Improvement of relative survival in elderly patients with acute myeloid leukaemia emerging from population-based cancer registries in Switzerland between 2001 and 2013

•Rise of annual AML cases is caused by demographic ageing and not by an increase of age-specific risks.•AML classification improves over time but diagnostics and reporting are less accurate with increasing age.•Increase of allogeneic HSCT and clinical trial activities in elderly AML patients aged 65...

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Veröffentlicht in:Cancer epidemiology 2018-02, Vol.52, p.55-62
Hauptverfasser: Schnegg-Kaufmann, Annatina, Feller, Anita, Baldomero, Helen, Rovo, Alicia, Manz, Markus G., Gregor, Michael, Efthymiou, Anna, Bargetzi, Mario, Hess, Urs, Spertini, Olivier, Chalandon, Yves, Passweg, Jakob R., Stussi, Georg, Arndt, Volker, Bonadies, Nicolas
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container_title Cancer epidemiology
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creator Schnegg-Kaufmann, Annatina
Feller, Anita
Baldomero, Helen
Rovo, Alicia
Manz, Markus G.
Gregor, Michael
Efthymiou, Anna
Bargetzi, Mario
Hess, Urs
Spertini, Olivier
Chalandon, Yves
Passweg, Jakob R.
Stussi, Georg
Arndt, Volker
Bonadies, Nicolas
description •Rise of annual AML cases is caused by demographic ageing and not by an increase of age-specific risks.•AML classification improves over time but diagnostics and reporting are less accurate with increasing age.•Increase of allogeneic HSCT and clinical trial activities in elderly AML patients aged 65–74yrs.•Improvement of relative survival for elderly AML patients caused by general changes in management.•Therapeutic nihilism in elderly AML patients is not justifiable. Acute Myeloid Leukaemia (AML) is a rare and heterogeneous haematological malignancy with increasing incidence in the elderly. We performed a population-based, observational analysis of AML cases reported to the Cantonal Cancer Registries in Switzerland. Data was aggregated by the National Institute for Epidemiology and Cancer Registration and stratified for the two time periods 2001–2007 and 2008–2013. Overall, 2351 new AML cases were registered with a stable age-standardised incidence rate (3.0 [95 CI: 2.8-3.2] per 100,000 person-years). This indicates that our observed raise of annual AML cases (+10.9%) is mainly related to demographic ageing and not to an increase of age-specific risks. The fraction of non-classifiable AML cases decreased over time (54.6% to 41.8%) but remained high in elderly patients (65–74yrs: 44%; 75–84yrs: 54.2%, 85+yrs: 59.1%), suggesting less accurate diagnostics and reporting with increasing age. 5yrs relative survival (RS) correlated with AML risk class (favorable: 61.7%-68.4%; adverse risk: 11.4%-21.9%) and age (
doi_str_mv 10.1016/j.canep.2017.11.008
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Acute Myeloid Leukaemia (AML) is a rare and heterogeneous haematological malignancy with increasing incidence in the elderly. We performed a population-based, observational analysis of AML cases reported to the Cantonal Cancer Registries in Switzerland. Data was aggregated by the National Institute for Epidemiology and Cancer Registration and stratified for the two time periods 2001–2007 and 2008–2013. Overall, 2351 new AML cases were registered with a stable age-standardised incidence rate (3.0 [95 CI: 2.8-3.2] per 100,000 person-years). This indicates that our observed raise of annual AML cases (+10.9%) is mainly related to demographic ageing and not to an increase of age-specific risks. The fraction of non-classifiable AML cases decreased over time (54.6% to 41.8%) but remained high in elderly patients (65–74yrs: 44%; 75–84yrs: 54.2%, 85+yrs: 59.1%), suggesting less accurate diagnostics and reporting with increasing age. 5yrs relative survival (RS) correlated with AML risk class (favorable: 61.7%-68.4%; adverse risk: 11.4%-21.9%) and age (&lt;65yrs: 42.6–43.3%; 75–84yrs: 2.0-3.0%), but improved only modestly overall (19.2% to 23.3%). Interestingly, we identified a significant improvement of RS in patients aged 65–74yrs (5yrs: 5.2% to 13.5%; p&lt;0.001). As surrogate for changes in management, we found an increase of allogeneic haematopoietic stem cell transplantations (1.4 to 7%) and clinical trial activities (25 to 29%) for elderly AML patients during the observation period. 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All rights reserved.</rights><rights>Copyright Elsevier Limited 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c387t-4a2730b60ecf5076df3ac998244e840f74af94a04b110a6806b5557b13698e8d3</citedby><cites>FETCH-LOGICAL-c387t-4a2730b60ecf5076df3ac998244e840f74af94a04b110a6806b5557b13698e8d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2007509549?