title: Trends in all-cause mortality among patients with chronic myeloid leukemia: a Surveillance, Epidemiology, and End Results database analysis.
abstract: BACKGROUND
  Outcomes for patients with chronic myeloid leukemia (CML) have improved after the advent of tyrosine kinase inhibitors (TKIs), which target the BCR/ABL fusion gene product. Nonetheless, differences in survival persist between age groups. The authors performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database to assess 5-year overall survival (OS) in various patient age groups.
  
  
  METHODS
  Patients who had a diagnosis of CML were identified using the SEER 19 registries database. Patients who were included had SEER diagnosis codes for CML not otherwise specified (code 9863) and BCR/ABL-positive CML (code 9875) diagnosed between January 2000 and December 2005. Patients were divided into cohorts based on age at diagnosis: ages 15 to 44 years, 45 to 64 years, 65 to 74 years, and 75 to 84 years. OS was estimated using the Kaplan-Meier method, and Cox regression was used to estimate predictors of patient survival.
  
  
  RESULTS
  In total, 5138 patients with a new CML diagnosis were identified. Five-year OS improved for all patients between the years 2000 and 2005. Compared with patients who were diagnosed in 2000, 5-year survival improved among patients ages 15 to 44 years (hazard ratio [HR] for mortality, 0.424; P < .0001), ages 45 to 64 years (HR, 0.716; P = .0315), and ages 65 to 74 years (HR, 0.692; P = .0126); and patients ages 75 to 84 years had an increased 5-year OS rate from 19.2% in 2000 to 36.4% in 2005 (HR, 0.568; P < .0001).
  
  
  CONCLUSIONS
  OS at 5 years improved among all patients, including those ages 75 to 84 years, a group with historically poor outcomes. However, older age retained an association with worse survival, suggesting opportunities for further progress.
authors.affiliation: Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Brunner
authors.forename: Federico
authors.initials: F
authors.lastname: Campigotto
authors.forename: Hossein
authors.initials: H
authors.lastname: Sadrzadeh
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Drapkin
authors.forename: Yi-Bin
authors.initials: YB
authors.lastname: Chen
authors.forename: Donna S
authors.initials: DS
authors.lastname: Neuberg
authors.forename: Amir T
authors.initials: AT
authors.lastname: Fathi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018426:SEER Program; D014481:United States / Q000453:epidemiology
keywords: age groups; bcr-abl; chronic myeloid leukemia; population survival; tyrosine kinase inhibitor