Chronic Lymphocytic Leukaemia in the Netherlands: Trends in incidence, treatment and survival, 1989–2008

Abstract

We present trends in incidence, early treatment and survival of Chronic Lymphocytic Leukaemia (CLL) between 1989 and 2008, based on population-based data from the Netherlands Cancer Registry. Incidence rates were stable at 5.1 per 100,000 person-years for males, but increased from 2.3 to 2.5 for females, especially for females aged 50-64 years (from 3.6 to 4.3). Patients were less likely to receive chemotherapy within six months, i.e. from 29% to 24% among males and from 25% to 21% among females. Five-year relative survival increased from 61% in 1989-1993 to 70% 2004-2008 for males, and from 71% to 76% for females. The relative excess risk of dying decreased in time to 0.7 (males) and 0.9 (females) in 2004-2008, reference 1989-1993, and increased with age to 2.9 (males) and 1.8 (females) in patients aged 75-94 years, reference 30-64 years. The increasing incidence among females aged 50-64 coincided with the introduction of mass screening for breast cancer, which resulted in a large group of women under increased surveillance and possibly led to increased detection of CLL. The increase in survival might be underestimated due to possible decreased or delayed registration of indolent cases and the retroactive effect of the introduction of new therapies.

Chemotherapy Exposure and outcomes of Chronic Lymphoid Leukemia Patients

“…CLL patients receiving chemotherapy were selected from the PHARMO-ECR cohort. Age and gender of the study patients is similar to descriptions of CLL patients in the literature [3][4][5].…”

“…A previous study has shown increased survival rates for CLL patients over the years. Five-year relative survival increased from 61% in 1989-1993 to 70% 2004-2008 for males, and from 71% to 76% for females [5]. The one-year survival rate was slightly higher among patients starting chemotherapy more than 6 months after initial diagnosis than for patients starting chemotherapy within 6 months after initial diagnosis.…”

“…CLL primarily affects patients aged 60 and older and men are affected twice as often as women [3][4][5]. In Europe, the agestandardized incidence rate of CLL is 3.8 per 1,00,000 person-years [5,6] and 5.1 per 1,00,000 person-years in the US [3].…”

A Case of Comorbid Myxoma and Chronic Lymphocytic Leukemia: Not Just a Coincidence?

“…However, the chances of this are vanishingly small. In an Irish study, myxoma occurred at a rate of 0.5 cases per million people per year [5], while a Dutch study showed that middle aged women developed CLL at a rate of 4 per 100,000 people per year [6]. The cumulative likelihood of developing these as independent processes is, therefore, estimated to be 0.002 per billion people per year.…”

Leukemia in Iran: Epidemiology and Morphology Trends

“…Also an incidence increase has been observed in a twenty years period in Netherlands among women between 50-64 years old (Van den Broek et al, 2012) and for Denmark between 1943-2003(Thygesen et al, 2009.…”