scholarly journals Multiple Myeloma in Armenia During the Period 2006-2018: Facts and Discussion

2020 ◽  
Author(s):  
Narine Ghazaryan ◽  
Samvel Danelyan ◽  
Samvel Bardakhchyan ◽  
Anahit Saharyan ◽  
Lusine Sahakyan
Keyword(s):  
Multiple Myeloma ◽  
Hematological Malignancies ◽  
Additional Data ◽  
Risk Group ◽  
Survival Rates ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Comprehensive Analysis ◽  
Death Certificates ◽  
Time Period

Abstract Background: It is well known that the increased incidence of hematological malignancies is mainly caused by the growth of non-Hodgkin's lymphoma and multiple myeloma (MM). The indicated annual increase of ММ incidence in the world is 0.7%. Despite significant advances in the MM treatment the mortality rates are reaching 0.8-1.7%. The aim of the current study was a comprehensive analysis of ММ, i.e., their prevalence, incidence and survival rates in Armenia for the period of 2006-2018. Methods: The initial data for this survey were derived from ambulance cards, hospitalization journals, and clinical data from the Registry of Blood Diseases at the Hematology Center named after Yeolyan. Additional data was acquired from the National center of oncology named after Fanarjian, as well as from death certificates. Results: Data analysis showed that during the reported time period the increase of the MM incidence was 1.23 per 100 000 population. In comparison to the results obtained for 1966-1971 and 1998-2004, a significant increase in incidence of MM was found. Conclusions: The incidence rates for the MM increased during the analyzed period and women are particularly in the risk group. Moreover, attention should be paid to the fact that the most favorable age for male with MM is 59 years and below.

scholarly journals Multiple myeloma in Armenia during the period 2006–2018: facts and discussion

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Narine Ghazaryan ◽  
Samvel Danelyan ◽  
Samvel Bardakhchyan ◽  
Anahit Saharyan ◽  
Lusine Sahakyan
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Retrospective Cohort ◽  
Hematological Malignancies ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Age Group ◽  
Blood Diseases ◽  
Average Annual Incidence ◽  
Males And Females

Abstract Background It is known that one of the reasons for the increased incidence of hematological malignancies is caused by the growth of multiple myeloma (MM). Worldwide, approximately 159,985 new cases of MM are diagnosed representing 0.9% of all cancer diagnoses and 106,105 patients will die from MM accounting for 1.1% of all cancer deaths per year. Despite significant advances in the MM treatment the mortality rates are still high. The presented study is the first accurate epidemiological study of ММ in Armenia for the period of 2006–2018. Methods The initial data for this retrospective cohort survey were derived from ambulance cards, hospitalization journals, and clinical data from the Registry of Blood Diseases at the Yeolyan Hematology Center. Results Data analysis showed that during 2006–2018 the average annual incidence for the MM was 1.2 per 100,000 population. A significant increase was observed in 2018 compared to 2006, 1.9 vs. 0.7 per 100,000 population. Interestingly, there were no sex differences in the overall MM incidence during the study period. According to the received data, during the period of the 2006–2009 and 2014–2018 the 1-year survival rate for both sexes decreased dramatically from 83 to 64.1% at age group 60 years and below and from 78.5 to 68.1% in group 60 years and over. The 1-year overall survival (OS) for both sexes decreased by 18.9% for patients (≤60 age group) and 10.4% (> 60 age group) in the period of 2006–2009 to the period of 2014–2018. Conclusions The incidence rates for the MM increased during the analyzed period. Our study showed that males and females in the age group 60 years and below had better 5-year overall survival compared to elder ones and females have better survival.

Solitary Plasmacytoma Incidence, Mortality, and Survival Trends in the United States

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5629-5629
Author(s):  
Anirudh Bikmal ◽  
Lakshmi Radhakrishnan ◽  
Ajay K. Nooka
Keyword(s):  
Regression Analysis ◽  
Black Males ◽  
Survival Rates ◽  
The United States ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Study Cohort ◽  
Solitary Plasmacytoma ◽  
Incidence And Mortality ◽  
Adjusted Incidence