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29223104$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schnegg-Kaufmann, Annatina</creatorcontrib><creatorcontrib>Feller, Anita</creatorcontrib><creatorcontrib>Baldomero, Helen</creatorcontrib><creatorcontrib>Rovo, Alicia</creatorcontrib><creatorcontrib>Manz, Markus G.</creatorcontrib><creatorcontrib>Gregor, Michael</creatorcontrib><creatorcontrib>Efthymiou, Anna</creatorcontrib><creatorcontrib>Bargetzi, Mario</creatorcontrib><creatorcontrib>Hess, Urs</creatorcontrib><creatorcontrib>Spertini, Olivier</creatorcontrib><creatorcontrib>Chalandon, Yves</creatorcontrib><creatorcontrib>Passweg, Jakob R.</creatorcontrib><creatorcontrib>Stussi, Georg</creatorcontrib><creatorcontrib>Arndt, Volker</creatorcontrib><creatorcontrib>Bonadies, Nicolas</creatorcontrib><creatorcontrib>the NICER Working Group</creatorcontrib><creatorcontrib>NICER Working Group</creatorcontrib><title>Improvement of relative survival in elderly patients with acute myeloid leukaemia emerging from population-based cancer registries in Switzerland between 2001 and 2013</title><title>Cancer epidemiology</title><addtitle>Cancer Epidemiol</addtitle><description>•Rise of annual AML cases is caused by demographic ageing and not by an increase of age-specific risks.•AML classification improves over time but diagnostics and reporting are less accurate with increasing age.•Increase of allogeneic HSCT and clinical trial activities in elderly AML patients aged 65–74yrs.•Improvement of relative survival for elderly AML patients caused by general changes in management.•Therapeutic nihilism in elderly AML patients is not justifiable. Acute Myeloid Leukaemia (AML) is a rare and heterogeneous haematological malignancy with increasing incidence in the elderly. We performed a population-based, observational analysis of AML cases reported to the Cantonal Cancer Registries in Switzerland. Data was aggregated by the National Institute for Epidemiology and Cancer Registration and stratified for the two time periods 2001–2007 and 2008–2013. Overall, 2351 new AML cases were registered with a stable age-standardised incidence rate (3.0 [95 CI: 2.8-3.2] per 100,000 person-years). This indicates that our observed raise of annual AML cases (+10.9%) is mainly related to demographic ageing and not to an increase of age-specific risks. The fraction of non-classifiable AML cases decreased over time (54.6% to 41.8%) but remained high in elderly patients (65–74yrs: 44%; 75–84yrs: 54.2%, 85+yrs: 59.1%), suggesting less accurate diagnostics and reporting with increasing age. 5yrs relative survival (RS) correlated with AML risk class (favorable: 61.7%-68.4%; adverse risk: 11.4%-21.9%) and age (&lt;65yrs: 42.6–43.3%; 75–84yrs: 2.0-3.0%), but improved only modestly overall (19.2% to 23.3%). Interestingly, we identified a significant improvement of RS in patients aged 65–74yrs (5yrs: 5.2% to 13.5%; p&lt;0.001). As surrogate for changes in management, we found an increase of allogeneic haematopoietic stem cell transplantations (1.4 to 7%) and clinical trial activities (25 to 29%) for elderly AML patients during the observation period. 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numerical data</subject><subject>Risk Factors</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Switzerland - epidemiology</subject><subject>Time Factors</subject><subject>Trends</subject><subject>Tumors</subject><subject>Young Adult</subject><issn>1877-7821</issn><issn>1877-783X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kTFv1TAUhSNERUvhFyAhSywsSa9jJ04GBlQVqFSpAyCxWY5z8_AjiYOdpHr8of5NbnilAwOTLfvzOcf3JMkrDhkHXl7sM2tGnLIcuMo4zwCqJ8kZr5RKVSW-PX3c5_w0eR7jHqAsOS-eJad5neeCgzxL7q-HKfgVBxxn5jsWsDezW5HFJaxuNT1zI8O-xdAf2ERXxEV25-bvzNhlRjYcsPeuZT0uPwwOzjDSCjs37lgX_MAmPy2bpB_TxkRsGYW2GMho5-IcHMbN4TMp_iIPM7aswfkOcWQ5AGfbAX1QvEhOOtNHfPmwnidfP1x9ufyU3tx-vL58f5NaUak5lSZXApoS0HYFqLLthLF1XeVSYiWhU9J0tTQgG87BlBWUTVEUquGirCusWnGevD3q0lR-LhhnPbhosadk6Jeoea0KEFKpktA3_6B7v4SR0mmKTlhdyJoocaRs8DEG7PQU3GDCQXPQW496r__0qLceNeeaeqRXrx-0l2bA9vHN3-IIeHcEkIaxOgw6WurGYusC2lm33v3X4DdBzbEH</recordid><startdate>20180201</startdate><enddate>20180201</enddate><creator>Schnegg-Kaufmann, Annatina</creator><creator>Feller, Anita</creator><creator>Baldomero, Helen</creator><creator>Rovo, Alicia</creator><creator>Manz, Markus G.</creator><creator>Gregor, Michael</creator><creator>Efthymiou, Anna</creator><creator>Bargetzi, Mario</creator><creator>Hess, Urs</creator><creator>Spertini, Olivier</creator><creator>Chalandon, Yves</creator><creator>Passweg, Jakob R.