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. 2010 Mar;148(5):739-53.
doi: 10.1111/j.1365-2141.2009.08010.x. Epub 2009 Dec 1.

The Haematological Malignancy Research Network (HMRN): a new information strategy for population based epidemiology and health service research

Alexandra Smith  1 , Eve Roman, Debra Howell, Richard Jones, Russell Patmore, Andrew Jack; Haematological Malignancy Research Network
Collaborators, Affiliations
Free PMC article

The Haematological Malignancy Research Network (HMRN): a new information strategy for population based epidemiology and health service research

Alexandra Smith et al. Br J Haematol. 2010 Mar.
Free PMC article

Abstract

The Haematological Malignancy Research Network (HMRN) was established in 2004 to provide robust generalizable data to inform clinical practice and research. It comprises an ongoing population-based cohort of patients newly diagnosed by a single integrated haematopathology laboratory in two adjacent UK Cancer Networks (population 3.6 million). With an emphasis on primary-source data, prognostic factors, sequential treatment/response history, and socio-demographic details are recorded to clinical trial standards. Data on 8131 patients diagnosed over the 4 years 2004-08 are examined here using the latest World Health Organization classification. HMRN captures all diagnoses (adult and paediatric) and the diagnostic age ranged from 4 weeks to 99 years (median 70.4 years). In line with published estimates, first-line clinical trial entry varied widely by disease subtype and age, falling from 59.5% in those aged <15 years to 1.9% in those aged over 75 years - underscoring the need for contextual population-based treatment and response data of the type collected by HMRN. The critical importance of incorporating molecular and prognostic markers into comparative survival analyses is illustrated with reference to diffuse-large B-cell lymphoma, acute myeloid leukaemia and myeloma. With respect to aetiology, several descriptive factors are highlighted and discussed, including the unexplained male predominance evident for most subtypes across all ages.

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Figures

Fig 1
Fig 1
Cancer registrations United Kingdom, 2005.
Fig 2
Fig 2
Age and sex distribution: Haematological Malignancy Research Network (HMRN), 2004–2008.
Fig 3
Fig 3
Population age and sex structure of the Haematological Malignancy Research Network (HMRN) region (bars) compared to the UK as a whole (lines), 2001.
Fig 4
Fig 4
Sex rate ratios: Haematological Malignancy Research Network (HMRN), 2004–2008.
Fig 5
Fig 5
Age at diagnosis distributions: Haematological Malignancy Research Network (HMRN), 2004–2008.
Fig 6
Fig 6
Kaplan–Meier survival estimates for (A) AML patients by ICD-O-3 subtype and (B) for AML not otherwise specified (NOS) patients according to FLT3 length mutation status: Haematological Malignancy Research Network (HMRN), 2004–2008.
Fig 7
Fig 7
International Prognostic Index (IPI) derivation from components in diffuse large-B-cell lymphoma (DLBCL): Haematological Malignancy Research Network (HMRN), 2004–2008. (ECOG, Eastern Cooperative Oncology Group).
Fig 8
Fig 8
Myeloma patient pathway of two patients: Haematological Malignancy Research Network (HMRN), 2004–2008.
See this image and copyright information in PMC

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