Abstract Background: The trends of incidence of solitary bone plasmacytoma (SBP) varied over time due to the changing definitions and the absence of clarity of the criteria. Prior studies have attempted to identify factors such as older age, gender, race as prognostic factors that influence survival of patients with SBP, but with changing paradigm of myeloma treatments, there is limited literature regarding the incidence, mortality and survival trends of SBP. Methods: We used the SEER registry from 1973-2009 to evaluate the incidence, mortality and survival trends in patients with SBP. The results were reported as crude incidence, mortality and survival rates. Two-sample t-tests, ANOVA as well regression analysis were used to examine correlation. Statistics were computed using the National Cancer Institute SEER*Stat software, version 8.2.0. and SAS software, version 9.4 (SAS Institute Inc, Cary, NC). Using the ICD-O-3 and morphologic codes of 9731/3 to identify cases, the final study cohort consisted of 2,734 cases. Trends were evaluated by the eras of diagnosis: 1973-1980, 1981-1985, 1986-1990, 1991-1995, 1996-2000, 2001-2005, and 2006-2009. Age-adjusted incidence rates (IR), standard mortality rates (SMR), survival rate (SR) were expressed as new cases per 100,000 person-years, and age-adjusted to the 2000 US standard population. Results: The median age of diagnosis of SBP among blacks is 61 years (range, 21-91) compared to others: 60 years (range, 28-88) and whites: 66 years (20-97). The age adjusted incidence rates for black males is: 0.3 (95%CI 0.2, 0.3) followed by black females 0.2 (95%CI 0.1, 0.2) white males 0.2 (95%CI 0.2, 0.2) white females 0.1 (95%CI 0.1, 0.1). The trends in incidence and mortality rates are illustrated in table 1 with highest IR noted for black males during the era 2006-2009. The 5-year survival rates for both males (figure 1) and females (figure 2) seem to be trending down over the eras examined. Regression analysis suggests males and other race have increased odds of survival (HR = 0.829, p=0.0078; HR = 0.54 and p=0.0038, respectively). Conclusions: Similar to myeloma, black patients tend to be diagnosed with SBP younger and have increased incidence. The incidence rates seem to be increasing, highest among blacks males, more likely from increased awareness and diagnosis. The mortality and survival patterns are comparable to whites. Interestingly, while the 5-year survival for myeloma among all racial groups is improving this analysis shows a decreasing trend for SBP. This observation is more likely from including myeloma patients under the diagnosis of SBP over the period of study. Recently, the International Myeloma Working Group (IMWG) clarified the definition of SBP which will help in accurate diagnosis and ultimately can help in accurate representation of the survival trends. Table 1. Incidence and Mortality Rates across Study Eras (SEER-9), 1973-2009 Years White (IR) White (MR) Black (IR) Black (MR) Other (IR) Other (MR) Male 1973-1980 0 0 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.2) 0 (0, 0.1) 1981-1985 0 0 0 (0, 0.2) 0 (0, 0.1) 0 (0, 0.2) 0 (0, 0.1) 1986-1990 0.1 (0.1, 0.2) 0.1 (0, 0.1) 0.1 (0, 0.3) 0.1 (0, 0.2) 0.3 (0.1, 0.5) 0 (0, 0.2) 1991-1995 0.2 (0.1, 0.2) 0.1 (0.1, 0.2) 0.2 (0.1, 0.4) 0 (0, 0.1) 0.1 (0, 0.3) 0.1 (0, 0.2) 1996-2000 0.2 (0.2, 0.3) 0.1 (0.1, 0.1) 0.3 (0.1, 0.5) 0.2 (0.1, 0.4) 0.2 (0.1, 0.4) 0.2 (0, 0.4) 2001-2005 0.4 (0.4, 0.5) 0.2 (0.2, 0.3) 0.5 (0.3, 0.7) 0.3 (0.1, 0.6) 0.2 (0, 0.2) 0 (0, 0.2) 2006-2009 0.4 (0.4, 0.5) 0.2 (0.2, 0.3) 0.7 (0.4, 1) 0.3 (0.1, 0.5) 0.1 (0, 0.2) 0.1 (0, 0.2) Female 1973-1980 0 0 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.1) 1981-1985 0 0 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.1) 0 (0, 0.1) 1986-1990 0.1 (0, 0.1) 0 (0, 0.1) 0.1 (0, 0.2) 0 (0, 0.1) 0 (0, 0.2) 0 (0, 0.2) 1991-1995 0.1 (0.1, 0.1) 0 (0, 0.1) 0.2 (0.1, 0.3) 0.1 (0, 0.2) 0 (0, 0.1) 0 (0, 0.1) 1996-2000 0.1 (0.1, 0.1) 0.1 (0.1, 0.1) 0.1 (0, 0.2) 0.1 (0, 0.2) 0.1 (0.2) 0 (0, 0.1) 2001-2005 0.2 (0.2, 0.2) 0.1 (0.1, 0.2) 0.3 (0.2, 0.4) 0.1 (0, 0.2) 0.1 (0, 0.2) 0 (0, 0.1) 2006-2009 0.2 (0.2, 0.3) 0.1 (0.1, 0.2) 0.3 (0.2, 0.5) 0.2 (0.1, 0.3) 0.1 (0, 0.2) 0 (0, 0.1) Figure 1. 5-year Survival Rates in males (SEER-9), 1973-2012 Figure 1. 5-year Survival Rates in males (SEER-9), 1973-2012 Figure 2. 5-year Survival Rates in females (SEER-9), 1973-2012 Figure 2. 5-year Survival Rates in females (SEER-9), 1973-2012 Disclosures Nooka: Spectrum Pharmaceuticals: Consultancy; Onyx Pharmaceuticals: Consultancy.

Future patient distribution and incidence in hemato-oncology: a study using data from the cancer registry in Kanagawa, Japan

2020 ◽  
Author(s):  
Hiroto Narimatsu ◽  
Sho Nakamura ◽  
Masahiko Sakaguchi ◽  
Kayoko Katayama
Keyword(s):  
Multiple Myeloma ◽  
Malignant Lymphoma ◽  
Cancer Registry ◽  
Urban Areas ◽  
Hematological Malignancies ◽  
Incidence Rates ◽  
Care Plan ◽  
Future Health ◽  
Number Of Patients ◽  
The Future

Abstract BACKGROUND AND PURPOSEThe distribution of patients with hematological malignancies will probably markedly change because society is aging. We assessed the expected incidence rates of leukemia, malignant lymphoma, and multiple myeloma using estimates of the nation’s population and Kanagawa Cancer Registry data.METHODSTo estimate the future incidence, we multiplied the 2010 rate by the predicted population according to age groups.RESULTS The total number of patients newly diagnosed as having hematological malignancy in Kanagawa in 2010 was 1,970. This was predicted to increase to 2,581 in 2025 and to decrease to 2,712 in 2040. Trends were almost the same for all three hematological malignancies. The incidence rates of the three hematological malignancies were predicted to continuously increase in patients aged ≥65 years: a 169% (450/266) increase in leukemia, 167% (1205/722) increase in malignant lymphoma, and 169% (309/183) increase in multiple myeloma from 2010 to 2040. In the group of patients aged <65 years, the incidence rates of these hematological malignancies were predicted to decrease.CONCLUSIONS The distribution of patients will change in the future: the number of elderly patients will increase, and the number of patients living in urban areas will increase. This prediction may have a great impact on the future health care plan.

scholarly journals Trends in Inpatient Chemotherapy Hospitalizations, Cost and Mortality for Patients with Hematological Malignancies: Insights from the National Inpatient Sample

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 53-54
Author(s):  
Ghulam Rehman Mohyuddin ◽  
Kellen Gil ◽  
Brian McClune ◽  
Nausheen Ahmed ◽  
Al-Ola Abdallah ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Length Of Stay ◽  
Myeloid Leukemia ◽  
Research Funding ◽  
Hematological Malignancies ◽  
Mortality Rates ◽  
National Inpatient Sample ◽  
Inpatient Mortality ◽  
Lymphoid Leukemia ◽  
Acute Myeloid

