Incidence and survival of lymphohematopoietic neoplasms according to the World Health Organization classification: a population-based study from the Victorian Cancer Registry in Australia

Abstract

We studied the incidence and relative survival of 39 837 cases of lymphohematopoietic neoplasms (LHN) reported to the Victorian Cancer Registry during 1982-2004, classified according to the World Health Organization (WHO) classification. We modeled excess mortality using Poisson regression to estimate differences in survival by age, sex, and time period. Age-standardized incidence rates varied across subtypes of lymphoid and myeloid neoplasms. All major subtypes predominantly affected the elderly except Hodgkin lymphoma (incidence peaks at 20-24 and 75-79 years) and acute lymphoblastic leukemia (0-9 years). After an initial rise, overall lymphoid and myeloid incidence stabilized in the mid-1990s. The 5-year relative survival was 58% for lymphoid and 35% for myeloid neoplasms. Survival improved during 1990-2004 for diffuse large B-cell lymphoma, follicular lymphoma, acute myeloid leukemia, chronic myeloid leukemia, and myelodysplastic syndromes (p < 0.001) and declined with advancing age for all subtypes (p < 0.001). Female sex was associated with higher survival for most myeloid subtypes. The results represent a rare epidemiological characterization of the whole range of LHN according to WHO subtypes.