title: Trends in chronic myeloid leukemia incidence and survival in the United States from 1975 to 2009.
abstract: The use of interferon-α and allogeneic stem cell transplant and more recently of tyrosine kinase inhibitors (TKIs) have improved the outcome of patients with chronic myeloid leukemia (CML). We performed a population-based study of CML to evaluate relative survival (RS) trend by treatment eras. All instances of CML diagnosed between 1975 and 2009 reported in the Surveillance, Epidemiology and End Results databases were reviewed. The incidence of CML was 1.75/100 000 persons per year and increased with age. The incidence was highest in Detroit and lowest among Asians. The 5-year RS ratios increased from 0.26 in patients diagnosed in 1975-1989 to 0.36 in 1990-2000 and 0.56 in 2001-2009. There was a significant improvement in 5-year RS ratios in the 2005-2009 calendar period compared to the 2001-2004 period (p < 0.05), corresponding to the introduction of second-generation TKIs. Age was the most important prognostic factor for RS, but the improvement in 5-year RS ratios was observed in all age groups except the group aged < 15 years (p > 0.05), including adolescents and young adults and elderly patient groups. There are ethnic and geographic variations in the incidence of CML. The RS improved with each treatment era, with the greatest improvement in all age groups occurring during the TKI era.
authors.affiliation: Department of Leukemia and Lymphoma/Myeloma, The University of Texas M D Anderson Cancer Center and Texas Children Hospital, Houston, TX 77030, USA.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Chen
authors.forename: Haijun
authors.initials: H
authors.lastname: Wang
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000453:epidemiology* / Q000266:history / Q000401:mortality; D008297:Male; D008875:Middle Aged; D018426:SEER Program; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology / Q000208:ethnology; D055815:Young Adult