Summary. We have published previously a prototype of a decision model for anaemic patients with myelodysplastic syndromes (MDS), in which transfusion need and serum erythropoietin (S-Epo) were used to define three groups with different probabilities of erythroid response to treatment with granulocyte colony-stimulating factor (G-CSF) + Epo. S-Epo £ 500 U/l and a transfusion need of < 2 units/month predicted a high probability of response to treatment, S-Epo > 500 U/l and ‡ 2 units/month for a poor response, whereas the presence of only one negative prognostic marker predicted an intermediate response. A total of 53 patients from a prospective study were included in our evaluation sample. Patients with good or intermediate probability of response were treated with G-CSF + Epo. The overall response rate was 42% with 28AE3% achieving a complete and 13AE2% a partial response to treatment. The response rates were 61% and 14% in the good and intermediate predictive groups respectively. The model retained a significant predictive value in the evaluation sample (P < 0AE001). Median duration of response was 23 months. Scores for global health and quality of life (QOL) were significantly lower in MDS patients than in a reference population, and fatigue and dyspnoea was significantly more prominent. Global QOL improved in patients responding to treatment (P ¼ 0AE01). The validated decision model defined a subgroup of patients with a response rate of 61% (95% confidence interval 48-74%) to treatment with G-CSF + Epo. The majority of these patients have shown complete and durable responses.

Treatment for follicular lymphoma (FL) improved with rituximab. In Sweden, first-line rituximab was gradually introduced between 2003 and 2007, with regional differences. The first national guidelines for FL were published in November 2007, recommending rituximab in first-line therapy. Using the population-based Swedish Lymphoma Registry, 2641 patients diagnosed with FL from 2000 to 2010 were identified and characterized by year and region of diagnosis, age (median, 65 years), gender (50% men), first-line therapy and clinical risk factors. Overall and relative survivals were estimated by calendar periods (2000-2002, 2003-2007 and 2008-2010) and region of diagnosis. With each period, first-line rituximab use and survival increased. Survival was superior in regions where rituximab was quickly adopted and inferior where slowly adopted. These differences were independent in multivariable analyses. Ten-year relative survival for patients diagnosed 2003-2010 was 92%, 83%, 78% and 64% in the age groups 18-49, 50-59, 60-69 and ⩾70, respectively. With increasing rituximab use, male sex emerged as an adverse factor. Survival improved in all patient categories, particularly in elderly women. The introduction and the establishment of rituximab have led to a nationwide improvement in FL survival. However, rituximab might be inadequately dosed in younger women and men of all ages.

The myelodysplastic syndromes (MDS) have attracted great interest during the last decade. Unfortunately there is not much material published concerning the incidence of these conditions. We present epidemiologic data on MDS based on case registration of patients in a well‐defined population and as a comparison similar data on acute myeloid leukaemia (AML). Between the years 1978–1992 we registered 120 cases of MDS and 146 cases of AML. The median age for all the MDS cases was 74.1 years for men and 78.2 years for women. Among haematologists there is a suspicion that the incidence of MDS is rising. Our study does not support this opinion. We have divided the study period into 5‐year periods and the crude incidence has been 3.2, 4.1 and 3.5/100 000/year for each period. In the age group over 70 years MDS was more frequent than AML and in the last 5‐year period the incidence was 15.0/100 000/year for MDS compared to 10.2/100 000/year for AML. In conclusion MDS is quite common among elderly people and there is no evidence for a rising incidence during the last 15 years.

Introduction Follicular lymphoma (FL) is the most common indolent lymphoma, with 200-250 cases in Sweden per year. FL is considered incurable, because conventional therapy only leads to temporary remissions of varying length. Studies indicate that survival for patients with FL has improved since the introduction of rituximab. In Sweden first-line rituximab was gradually introduced between 2003 and 2007 and the speed of rituximab adoption varied geographically. In the publication of the first national Swedish guidelines for FL in November 2007, rituximab was recommended as first-line therapy and as maintenance after first relapse. Methods We conducted a nationwide, population-based registry study to assess patterns of FL survival before and after the introduction of first-line rituximab and to identify prognostic factors in the rituximab era. In the Swedish Lymphoma Registry (SLR) 2641 patients were identified with a FL diagnosed between January 1, 2000 and December 31, 2010. Clinical data, including first-line treatment were collected from the SLR. Overall survival (OS) and relative survival (RS) were estimated by calendar period (the pre-rituximab era 2000-2002, the transitional period 2003-2007 and the established period 2008-2010) and national health care region. Results First-line rituximab use increased gradually during the study period (2000-2002, 13%; 2003-2007, 61%; 2008-2010, 86%). During the transitional period, one health care region incorporated first-line rituximab quickly (92% first-line rituximab use) and one slowly (31%), whereas the remaining regions showed a moderate use of first-line rituximab (in total, 62%). OS and RS improved incrementally with each calendar period (P < 0.00005) (Figure 1A). Survival differed, during the transitional period, between regions with different rituximab use (OS, P = 0.039) (Figure 1B). After the national guidelines were published, no regional differences in use of first-line rituximab remained (P = 0.91). The improvement in OS and RS during the study period was greater in women than in men (Figure 1C). Survival improved in all age groups, but most in elderly patients (Figure 2). Conclusions The policy of first-line rituximab has resulted in a nationwide improvement in FL survival in Sweden. Women and elderly patients have benefited the most from rituximab. Figure 1. Cumulative relative survival of follicular lymphoma by (A) calendar period of diagnosis, (B) regional adoption of rituximab during 2003-2007, and (C) calendar period of diagnosis and gender. Figure 1. Cumulative relative survival of follicular lymphoma by (A) calendar period of diagnosis, (B) regional adoption of rituximab during 2003-2007, and (C) calendar period of diagnosis and gender. Can't read 3B2 tag because stream don't exist.Tag: Figure_31 Figure 2 Figure 2. Disclosures No relevant conflicts of interest to declare.