scholarly journals Survival of Patients with Rare Plasma Cell or Lymphoplasmacytoid Malignancies in Germany and the United States in the Early 21st Century

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4767-4767
Author(s):  
Dianne Pulte ◽  
Janick Weberpals ◽  
Lina Jansen ◽  
Alexander Katalinic ◽  
Alice Nennecke ◽  
...  
Keyword(s):  
United States ◽  
Plasma Cell ◽  
21St Century ◽  
Research Funding ◽  
Relative Survival ◽  
The United States ◽  
Period Analysis ◽  
Early 21St Century ◽  
The Us ◽  
The Early 21St Century

Abstract Background: Population level survival has improved for myeloma in the early 21st century, but it is unknown whether a similar improvement has occurred in other plasma cell or lymphoplasmacytoid conditions. Methods: Data were extracted from 12 population-based cancer registries in Germany and the Surveillance, Epidemiology, and End Results database in the United States (US). Cases of Waldenström macroglobulinemia (WM), lymphoplasmacytic lymphoma (LPL), and plasmacytoma diagnosed in 1998-2012 were included. Myeloma survival was analyzed for comparison. Plasma cell leukemia was not included due to case numbers being too small to produce reliable estimates. Period analysis was used to determine 5-year relative survival for patients with the above malignancies in 2003-12. Trends in survival in the early 21st century were analyzed using modeled period analysis, comparing survival for 2003-07 to 2008-12. Results: In Germany, 5-year age adjusted relative survival in 2003-12 was 72.1% overall and 56.5% for patients with plasmacytoma, 74.9% for LPL not otherwise specified and 80.8% for WM. In the US, survival was higher overall at 75.1%, with survival for individual entities of 81.9% for WM, 77.2% for LPL, and 62.3% for plasmacytoma. Five year relative survival estimates for myeloma in 2003-12 were 45.2% and 43.1% in Germany and the US, respectively. Trend analysis for the years 2003-07 and 2008-12 revealed an increase in survival overall in Germany and the US, with survival for all malignancies going from 69.2% to 74.2% in Germany and 73.3% to 76.8% in the US (see table). A small, borderline significant increase in survival was observed for WM in Germany, with survival going from 74.8% to 84.3% (p=0.05) and a significant increase was observed for LPL, going from 71.7% to 77.4% (p=0.01). A pattern of small increases in survival was observed for plasmacytoma in Germany and each individual malignancy in the US. A strong and significant increase was observed in both countries for myeloma, with 5-year survival going from 41.4% to 47.9% in Germany and 38.8% to 47.0% in the US (p<0.0001 for both). Conclusions: Five year survival for patients with plasma cell and plasmacytoid conditions other than myeloma varies depending on the morphology. Some evidence of increased survival was observed in rare plasma cell and plasmacytoid malignancies, but small case numbers make determination of statistical significance difficult and magnitude of the differences are less than for myeloma in most cases, with the exceptions of WM in Germany. Increased research focusing specifically on rare plasma cell malignancies and implementation of findings into cancer care may improve survival further. Table Trends in 5-year relative survival for 2003-07 to 2008-12 for rare plasma cell and plasmacytoid malignancies, with comparison to myeloma. Table. Trends in 5-year relative survival for 2003-07 to 2008-12 for rare plasma cell and plasmacytoid malignancies, with comparison to myeloma. Disclosures Pulte: EBSCO: Other: Review of content for Dynamed medical reference product; Selexys Pharmaceuticals: Research Funding; ApoPharma: Research Funding.

Trends in Survival after Diagnosis with Hematologic Malignancy in Adolescence or Young Adulthood in the United States, 1981- 2005

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 877-877
Author(s):  
Dianne Pulte ◽  
Adam Gondos ◽  
Hermann Brenner
Keyword(s):  
21St Century ◽  
Hematologic Malignancy ◽  
Lymphoblastic Leukemia ◽  
Relative Survival ◽  
Hematologic Malignancies ◽  
The United States ◽  
Acute Leukemias ◽  
Period Analysis ◽  
Early 21St Century ◽  
Survival Expectations

