The rising prevalence of chronic myeloid leukemia in France

Abstract

Outcomes in chronic myeloid leukemia (CML) have been dramatically improved since the emergence of imatinib and the subsequent generation of tyrosine kinase inhibitors (TKI) in the early 2000s. Indeed, CML is now associated with near-normal life expectancy for the majority of patients, provided they adhere to lifelong TKI-based treatment. This paradigm, in which CML can be regarded as a chronic disease, has inherent consequences on the prevalence of the disease. Our objective was to study CML prevalence trend in the French population from 1960 to 2060. We used a cohort component-based model to forecast the prevalence of CML using projections of the French population, the estimated incidence rates by age and sex, and various hypotheses on the year-specific relative survival. CML prevalence in France is estimated at 2.5 per 100,000 inhabitants before the 1980s, with a progression up to 6 by 2002. Since 2002 this trend has increased further, with current and predicted prevalence reaching levels around 18 and 24 per 100,000 in 2018 and 2030 respectively. CML prevalence reaches 30 per 100,000 by 2050 when progression slows. Our simulations show that prevalence of CML is driven by both population aging and relative survival improvement. The grey area corresponds to the expected prevalence of CML.

Keywords: Chronic diseases; Chronic myeloid leukemia; Epidemiological transition; Incidence; Population aging; Prevalence; Relative survival; Tyrosine kinase inhibitor.