Ethnicity variables in the incidence rates of leukemias in New Zealand populations: implications for stem-cell transplantation.
New Zealand has a population of 4 million people comprising four main ethnic groups: Caucasian (72.9%), New Zealand Maori (14.7%), New Zealand Pacific Islands people (5.6%), and Asians (6.3%). We examined 10 years of data (1993-2002) from the New Zealand Cancer Registry to determine if there are ethnic differences in leukemia incidence in New Zealand, and we relate this to availability of stem-cell transplantation. We found that New Zealand Asians have a generally lower incidence of all leukemias investigated. New Zealand Maori have an increased risk of acute myeloid leukemia (RR 1.5 in the age group 25-49 and RR 1.31 in the age group 50-74), relative to New Zealand Caucasians. New Zealand Pacific Islanders have an increased risk of chronic myeloid leukemia (RR 2.13 in the age group 25-49 and RR 1.52 in the age group 50-74). Stem-cell transplantation is a standard curative treatment for ages 25-49, and current opinion is extending the acceptable age up to age 60, in certain cases. We conclude that, among New Zealand Maori and New Zealand Pacific Islanders, there is an increased risk of acute myeloid leukemia and chronic myeloid leukemia in age groups suitable for stem-cell transplantation. However, both of these ethnic groups have previously been shown to have a reduced chance of finding a 6/6-matched unrelated donor on international registries. This leads to disproportionate provision of transplantation health care among the ethnic groups in New Zealand.
Tracey
Mary Clare
MC
Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand. maryclare@wnmeds.ac.nz
Carter
John M
JM
D000208:Acute Disease; D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007938:Leukemia / Q000208:ethnology* / Q000628:therapy; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000208:ethnology / Q000209:etiology; D007951:Leukemia, Myeloid / Q000208:ethnology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D012306:Risk; D033581:Stem Cell Transplantation