Summary Standardized criteria of response to treatment and a unified definition of resistance/intolerance to hydroxycarbamide (HC) in essential thrombocythaemia (ET) have been proposed by the European LeukaemiaNet (ELN). We have retrospectively evaluated such criteria in 166 ET patients treated with HC for a median of 4·5 years. Overall, 134 patients achieved a complete clinicohaematological response (CR) and 25 a partial response. Thirty‐three patients met at least one of the ELN criteria defining resistance (n = 15) or intolerance (n = 21) to HC. Fifteen cases developed anaemia with thrombocytosis, which was associated with a high incidence of myelofibrosis and death from any cause. Other definitions of resistance were less useful. Factors determining the thrombotic risk were a history of prior thrombosis and a baseline leucocyte count >10 × 109/l. Of note, patients achieving a CR, even if sustained during the entire follow‐up, did not benefit from a lower incidence of thrombosis or an improved survival. In conclusion, most ET patients respond to HC, but the achievement of response, as defined by the ELN, does not correlate with the patients’ outcome. The best discriminating ELN criterion of resistance to HC was the detection of anaemia, which also identified a subgroup of patients with poor prognosis.

Dynamic life tables arise as an alternative to the standard (static) life table with the aim of incorporating the evolution of mortality over time. The parametric model introduced by Lee and Carter in 1992 for projected mortality rates in the US is one of the most outstanding and has been largely used since then. Different versions of the model have been developed but all of them, together with other parametric models, consider the observed mortality rates as independent observations. This is a difficult hypothesis to hold when looking at the graph of the residuals obtained with any of these methods.Methods of adjustment and prediction based on geostatistical techniques which exploit the dependence structure existing among the residuals are an alternative approach to classical methods. Dynamic life tables can be considered as a two-way table on a grid equally spaced in either the vertical (age) or horizontal (year) direction, and the data can be decomposed into a deterministic large-scale variation (trend) plus a stochastic small-scale variation (residuals). Preprint submitted to Insurance: Mathematics and EconomicsFebruary 8, 2010Our contribution consists of applying geostatistical techniques for estimating the dependence structure of the mortality data and for prediction purposes, also including the influence of the year of birth (cohort). We compare the performance of this new approach with different versions of the Lee-Carter model. Additionally, we obtain bootstrap confidence intervals for predicted q xt resulting from applying both methodologies, and we study their influence on the predictions of e 65t and a 65t .

Resection of primary tumor should be considered not only as a palliative or preventive strategy but also as an approach that possibly contributes to the control of the disease in selected patients.

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