Most cited article - PubMed ID 36828868
Survival in hematological malignancies in the Nordic countries through a half century with correlation to treatment
For many hematological malignancies (HMs) survival among older patients is compromised. We want to test the most up-to-date age-group-specific survival differences in five hematological malignancies, Hodgkin lymphoma (HL), multiple myeloma (MM), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML) and myeloproliferative diseases (MPD) in Sweden (SE) and compared these to Denmark, Finland and Norway. For analysis we apply a recently published metric for comparing and visualizing age-group-specific relative survival differences using data from the NORDCAN database between 1972 and 2021. Periodic changes in age-related deviation in SE survival showed increasing differences for AML and MM while for the other HMs the differences declined in the course of time. Country-specific differences were observed, for Finnish male CLL and female MPD deviations were larger than those for the other countries, both of which were explained by the deviant survival of the oldest patients. Age-related deviations in 5-year survival increased for AML and MM for which survival improvements have been achieved through intense treatment regimens but these are not offered to old patients because of risk of complications. Paradoxically, improving overall survival in AML and MM has contributed to the widening of the age gaps. For the remaining HMs, age-related deviations declined with time as even old patients benefitted from the survival improvements; most notably female MPD and CLL patients had hardly any age gaps. Age disparities are an issue in hematological malignancies, and an intense search for novel treatments also includes old patients with an example of success as a novel drug venetoclax.
- Keywords
- Cancer registry, Periodic survival, Prognosis, Treatment,
- MeSH
- Adult MeSH
- Hematologic Neoplasms * mortality diagnosis epidemiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Survival Rate trends MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Age Factors MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
- Geographicals
- Denmark epidemiology MeSH
- Finland epidemiology MeSH
- Norway epidemiology MeSH
- Sweden epidemiology MeSH
- MeSH
- Leukemia, Myeloid, Acute * epidemiology therapy MeSH
- Humans MeSH
- Age Factors MeSH
- Check Tag
- Humans MeSH
- Publication type
- Letter MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Scandinavian and Nordic Countries epidemiology MeSH
- MeSH
- Humans MeSH
- Multiple Myeloma * epidemiology therapy MeSH
- Risk Factors MeSH
- Age Factors MeSH
- Check Tag
- Humans MeSH
- Publication type
- Letter MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Scandinavian and Nordic Countries epidemiology MeSH