Overall survival and competing risks of death in patients with Waldenström macroglobulinaemia: an analysis of the Surveillance, Epidemiology and End Results database

Abstract

Waldenström macroglobulinaemia (WM) is a rare and incurable lymphoma. Given that the survival of WM patients can be prolonged, our objective was to describe trends in overall survival (OS) and analyse competing risks of death in patients with WM. The analysis included 5784 patients diagnosed with WM between 1991 and 2010 from the Surveillance, Epidemiology and End Results (SEER) database. Multivariate hazard models for OS and cumulative incidence of death were fitted according to epoch of diagnosis (1991-2000 vs. 2001-10) while adjusting for age, sex, race, histology, site of involvement and registry. Median OS for the 1991-2000 and the 2001-10 cohorts was 6 and 8 years, respectively (P < 0·001). In the multivariate analysis, better OS [hazard ratio (HR) 0·73, 95% confidence interval (CI) 0·67-0·79; P < 0·001] was seen in the 2001-10 cohort. Survival benefits were identified, for the 2001-10 cohort, in almost every stratum analysed, with the exception of patients aged <50 years and blacks. In the multivariate competing-risk analysis, the 2001-10 cohort experienced lower rates of WM-related (HR 0·57, 95% CI 0·49-0·66; P < 0·001) and non-WM-related deaths (HR 0·72, 95% CI 0·66-0·79; P < 0·001). In conclusion, there have been significant improvements in OS, WM-related and non-WM-related mortality in patients with WM diagnosed in the last decade.

Keywords: Waldenström macroglobulinaemia; competing risks; epidemiology; outcomes; survival.