INTRODUCTION: With the advent of newer treatment options for patients with acute leukemia and myeloma, therapies are increasingly safely administered on an outpatient basis. We hypothesized increasing utilization of outpatient options would result in decreased hospitalizations for chemotherapy, albeit with increased hospitalization charges. We interrogated chemotherapy utilization amongst adult inpatients with these malignancies using the National Inpatient Sample (NIS). METHODS: The NIS is a database providing information on all inpatient hospitalizations in the United States (US), including primary and secondary diagnoses, procedures, length of stay, and disposition. Approximately 20% of admissions are tracked, and weighted estimates are provided regarding the total number of hospitalizations in the US. Using the NIS, we tracked chemotherapy admissions for patients with the following hematological malignancies: acute myeloid leukemia (AML), acute lymphoid leukemia (ALL) and multiple myeloma (MM). Admissions for hematopoietic stem cell transplants were excluded from our analysis, and only patients aged 18 or greater were included in our analysis. Procedural International Classification of Disease (ICD) 9 and 10 codes were used to gain insight into trends of hospitalizations, elective versus urgent status, costs and length of stay for each indication. Time frame 2002-2017 was chosen as this was the most recent year for which NIS data is available. Inflation adjustments for charges were calculated based on US Department of Labor statistics. RESULTS: For MM, there were a total of 54,357 admissions for chemotherapy from 2002-2017. Amongst these admissions, 37,517 were elective, and 16,670 were non-elective, with the remainder lacking data on elective status. Figure 1 highlights trends in admissions for MM, with a significant decrease noted in the overall volume (7,547 in 2002 to 2,710 in 2014 (p=0.003)). Mortality rates for MM chemotherapy admissions, also highlighted in Figure 1, did not change significantly from 2002 to 2017 (p=0.15). Mean length of stay for chemotherapy hospitalizations increased from 4.67 days in 2002 to 6.47 days in 2017 (p&lt;0.0001). Mean inflation-adjusted hospitalization charges increased from $20,865 in 2002 to $79,161 in 2017 (p&lt;0.0001). For AML, we noted 198,288 admissions for chemotherapy from 2002-2017 of which 127,277 were considered elective, and 70,566 non-elective, with the remainder lacking data on elective status. Figure 2 highlights trends in AML admissions with a decreased volume of admissions noted from 2011 onwards after an initial increase from 2005-2008. There was a total of 14,214 admissions in 2011 compared to 10,515 in 2017 (p=0.004) There was a decrease in inpatient mortality rates from 5.5% in 2002 to 2.4% in 2017 (p&lt;0.0001). Mean length of stay was consistent during this time period from 13.35 days in 2002 to 13.34 days in 2017 (p=0.15). Mean inflation-adjusted hospitalization charges increased from $83,904 in 2002 to $133,295 in 2017 (p&lt;0.001). There was a total of 82,730 admissions for chemotherapy from 2002-2017 for ALL. Amongst these admissions, 54,565 were elective and 27,963 were non-elective, with the remainder lacking data on elective status. Figure 3 highlights trends in admissions, with an increase in number of admissions from 4,092 in 2002 to 5,960 in 2017 (p=0.86). There was a decrease in the inpatient mortality rate from 0.8% in 2002 to 0.4% in 2017 (p=0.0007). Mean length of stay stayed consistent at 7.70 days in 2002 to 7.62 days in 2017 (p=0.06). Mean inflation-adjusted hospitalization charges increased from $49,283 in 2002 to $94,787 in 2017 (p&lt;0.0001). CONCLUSIONS: There has been a steady decline in the number of admissions for inpatient chemotherapy for patients with multiple myeloma and acute myeloid leukemia over time, owing to advances in therapies delivered safely and efficaciously as an outpatient. There has also been a steady decline in inpatient mortality for chemotherapy for acute myeloid and acute lymphoid leukemia, in part due to advances in supportive care. However, the inpatient mortality rate for myeloma has not decreased, likely due to sicker patients preferentially needing admission for inpatient chemotherapy. Inflation-adjusted hospitalization charges have gone up dramatically and further work is needed to elucidate factors driving these costs, and how to mitigate them. Disclosures Ganguly: Kadmon: Other: Ad Board; Settle Genetics: Speakers Bureau; KITE Pharma: Speakers Bureau. McGuirk:Astellas: Research Funding; Novartis: Research Funding; Allo Vir: Consultancy, Honoraria, Research Funding; Juno Therapeutics: Consultancy, Honoraria, Research Funding; Kite Pharmaceuticals: Consultancy, Honoraria, Research Funding, Speakers Bureau; Pluristem Ltd: Research Funding; Gamida Cell: Research Funding; Bellicum Pharmaceutical: Research Funding; Fresenius Biotech: Research Funding.

scholarly journals Hepatocellular Carcinoma Incidence, Mortality, and Survival Trends in the United States From 1975 to 2005

2009 ◽  
Vol 27 (9) ◽  
pp. 1485-1491 ◽  
Author(s):  
Sean F. Altekruse ◽  
Katherine A. McGlynn ◽  
Marsha E. Reichman
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
At Risk ◽  
Cancer Mortality ◽  
Survival Rates ◽  
The United States ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Incidence And Mortality ◽  
Adjusted Incidence

Purpose Hepatocellular carcinoma (HCC) is the third leading cause of cancer mortality worldwide. Incidence rates are increasing in the United States. Monitoring incidence, survival, and mortality rates within at-risk populations can facilitate control efforts. Methods Age-adjusted incidence trends for HCC were examined in the Surveillance, Epidemiology, and End Results (SEER) registries from 1975 to 2005. Age-specific rates were examined for birth cohorts born between 1900 and 1959. Age-adjusted incidence and cause-specific survival rates from 1992 to 2005 were examined in the SEER 13 registries by race/ethnicity, stage, and treatment. United States liver cancer mortality rates were also examined. Results Age-adjusted HCC incidence rates tripled between 1975 and 2005. Incidence rates increased in each 10-year birth cohort from 1900 through the 1950s. Asians/Pacific Islanders had higher incidence and mortality rates than other racial/ethnic groups, but experienced a significant decrease in mortality rates over time. From 2000 to 2005, marked increases in incidence rates occurred among Hispanic, black, and white middle-aged men. Between 1992 and 2004, 2- to 4-year HCC survival rates doubled, as more patients were diagnosed with localized and regional HCC and prognosis improved, particularly for patients with reported treatment. Recent 1-year survival rates remained, however, less than 50%. Conclusion HCC incidence and mortality rates continue to increase, particularly among middle-aged black, Hispanic, and white men. Screening of at-risk groups and treatment of localized-stage tumors may contribute to increasing HCC survival rates in the United States. More progress is needed.

Cancer in Adolescents

1979 ◽  
Vol 1 (5) ◽  
pp. 147-152
Author(s):  
Jordan W. Finkelstein
Keyword(s):  
Health Care ◽  
Cancer Incidence ◽  
Health Care Professionals ◽  
Survival Rates ◽  
Age Groups ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Age Group ◽  
Clear Cut ◽  
Cancer Incidence Rates

Cancer is the fourth leading cause of death in the adolescent age group, preceded only by accidents, homicide, and suicide. Table 1 lists by age, sex, and race cancer incidence rates (per million) for a three-year period (1969-1971) reported by the National Cancer Institute. Table 2 lists the most commonly involved sites. There are significant differences between the younger and the older age groups. With the advent of improved treatment, survival rates have increased. Table 3 lists the survival rates for the most common forms of cancer and includes all children under 15 years of age. Although survival rates are increasing, the majority of children with cancer still die. Table 4 lists cancer mortality rates for adolescents. The issues involved in diagnosis, treatment, survival, and death present problems for all of those who care for the adolescent with cancer—the patient himself or herself, family and friends, the physician, and other health care professionals. The objectives of this article are: to increase awareness of the types of problems commonly encountered in caring for adolescents with cancer and to describe some of the ways of dealing with these problems. The problems are by no means clear-cut, and the suggested methods of dealing with them must be individualized to meet the needs of all involved.

scholarly journals Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2017

2020 ◽  
Vol 52 (2) ◽  
pp. 335-350 ◽  
Author(s):  
Seri Hong ◽  
Young-Joo Won ◽  
Young Ran Park ◽  
Kyu-Won Jung ◽  
Hyun-Joo Kong ◽  
...  
Keyword(s):  
Cancer Incidence ◽  
Temporal Trends ◽  
Survival Rates ◽  
Relative Survival ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Comprehensive Cancer Control ◽  
Dramatic Improvement ◽  
Cancer Statistics ◽  
Incidence And Mortality