</creator><creator>Stussi, Georg</creator><creator>Arndt, Volker</creator><creator>Bonadies, Nicolas</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20180201</creationdate><title>Improvement of relative survival in elderly patients with acute myeloid leukaemia emerging from population-based cancer registries in Switzerland between 2001 and 2013</title><author>Schnegg-Kaufmann, Annatina ; Feller, Anita ; Baldomero, Helen ; Rovo, Alicia ; Manz, Markus G. ; Gregor, Michael ; Efthymiou, Anna ; Bargetzi, Mario ; Hess, Urs ; Spertini, Olivier ; Chalandon, Yves ; Passweg, Jakob R. ; Stussi, Georg ; Arndt, Volker ; Bonadies, Nicolas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c387t-4a2730b60ecf5076df3ac998244e840f74af94a04b110a6806b5557b13698e8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acute myeloid leukaemia</topic><topic>Acute myeloid leukemia</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Classification</topic><topic>Demographics</topic><topic>Disease</topic><topic>DNA methylation</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Geriatrics</topic><topic>Hematology</topic><topic>Hematopoietic stem cells</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Leukemia</topic><topic>Leukemia, Myeloid, Acute - epidemiology</topic><topic>Leukemia, Myeloid, Acute - mortality</topic><topic>Leukemia, Myeloid, Acute - therapy</topic><topic>Male</topic><topic>Malignancy</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Older people</topic><topic>Patients</topic><topic>Population</topic><topic>Prognosis</topic><topic>Registration</topic><topic>Registries - statistics &amp; 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Acute Myeloid Leukaemia (AML) is a rare and heterogeneous haematological malignancy with increasing incidence in the elderly. We performed a population-based, observational analysis of AML cases reported to the Cantonal Cancer Registries in Switzerland. Data was aggregated by the National Institute for Epidemiology and Cancer Registration and stratified for the two time periods 2001–2007 and 2008–2013. Overall, 2351 new AML cases were registered with a stable age-standardised incidence rate (3.0 [95 CI: 2.8-3.2] per 100,000 person-years). This indicates that our observed raise of annual AML cases (+10.9%) is mainly related to demographic ageing and not to an increase of age-specific risks. The fraction of non-classifiable AML cases decreased over time (54.6% to 41.8%) but remained high in elderly patients (65–74yrs: 44%; 75–84yrs: 54.2%, 85+yrs: 59.1%), suggesting less accurate diagnostics and reporting with increasing age. 5yrs relative survival (RS) correlated with AML risk class (favorable: 61.7%-68.4%; adverse risk: 11.4%-21.9%) and age (&lt;65yrs: 42.6–43.3%; 75–84yrs: 2.0-3.0%), but improved only modestly overall (19.2% to 23.3%). Interestingly, we identified a significant improvement of RS in patients aged 65–74yrs (5yrs: 5.2% to 13.5%; p&lt;0.001). As surrogate for changes in management, we found an increase of allogeneic haematopoietic stem cell transplantations (1.4 to 7%) and clinical trial activities (25 to 29%) for elderly AML patients during the observation period. Our analysis indicates that recent progress made in management of elderly AML patients results in an improvement of survival on a population-based level in Switzerland and that therapeutic nihilism is not justifiable.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>29223104</pmid><doi>10.1016/j.canep.2017.11.008</doi><tpages>8</tpages></addata></record>
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1877-783X
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source MEDLINE; Elsevier ScienceDirect Journals Complete; ProQuest Central UK/Ireland
subjects Acute myeloid leukaemia
Acute myeloid leukemia
Adolescent
Adult
Age
Age Factors
Aged
Aged, 80 and over
Cancer
Cancer therapies
Chemotherapy
Child
Child, Preschool
Classification
Demographics
Disease
DNA methylation
Epidemiology
Female
Geriatrics
Hematology
Hematopoietic stem cells
Humans
Incidence
Infant
Infant, Newborn
Leukemia
Leukemia, Myeloid, Acute - epidemiology
Leukemia, Myeloid, Acute - mortality
Leukemia, Myeloid, Acute - therapy
Male
Malignancy
Medical prognosis
Middle Aged
Mortality
Older people
Patients
Population
Prognosis
Registration
Registries - statistics & numerical data
Risk Factors
Survival
Survival Rate
Switzerland - epidemiology
Time Factors
Trends
Tumors
Young Adult
title Improvement of relative survival in elderly patients with acute myeloid leukaemia emerging from population-based cancer registries in Switzerland between 2001 and 2013
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