Abstract Background: There are few population based studies of long-term survival of adolescents and young adults (AYA) with hematologic malignancies, mostly pertaining to patients diagnosed in the 1990s or earlier. Traditionally, survival in AYA with hematologic malignancies has been worse than survival for children with similar malignancies. Here, we use period analysis to obtain up-to-date information on survival expectations of AYA diagnosed with hematologic malignancies through the early 21st century. Methods: Period analysis was used to calculate 5- and 10-year relative survival for AYA aged 15–24 diagnosed with hematologic malignancies for five calendar periods from 1981–85 to 2001–2005, using data from the Surveillance, Epidemiology, and End Results (SEER) database. Results: Data from 9836 patients aged 15–24 included in the SEER database who were diagnosed with Hodgkin’s lymphoma (HL), non-Hodgkin lymphoma (NHL), acute lymphoblastic leukemia (ALL), acute myeloblastic leukemia (AML), and chronic myelocytic leukemia (CML) were analyzed. HL was the most common malignancy, accounting for about 50% of all hematologic maligancies in each calendar period examined. Survival strongly improved for each of the five hematologic malignancies. Increases in 10-year relative survival were as follows: HL, from 80.4 to 93.4%; NHL, from 55.6 to 76.2%; ALL, from 30.5 to 52.1%; AML, from 15.2 to 45.1%; CML, from 0 to 74.5% (p<0.0001 in all cases, see table). However, while survival improved steadily throughout the period examined for the lymphomas and CML, survival was stable during the late 1990s and early 21st century for the acute leukemias. Survival has not improved for AML since 1990–95 or for ALL since 1996–2000 (see table). Discussion: Survival expectations for AYA with hematologic malignancies have strongly improved since the 1980s. However, with the exception of HL, survival rates have not reached the levels observed for children diagnosed with the same malignancies. In particular, 10-year survival in children aged 10–14 with ALL was over 75% for the 2000–04 period1 compared to about 50% for AYA in 2001–05. Similarly, 10-year survival for children aged 0–14 diagnosed with acute non-lymphoblastic leukemia was about 60% in the 2000–04 period compared with less than 50% for AYA with AML in the 2001–05 period. Some caution must be used when comparing survival in AYA versus in children since survival estimates for children are for absolute survival, while those for AYA are for relative survival. However, relative survival in children and AYA is close to 100%, making the comparison relatively straightforward. Furthermore, survival estimates for the acute leukemias have not improved since the 1990s while survival for children continued to improve during the early 21st century. Reasons for the poorer survival observed may include differences in the biology of the malignancies, poorer compliance in AYA, differences in treatment protocols in children versus AYA, lower availability of clinical trials in AYA than in children, and low rates of health insurance in AYA patients, particularly after age 18. Further examination of the reasons for the poorer outcomes observed for AYA with acute leukemias may clarify this issue. 1 Pulte D, Gondos A, Brenner H. Trends in 5- and 10-year survival after diagnosis with childhood hematologic malignancies in the United States, 1990–2004. Accepted JNCI 7/08. Table: 10-year relative survival 1981–85 to 2001–05 by hematologic malignancy Diagnosis 1981– 85 1986–90 1991–95 1996–2000 2001–05 Diff1 p-val2 PE3 SE4 PE SE PE SE PE SE PE SE 1 Difference in survival, 1981–85 versus 2001–05. 2 P-value for trend. 3 Point estimate 4 Standard error HL 80.4 1.5 82.6 1.4 86.9 1.2 88.9 1.2 93.4 1.0 +13.0 <0.0001 NHL 55.6 3.1 59.9 2.9 62.7 2.7 67.9 2.6 76.2 2.3 +20.6 <0.0001 ALL 30.5 4.1 35.8 4.0 42.1 3.9 51.6 3.9 52.1 3.7 +21.6 <0.0001 AML 15.2 3.4 22.3 4.1 43.6 4.7 39.5 4.0 45.1 4.0 +29.9 <0.0001 CML 0 0 22.5 6.5 20.8 6.5 41.4 7.9 74.5 7.6 +74.5 <0.0001

scholarly journals Survival of patients with hepatobiliary tract and duodenal cancer sites in Germany and the United States in the early 21st century

2018 ◽  
Vol 143 (2) ◽  
pp. 324-332 ◽  
Author(s):  
Dianne Pulte ◽  
Janick Weberpals ◽  
Chloé Charlotte Schröder ◽  
Katharina Emrich ◽  
Bernd Holleczek ◽  
...  
Keyword(s):  
United States ◽  
21St Century ◽  
The United States ◽  
Duodenal Cancer ◽  
Early 21St Century ◽  
Hepatobiliary Tract ◽  
The Early 21St Century

scholarly journals Changes in Survival of Older Patients with Hematologic Malignancies in the Early 21st Century

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3288-3288
Author(s):  
Dianne Pulte ◽  
Lina Jansen ◽  
Felipe Castro ◽  
Hermann Brenner
Keyword(s):  
21St Century ◽  
Older Patients ◽  
Research Funding ◽  
Hematologic Malignancy ◽  
Relative Survival ◽  
Hematologic Malignancies ◽  
Younger Patients ◽  
Early 21St Century ◽  
Survival Expectations ◽  
The Early 21St Century