PurposeThis study reports the cancer statistics and temporal trends in Korea on a nationwide scale, including incidence, survival, prevalence, and mortality in 2017.Materials and MethodsThe incidence, survival, and prevalence rates of cancer were evaluated using data from the Korea National Cancer Incidence Database from 1999 to 2017 with follow-up until December 31, 2018. Deaths from cancer were assessed using cause-of-death data from 1983 to 2017, obtained from Statistics Korea. Crude and age-standardized rates (ASRs) for incidence, mortality, and prevalence, and 5-year relative survival rates were calculated and trend analysis was performed.ResultsIn 2017, newly diagnosed cancer cases and deaths from cancer numbered 232,255 (ASR, 264.4 per 100,000) and 78,863 (ASR, 76.6 per 100,000), respectively. The overall cancer incidence rates increased annually by 3.5% from 1999 to 2011 and decreased by 2.7% annually thereafter. Cancer mortality rates have been decreasing since 2002, by 2.8% annually. The 5-year relative survival rate for all patients diagnosed with cancer between 2013 and 2017 was 70.4%, which contributed to a prevalence of approximately 1.87 million cases by the end of 2017.ConclusionThe burden of cancer measured by incidence and mortality rates have improved in Korea, with the exception of a few particular cancers that are associated with increasing incidence or mortality rates. However, cancer prevalence is increasing rapidly, with the dramatic improvement in survival during the past several years. Comprehensive cancer control strategies and efforts should continue, based on the changes of cancer statistics.

scholarly journals The relationship between urologic cancer outcomes and national Human Development Index: trend from 2012 to 2018

2019 ◽  
Author(s):  
Nan Zhang ◽  
Hua Mu ◽  
Yan-rou Jiang ◽  
Shi-geng Zhang
Keyword(s):  
Prostate Cancer ◽  
Cancer Incidence ◽  
Survival Rates ◽  
Substantial Reduction ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Cancer Outcomes ◽  
Net Survival ◽  
Incidence And Mortality ◽  
Urologic Cancer

Abstract Objectives To describe the influence of the socioeconomic development on worldwide age-standardized incidence and mortality rates, as well as mortality-to-incidence ratio (MIR) and 5-year net survival of urologic cancer patients from 2012 to 2018. Methods The HDI values were obtained from the United Nations Development Programme, data on age-standardized incidence/mortality rates of prostate, bladder and kidney cancer were retrieved from the GLOBOCAN database, 5-year net survival was provided by the CONCORD-3 program. We then evaluated the association between incidence/MIR/survival and HDI, with a focus on geographic variability as well as temporal patterns during the last 6 years. Results Urologic cancer incidence rates were positively correlated with HDIs, and MIRs were negatively correlated with HDIs. Prostate cancer survival also correlated positively with HDIs, solidly confirming the interrelation among cancer indicators and socioeconomic factors. Most countries experienced incidence decline over the most recent 6 years, and a substantial reduction in MIR was observed. Survival rates of prostate cancer have simultaneously improved. Conclusion Development has a prominent influence on urologic cancer outcomes. HDI values are significantly correlated with cancer incidence, MIR and survival rates. HDI values have risen along with increased incidence and improved outcomes of urologic caner in recent years.

scholarly journals Changes in the Incidence and Overall Survival of Patients with Myeloproliferative Neoplasms between 2002 and 2016 in the United States

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 12-13
Author(s):  
Srdan Verstovsek ◽  
Jingbo Yu ◽  
Robyn M. Scherber ◽  
Shivani Pandya ◽  
Christopher Dieyi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Research Funding ◽  
Myeloproliferative Neoplasms ◽  
The United States ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Publicly Traded ◽  
Time Period ◽  
Time Periods ◽  
Over Time

