adjusted to the 2000 US Standard Population. Black/White incidence rate ratios (IRRBW) are shown with corresponding 95% confidence intervals (CI). Kaplan-Meier estimates of CML-specific survival (CPS) and overall survival (OS) were estimated at 5-years post-diagnosis with the event being time to CML-specific death or any death, respectively. Stratified Cox proportional hazards models were constructed to assess the impact of age and race on the risk of death expressed as a hazard ratio (HR). Results: Since 2002, 6,632 patients diagnosed with CML were reported to the SEER 18 registries including 5,829 White patients (87.9%) and 803 Black patients (12.1%) with 57% being male. The age-adjusted incidence rate for Blacks was 1.18 (95% CI, 1.10–1.27) per 100,000 and 1.12 (95% CI, 1.09–1.27) per 100,000 for Whites. The corresponding IRRBW was 1.06 (95% CI, 0.98– 1.14). When considering 20-year age-groups, Blacks had higher incidence rates in the 20–39 and 40–59 age groups; IRRBW of 1.26 (95% CI, 1.06–1.49; p=0.0073) and 1.23 (95% CI, 1.09–1.39; p=0.0007), respectively. No statistically significant differences in IRRBW were seen within the 0–19, 60–79 and 80+ age-groupings although Whites have higher non-significant incidence rates in the latter 2 age-groups. Differences in IRRBW prompted an assessment of survival to determine if the excess incidence observed in the younger age groups corresponded with a worse survival. CPS at 5-years was 85.5% (95% CI, 84.3–86.6). In univariate analysis, age was an important predictor of outcome (p<0.0001) with patients diagnosed after age 80 having the worse outcomes (OS: 58.3%), followed by patients diagnosed between 60 and 79 years (OS 84.7%), 0–19 years (OS: 87.1%), 40–59 years (OS: 90.2%), and 20–39 years (OS: 92.6%). When considering all age-groups, race was not a significant predictor of death (HR 0.91; 95% CI, 0.72–1.15). However, in a stratified analysis with 20-year age groups, Blacks had an increased risk of death as compared to Whites (Figure 1) in the 20–39 age group (HR: 2.94; 95% CI, 1.72–5.26; p<0.0001) and the 40–59 age group (HR: 1.67; 95% CI, 1.22–2.27; p=0.0069) while no differences were seen within the 0–19, 60–79 and 80+ age groups. Conclusions from OS models were similar to that of the CPS models. Conclusions: Through this analysis of population-based cancer registry data collected in the US between 2002 and 2009, we show that Blacks have a younger age at diagnosis with higher incidence rates observed in the 20–39 and 40–59 age-groups as compared to Whites. Both CPS and OS outcomes differed by race and age. Similar to the differences observed with the incidence rates, survival was worse in Blacks diagnosed within the 20–39 and 40–59 age-groups as compared to Whites. Although outcomes have globally improved in patients with CML since the advent of tyrosine kinase inhibitors, the persistence of incidence heterogeneity and poorer survival among Blacks warrants further attention. Access to care may be a possible reason for the differences observed but further studies are warranted to rule out biological differences which may be causing an earlier age at onset and poorer survival. Disclosures: No relevant conflicts of interest to declare.

Electric Convulsion Treatment in Patients Over 60

1945 ◽  
Vol 91 (382) ◽  
pp. 101-103 ◽  
Author(s):  
W. Mayer-Gross
Keyword(s):  
Clinical Picture ◽  
Age Distribution ◽  
Age Group ◽  
Middle Aged ◽  
Retrospective Survey ◽  
Younger Age ◽  
Depressive States

In view of the success of E.C.T. in depressive states of the middle-aged it seemed worth while to take the risk of extending its benefit to patients over 60, whose clinical picture often differs very little from that of the next younger age-group. Since January, 1941, when E.C.T. was first used in the Crichton Royal, an increasing number of such patients has been treated. It is proposed to give a short, retrospective survey of these cases in order to assess if the therapy has justified itself by its results, and to find out the dangers and the limits of its application. Among over 500 patients treated were 76 over 60, 62 females and 14 males, with the following age distribution:

scholarly journals Adipocytokine Associations with Insulin Resistance in British South Asians

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
D. R. Webb ◽  
K. Khunti ◽  
S. Chatterjee ◽  
J. Jarvis ◽  
M. J. Davies
Keyword(s):  
Metabolic Disease ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
South Asian ◽  
South Asians ◽  
Risk Groups ◽  
Serum Samples ◽  
Asian Populations ◽  
Glucose Dysregulation

Aims. Adipocytokines are implicated in the pathogenesis of type 2 diabetes and may represent identifiable precursors of metabolic disease within high-risk groups. We investigated adiponectin, leptin, and TNF-αand assessed the contribution of these molecules to insulin resistance in south Asians.Hypothesis. South Asians have adverse adipocytokine profiles which associate with an HOMA-derived insulin resistance phenotype.Methods. We measured adipocytokine concentrations in south Asians with newly diagnosed impaired glucose tolerance or Type 2 Diabetes Mellitus in a case-control study. 158 (48.5% males) volunteers aged 25–75 years with risk factors for diabetes but no known vascular or metabolic disease provided serum samples for ELISA and bioplex assays.Results. Total adiponectin concentration progressively decreased across the glucose spectrum in both sexes. A reciprocal trend in leptin concentration was observed only in south Asian men. Adiponectin but not leptin independently associated with HOMA-derived insulin resistance after logistic multivariate regression.Conclusion. Diasporic south Asian populations have an adverse adipocytokine profile which deteriorates further with glucose dysregulation. Insulin resistance is inversely associated with adiponectin independent of BMI and waist circumference in south Asians, implying that adipocytokine interplay contributes to the pathogenesis of metabolic disease in this group.

STUDIES ON AMOEBIASIS IN CANADA: PART I. THE INCIDENCE OF INTESTINAL PROTOZOAL INFECTIONS IN TWO INSTITUTIONALIZED GROUPS IN CANADA

1947 ◽  
Vol 25e (1) ◽  
pp. 1-4
Author(s):  
M. J. Miller ◽  
L. P. E. Choquette
Keyword(s):  
Old Age ◽  
Entamoeba Histolytica ◽  
Age Group ◽  
Intestinal Protozoa ◽  
Younger Age

The authors have made a survey of the intestinal protozoa in two institutions: an orphanage and an old people's home. Results showed that the incidence of infection was high in both groups but that the younger age group showed a consistently higher rate of infection for all species found. Entamoeba histolytica was found in 37% of the children and in 20.5% of the 'old-age' group.

The Age of Mexican Patients with Chronic Myeloid Leukemia (CML) Ph+ Is Quite Younger Than the Reported in USA and European Series.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4291-4291
Author(s):  
Pablo Vargas-Viveros ◽  
Rafael Hurtado Monroy ◽  
Eduardo Cervera ◽  
Carlos Best ◽  
Alvaro Aguayo ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Age Distribution ◽  
Age At Diagnosis ◽  
Response To Treatment ◽  
Female Ratio ◽  
Male Predominance ◽  
Younger Age ◽  
Male Female Ratio ◽  
Long Term Observation ◽  
Mexican Patients

Abstract Abstract 4291 CML accounts for approximately 15 percent of the cases of leukemia in adults. It has an annual incidence of 1 to 2 cases per 100000, with a slight male predominance. The median age at presentation is about 60 years and the incidence increases as a function of age, as reported in North American, Australian and European series. However, in our country we found a younger age at diagnosis. Herein we report our analysis of the age distribution of the patients included in the Mexican Cooperative Leukemia Group. We analyzed 356 patients with diagnosis of CML Ph+, from January 2001 to December 2008. The data analysis showed a median age at diagnosis of 37 years (range 16 to 64 years), with a male: female ratio of 1.1:1. There is a clear difference of age between Mexican patients with CML and those reported in the referred series (37 vs. 60 years) highlighting a geographical and/or ethnical pattern that may play a role as prognostic factor and response to treatment. Moreover, challenge the multistep theory of carcinogenesis in CML, inspired by the observation that cancer incidence increases as a higher order function of age, explained by an increasing somatic mutations rate with age. Further analysis and long term observation is required. Disclosures: No relevant conflicts of interest to declare.

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