Abstract Background: Survival expectations for patients with hematologic malignancies have improved in the early 21st century. However, survival for older patients remains low and prior studies have not demonstrated as robust an improvement for older patients as for younger patients. Newer, less toxic treatments for several hematologic malignancies have allowed improved survival in older patients in clinical trials. Here, we examine survival for older patients with hematologic malignancies in the early 21st century to determine whether survival has changed over this time period. Methods: Patients over age 65 with a common hematologic malignancy were identified from the Surveillance, Epidemiology, and End Results (SEER) 13 database for the periods 1997-2000, 2001-2004, 2005-2008, and 2009-2012. Malignancies examined included acute lymphoblastic leukemia (ALL), acute myeloblastic leukemia (AML), chronic lymphocytic leukemia (CLL), chronic myelocytic leukemia (CML), Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), and myeloma. Five-year relative survival for each malignancy was calculated using period analysis. For comparison, 5-year relative survival for patients age 50-59 was evaluated as well. Results: Survival expectations were lower for patients age 65 and older than for younger patients with a given hematologic malignancy and survival expectations decreased with age. Five year relative survival increased between 1997-2000 and 2009-12 for all hematologic malignancies. However, for AML and ALL, the increase was limited to patients age 65-74. Five year relative survival estimates increased for all age groups, including 85+, for HL, CML, NHL, CML, and myeloma (Table 1). Five-year relative survival for patients age 85+ increased by 39.6, 11.6 and 31.5 percent units for CLL, myeloma, and NHL, respectively between 1997-2002 and 2009-12. Conclusions: Survival for older patients with hematologic malignancies remains low compared to survival for younger patients. However, survival for older patients has increased in the early 21st century, possibly due to less toxic therapeutic options and improved supportive care, with the greatest improvement observed for NHL , CLL, and CML. Survival remains poor for older patients with acute leukemia, especially in the "oldest old" age group. Table 1. Cancer site Age at diagnosis 5-year relative survival (standard error) 1997-2000 2009-2012 Difference (% units) AML 50-59 21.4 (1.7) 35.0 (1.7) +13.6 65-69 6.6 (1.1) 15.6 (1.7) +9.0 70-74 4.1 (0.8) 8.1 (1.2) +4.0 75-79 3.2 (0.8) 3.4 (0.8) +0.2 80-84 0.4 (0.3) 0.4 (0.4) 0.0 85+ 0.6 (0.4) 0.4 (0.4) -0.2 CML 50-59 46.7 (2.9) 80.4 (2.1) +33.7 65-69 35.2 (3.1) 56.7 (3.5) +21.5 70-74 16.8 (2.2) 48.2 (3.6) +31.4 75-79 13.6 (2.1) 38.4 (3.4) +24.8 80-84 6.4 (1.5) 28.7 (3.6) +22.3 85+ 5.7 (1.7) 18.7 (3.9) +13.0 ALL 50-59 24.5 (4.2) 30.2 (3.8) +5.7 65-74 5.5 (2.0) 19.1 (3.8) +13.6 75+ 2.8 (1.9) 10.6 (3.6) +7.8 CLL 50-59 80.8 (1.4) 92.0 (1.0) +11.2 65-69 67.0 (1.7) 84.7 (1.5) +17.7 70-74 60.9 (1.6) 83.1 (1.6) +22.2 75-79 49.1 (1.7) 80.5 (1.9) +31.4 80-84 35.9 (1.9) 71.3 (2.4) +35.4 85+ 17.6 (1.5) 57.2 (3.2) +39.6 Myeloma 50-59 42.2 (1.6) 58.9 (1.3) +16.7 65-69 27.8 (1.4) 54.7 (1.6) +26.9 70-74 24.6 (1.3) 39.8 (1.5) +15.2 75-79 20.4 (1.2) 41.5 (1.8) +21.1 80-84 13.4 (1.2) 28.5 (1.7) +15.1 85+ 5.5 (0.9) 17.1 (2.0) +11.6 NHL 50-59 63.7 (0.8) 78.1 (0.6) +14.4 65-69 50.8 (0.9) 73.0 (0.9) +22.2 70-74 45.8 (0.9) 68.6 (1.0) +22.8 75-79 35.8 (0.9) 62.7 (1.1) +26.9 80-84 27.2 (0.9) 55.1 (1.3) +27.9 85+ 13.3 (0.8) 44.8 (1.6) +31.5 HL 50-59 71.3 (2.3) 80.7 (1.9) +9.4 65-74 49.8 (2.9) 66.2 (2.9) +16.4 75+ 23.0 (2.5) 45.9 (3.5) +22.9 Disclosures Pulte: ApoPharma: Research Funding; EBSCO: Consultancy; Selexys: Research Funding.