Background Patients (pts) with myeloproliferative neoplasms (MPNs), including polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF), have reduced overall survival (OS) compared with the general population. Previous reports have shown MPN incidence rates of 0.9-1.1, 0.7-1.0, and 0.3 per 100,000 person-years for PV, ET, and primary MF (PMF), respectively (Srour et al. Br J Haematol. 2016;174[3]:382; Deadmond et al. J Cancer Res Clin Oncol. 2015;141[12]:2131), with evidence of an increase in MPN incidence over time (Mesa et al. Blood. 2012;120[21]:2834). The median OS for pts with PV, ET, and PMF has been previously reported in the literature as 13.5, 19.8, and 5.2-5.9 years, respectively (Tefferi et al. Blood. 2014;124[16]:2507; Cervantes et al. Blood. 2009;113[13]:2895; Cervantes et al. J Clin Oncol. 2012;30[24]:2981). Contemporary analyses of MPN incidence and pt survival are needed, as the most recent available real-world analyses were conducted on time periods up to 2012. The objective of this analysis was to describe trends in incidence and OS among pts with MPNs in the United States using data through 2016 from the Surveillance, Epidemiology, and End Results (SEER) database. Study Design and Methods Adult pts with PV, ET, or PMF were identified from the SEER 18 registry (2002-2016) using the primary site of bone marrow (C421) and International Classification of Diseases for Oncology (ICD-O) histology codes (ICD-O-3: 9950 [PV], 9962 [ET], and 9961 [PMF]). Pts were excluded if they were aged &lt;18 y on the index date (date of diagnosis) or were missing demographic or survival information. Age-adjusted incidence rates (per 100,000 person-years) were standardized to the 2000 US population by dividing the incidence rates among adult pts per year by the adult US population in the year 2000. Confidence intervals for rates and rate ratios were calculated using the Tiwari method (Tiwari et al. Stat Methods Med Res. 2006;15[6]:547). Kaplan-Meier methodology was used to compare mortality rates by diagnosis year, categorized into 3 groups: 2002-2006, 2007-2011, and 2012-2016. Pts were censored at the end of each 5-year analysis timeframe. Results Data for 34,031 pts (mean age, 65 y; female, 50.5%) were included in this analysis, including 15,141 pts diagnosed with PV, 14,676 with ET, and 4214 with PMF. Over the entire study period, incidence rates (95% CI) for PV, ET, and PMF were 1.57 (1.55-1.60), 1.55 (1.52-1.57), and 0.44 (0.43-0.45) per 100,000 person-years, respectively. The annual incidence rates of PV and PMF were higher for male vs female pts (1.94 vs 1.23 and 0.59 vs 0.33, respectively); however, the ET incidence rate was higher for female pts (1.73 vs 1.34; Table 1). ET and PMF incidence increased across the 3 time periods, whereas PV incidence remained relatively stable. Mortality rates at 1, 2, and 5 years for each MPN subtype are presented by time period in Table 2. Over the 3 time periods, mortality rates decreased for PV and PMF, but not for ET. Improved OS was observed in pts with PMF over time (median [95% CI]: 2002-2006, 3.3 [2.4-3.6] y; 2007-2011, 3.6 [3.3-4.3] y; 2012-2016, 3.8 [3.5-4.2] y). The median (95% CI) OS for the entire time period investigated was 12.0 (11.7-12.4) years for pts with PV, 12.0 (11.7-12.3) years for those with ET, and 3.6 (3.4-3.8) years for pts with PMF. Conclusions In this nationally representative real-world study, incidence of ET and PMF appeared to increase over time from 2002-2016. Median OS of patients with PV, ET, and PMF was shorter than previous reports. A trend of improved survival over time was observed in pts with PV and PMF, which was not observed in pts with ET. Further investigation into the varying OS rates between MPN subtypes is needed, as these data may suggest that ET is lacking improvements in supportive care strategies or therapies that are currently available in PV and MF. Disclosures Verstovsek: Sierra Oncology: Consultancy, Research Funding; Incyte Corporation: Consultancy, Research Funding; Roche: Research Funding; NS Pharma: Research Funding; Promedior: Research Funding; Gilead: Research Funding; ItalPharma: Research Funding; Blueprint Medicines Corp: Research Funding; Novartis: Consultancy, Research Funding; Genentech: Research Funding; CTI Biopharma Corp: Research Funding; AstraZeneca: Research Funding; Protagonist Therapeutics: Research Funding; Celgene: Consultancy, Research Funding; PharmaEssentia: Research Funding. Yu:Incyte Corporation: Current Employment, Current equity holder in publicly-traded company. Scherber:Incyte Corporation: Current Employment, Current equity holder in publicly-traded company. Pandya:STATinMED Research: Current Employment; Incyte Corporation: Other: STATinMED Research is a paid consultant of Incyte Corporation. Dieyi:STATinMED Research: Current Employment; Incyte Corporation: Other: STATinMED Research is a paid consultant of Incyte Corporation. Chen:Incyte Corporation: Other: STATinMED Research is a paid consultant of Incyte Corporation; STATinMED Research: Current Employment. Parasuraman:Incyte Corporation: Current Employment, Current equity holder in publicly-traded company.

