Potential to Improve Therapy of Chronic Myeloid Leukemia (CML), Especially for Patients with Older Age: Incidence, Mortality, and Survival Rates of Patients with CML in Switzerland from 1995 to 2017

Abstract

Background: Tyrosine kinase inhibitors (TKI) substantially improved chronic myeloid leukemia (CML) prognosis. We aimed to describe time period- and age-dependent outcomes by reporting real-world data of CML patients from Switzerland. Methods: Population-based incidence, mortality, and survival were assessed for four different study periods and age groups on the basis of aggregated data from Swiss Cantonal Cancer Registries. Results: A total of 1552 new CML cases were reported from 1995 to 2017. The age-standardized rate (ASR) for the incidence remained stable, while the ASR for mortality decreased by 50–80%, resulting in a five-year RS from 36% to 74% over all four age groups. Importantly, for patients <60 years (yrs), the five-year RS increased only in earlier time periods up to 92%, whereas for older patients (+80 yrs), the five-year RS continued to increase later, however, reaching only 53% until 2017. Conclusions: This is the first population-based study of CML patients in Switzerland confirming similar data compared to other population-based registries in Europe. The RS increased significantly in all age groups over the last decades after the establishment of TKI therapy. Interestingly, we found a more prominent increase in RS of patients with older age at later observation periods (45%) compared to patients at younger age (10%), implicating a greater benefit from TKI treatment for elderly occurring with delay since the establishment of TKI therapy. Our findings suggest more potential to improve CML therapy, especially for older patients.

Clear Improvement in Real-World Chronic Myeloid Leukemia Survival: A Comparison With Randomized Controlled Trials

“…UK's Haematological Malignancy Research Network (242 CMLs, from 2004 to 2011; median age: 59 years) showed 5-year OS of 78.9% (72.3% to 84.0%) and 5-year RS of 88.6% (81.0% to 93.3%) (73). Other national studies are aligned with our survival results (74)(75)(76)(77)(78)(79)(80).…”

Assessment of knowledge, attitudes, and practices of CML patients and their families toward TKI therapy in China

“…[ 35 ] CML mortality continues to decline, resulting in more people living with the disease. [ 37 , 38 ] However, previous studies have focused on the psychological status of CML patients and sociodemographic variables that make them more susceptible to anxiety and depression, with rare reports about the mental health of the family members. The results of our study showed that 46.64% and 13.8% of family caregivers experienced anxiety and depression, compared with 29.71% and 11.51% of patients, raising concerns about family caregivers’ mental health.…”

Epidemiology of Chronic Myeloid Leukemia in Tunisia

“…In Tunisia Patients older than 65 years of age at diagnosis made up 10 % of the cohort and only 5% of the patients had less than 18 years of age at diagnosis. Older age has been considered a poor prognostic factor in patients with CML [10], the 2 more widely used prognostic score for CML, namely the sokal and Euro risk scores identified older age as a variable predicting lower response rates and worse outcome [11].…”