scholarly journals The Petroleum Bomb

2005 ◽  
Vol 127 (10) ◽  
pp. 30-34
Author(s):  
George P. Shultz ◽  
R. James Woolsey
Keyword(s):  
United States ◽  
21St Century ◽  
Economic Models ◽  
The United States ◽  
Economic Factors ◽  
Transportation Fuel ◽  
Early 21St Century ◽  
Long Run ◽  
The Early 21St Century

This article highlights the dependence on petroleum and its products for the major share of the world’s transportation fuel create special dangers in our time. These dangers are all driven by rigidities and pot entail vulnerabilities that have become serious problems because of the geopolitical realities of the early 21st century. Those who reason about these issues solely on the basis of abstract economic models that are designed to ignore such geopolitical realities will find much to disagree with in what follows. Although such models have utility in assessing the importance of more or less purely economic factors in the long run. The attractiveness to the consumer of being able to use electricity from overnight charging for a substantial share of the day’s driving is stunning. The average residential price of electricity in the United States is about 8.5 cents per kilowatt-hour.

scholarly journals Self-injury Mortality in the United States in the Early 21st Century

2016 ◽  
Vol 73 (10) ◽  
pp. 1072 ◽  
Author(s):  
Ian R. H. Rockett ◽  
Christa L. Lilly ◽  
Haomiao Jia ◽  
Gregory L. Larkin ◽  
Ted R. Miller ◽  
...  
Keyword(s):  
United States ◽  
21St Century ◽  
The United States ◽  
Early 21St Century ◽  
Injury Mortality ◽  
Self Injury ◽  
The Early 21St Century

Survival of cervical cancer patients in Germany in the early 21st century: A period analysis by age, histology, and stage

2012 ◽  
Vol 51 (7) ◽  
pp. 915-921 ◽  
Author(s):  
Tianhui Chen ◽  
Lina Jansen ◽  
Adam Gondos ◽  
Katharina Emrich ◽  
Bernd Holleczek ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
21St Century ◽  
Period Analysis ◽  
Early 21St Century ◽  
The Early 21St Century

The World of Uncertainty: Is America Losing Its Leverage Towards a Looming New China–Russia Alliance?

2021 ◽  
Vol 13 (04) ◽  
pp. 92-106
Author(s):  
Vitaly KOZYREV
Keyword(s):  
United States ◽  
21St Century ◽  
World Order ◽  
The United States ◽  
Great Power ◽  
Window Of Opportunity ◽  
The Us ◽  
The World ◽  
Alliance Building

The recent deterioration of US–China and US–Russia relations has stumbled the formation of a better world order in the 21st century. Washington’s concerns of the “great power realignment”, as well as its Manichean battle against China’s and Russia’s “illiberal regimes” have resulted in the activated alliance-building efforts between Beijing and Moscow, prompting the Biden administration to consider some wedging strategies. Despite their coordinated preparation to deter the US power, the Chinese and Russian leaderships seek to avert a conflict with Washington by diplomatic means, and the characteristic of their partnership is still leaving a “window of opportunity” for the United States to lever against the establishment of a formal Sino–Russian alliance.

scholarly journals Accounting for Student Success: Academic and Stakeholder Perspectives That Have Shaped the Discourse on Student Success in the United States

2018 ◽  
Vol 7 (1) ◽  
pp. 150-173 ◽  
Author(s):  
Victor M. H. Borden ◽  
Gretchen C. Holthaus
Keyword(s):  
United States ◽  
Student Success ◽  
21St Century ◽  
Extended Family ◽  
College Education ◽  
The United States ◽  
Research Literature ◽  
Time To Degree ◽  
Early 21St Century ◽  
Stakeholder Perspectives

Abstract The meaning of student success differs according to the goals, interests and roles among prospective students, their parents and extended family, educators, scholars, employers, legislators and other stakeholders. Despite this wide variation, accountability for student success has been mostly equated with readily available measures like degree completion rates, time to degree and credit accumulation. Recently, especially in the United States, where the student assumes a large cost burden for attending college, interest has increased regarding the amount of debt incurred and the employment and wages obtained post-graduation to enable students to pay off that debt. There are many from within and outside the academy who criticize these simplistic measures of student success and seek evidence about how a college education develops students intellectually and morally, preparing them to lead lives as productive citizens and members of the 21st Century workforce. In this article, we review the key concepts of student success that have emerged from the U.S. higher education research literature, as well as major U.S. policy initiatives related to improving student success. The purpose of this analysis is to develop an organizing framework that enables scholars and policy makers to place their work within a broader context as related to the discourse on student success in the early 21st Century, especially within the United States, but with increasingly common elements internationally.

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