scholarly journals Temporal Trends in Survival Among Multiple Myeloma Patients in the US: Impact of Age and Cardiac Comorbidities

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5944-5944
Author(s):  
Eric M Maiese ◽  
Kristin A Evans ◽  
Debra E Irwin
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Disease Management ◽  
The United States ◽  
Mortality Rates ◽  
Mortality Data ◽  
Time Period ◽  
Time Periods ◽  
Over Time ◽  
Cardiac Comorbidity

Abstract Introduction: Approximately 27,000 new cases of multiple myeloma (MM) are diagnosed in the United States each year, and over 11,000 deaths annually are attributed to MM (http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf). In the past decade, the introduction of new drugs has markedly changed the treatment paradigm and outcomes for patients with MM (Kumar et al. Leukemia 2014;28:1122-1128). However, it is not clear whether the improvements have been sustained in more recent years and if improvements were also experienced by patients with additional risk factors for death. This study examined temporal changes in MM survival among patients with additional factors known to be associated with death (i.e. older age and cardiac conditions). Methods: This was a retrospective observational cohort study using the Truven Health MarketScan® Commercial and Medicare Supplemental Databases. Study patients included those with at least 1 inpatient or 2 outpatient claims with an MM diagnosis between January 1, 2006 and December 31, 2014, who were at least 18 years old at diagnosis, were continuously enrolled in a health plan for at least 12 months before and at least 30 days after the first diagnosis, and had no prior history of any malignancies. Patients were followed from the date of the first MM diagnosis through the earliest event including death, end of enrollment, or end of the study period (September 30, 2015). All-cause mortality data were obtained from inpatient admissions with a discharge status of "death," and from Social Security Administration death records. Mortality rates were calculated overall, for patients <65 years-old and ≥65 years-old, and for patients with and without a cardiac comorbidity (heart failure, dysrhythmia, myocardial infarction, other ischemic heart disease) indicated in the 12-month baseline period grouped within two time periods according to the date of MM diagnosis (2006-2010 and 2011-2014). Kaplan-Meier survival curves were created for each group and compared using log-rank tests. Results: A total of 5,199 MM patients met all eligibility criteria and were included in the analysis. There were significant differences in survival between patients stratified by age and time period of diagnosis (Figure 1). The overall mortality rate was substantially lower among all patients <65 years-old, compared to those ≥65 (0.18 vs. 0.43 per 1,000 person-days, p<0.05), and mortality rates improved among both age groups from the 2006-2010 to the 2011-2014 time period (<65 years: 0.19 vs. 0.15 per 1,000 person-days, p<0.05; ≥65 years: 0.47 vs. 0.35 per 1,000 person-days, p<0.05). Over 41% of MM patients ≥65 years-old had a cardiac comorbidity, compared to approximately 17% of those <65 years-old. There were significant differences in survival between patients stratified by the presence of a cardiac comorbidity and time period of diagnosis (Figure 2). The mortality rates improved from the 2006-2010 to the 2011-2014 time period among both groups (no cardiac comorbidity: 0.26 vs. 0.20 per 1,000 person-days, p<0.05; cardiac comorbidity: 0.48 vs. 0.37 per 1,000 person-days, p<0.05) (Table 1). Patients who were ≥65 and with a cardiac comorbidity had the worst survival in both time periods; however, mortality rates improved from the 2006-2010 to 2011-2014 time period for all groups stratified by age and presence of a cardiac comorbidity (Table 1). Conclusion: This real-world analysis showed improved survival over time in patients with MM. Improvements in survival were most pronounced for older patients with a cardiac comorbidity, suggesting that changes in disease management over time may have contributed to better outcomes even among the most vulnerable MM patients. With the recent FDA approval of new MM treatment options, tailoring treatment plans for patients based on specific risk factors is even more feasible and may help to further optimize disease management and continue the improvements in survival. Disclosures Maiese: Janssen Scientific Affairs, LLC: Employment. Evans:Truven Health Analytics: Employment. Irwin:Truven Health Analytics: Employment.

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