title: Chronic myeloid leukemia incidence, survival and accessibility of tyrosine kinase inhibitors: a report from population-based Lithuanian haematological disease registry 2000-2013.
abstract: BACKGROUND
  Currently available chronic myeloid leukaemia (CML) survival reports have originated from more affluent countries. Herein we report the entire country data on incidence and survival of CML, as well as penetrance of tyrosine kinase inhibitors (TKIs) in Lithuania.
  
  
  METHODS
  We analyzed all patients (N = 601) from the national haematological disease monitoring system who were diagnosed with CML between 2000 and 2013. Crude (CR) and age-standardized (weighted) (ASW(R)) incidence and mortality rates, as well as 1-, 5-, and 10-year relative survival rates (RSR) were calculated. Information on TKI penetration is also reported.
  
  
  RESULTS
  Throughout the entire 2000-2013 period the median age at diagnosis of CML patients was 62 years. The respective incidence and mortality CRs were 1.28 and 0.78, both characterized by decreasing trends over the observation period. A 5-year RSR increased from 0.33 [95 % CI, 0.27-0.40] in 2000-2004 to 0.55 [95 % CI, 0.47-0.63] in 2005-2009. However, the respective 5-year RSRs for patients aged 65-74 and ≥75 were only 0.33 [95 % CI, 0.24-0.42] and 0.18 [95 % CI 0.07-0.23] during the entire study period. TKI penetrance for CML patients grew from 1.5 % in 2000-2004 to 30.6 % in 2005-2009 and 69.1 % in 2010-2013. TKI penetrance was low in the older age groups (60 % for the 65-74 and 19 % for the ≥75 patient group, in 2010-2013).
  
  
  CONCLUSIONS
  Relative CML survival in Lithuania steadily improved and paralleled the increase in TKI treatment availability. Patients above 64 years rarely received TKIs and their relative survival remained low throughout the observation period. The latency of TKI availability may have influenced the survival trends.
authors.affiliation: Clinical Medical School, University of Oxford, Oxford, UK. tumasbeinortas@gmail.com.|Centre for Evidence-Based Medicine, Clinics of Internal, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania. tumasbeinortas@gmail.com.
authors.forename: Tumas
authors.initials: T
authors.lastname: Beinortas
authors.affiliation: Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Klinikos, Santariskiu 2, 08661, Vilnius, Lithuania. ilma.tavoriene@santa.lt.
authors.forename: Ilma
authors.initials: I
authors.lastname: Tavorienė
authors.affiliation: Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Klinikos, Santariskiu 2, 08661, Vilnius, Lithuania. tadas.zvirblis@santa.lt.
authors.forename: Tadas
authors.initials: T
authors.lastname: Žvirblis
authors.affiliation: Clinics of Oncology and Hematology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Eivenių g. 2, 50009, Kaunas, Lithuania. gerbrola@yahoo.com.
authors.forename: Rolandas
authors.initials: R
authors.lastname: Gerbutavičius
authors.affiliation: Department of Oncology Haematology, Klaipeda Seamen Hospital, Liepojos 45, 92288, Klaipeda, Lithuania. mjurgutis@jurlig.lt.
authors.forename: Mindaugas
authors.initials: M
authors.lastname: Jurgutis
authors.affiliation: Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Klinikos, Santariskiu 2, 08661, Vilnius, Lithuania. laimonas.griskevicius@santa.lt.|Clinics of Internal, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania. laimonas.griskevicius@santa.lt.
authors.forename: Laimonas
authors.initials: L
authors.lastname: Griškevičius
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006801:Humans; D015994:Incidence; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009367:Neoplasm Staging; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D012042:Registries; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors