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. 2021 Dec 14;13(24):6269.
doi: 10.3390/cancers13246269.

Potential to Improve Therapy of Chronic Myeloid Leukemia (CML), Especially for Patients with Older Age: Incidence, Mortality, and Survival Rates of Patients with CML in Switzerland from 1995 to 2017

Michael Daskalakis  1   2 , Anita Feller  3   4 , Jasmine Noetzli  1   5 , Nicolas Bonadies  1   2 , Volker Arndt  3   6 , Gabriela Maria Baerlocher  2 , The Nicer Working Group
Affiliations

Potential to Improve Therapy of Chronic Myeloid Leukemia (CML), Especially for Patients with Older Age: Incidence, Mortality, and Survival Rates of Patients with CML in Switzerland from 1995 to 2017

Michael Daskalakis et al. Cancers (Basel). .

Abstract

Background: Tyrosine kinase inhibitors (TKI) substantially improved chronic myeloid leukemia (CML) prognosis. We aimed to describe time period- and age-dependent outcomes by reporting real-world data of CML patients from Switzerland.

Methods: Population-based incidence, mortality, and survival were assessed for four different study periods and age groups on the basis of aggregated data from Swiss Cantonal Cancer Registries.

Results: A total of 1552 new CML cases were reported from 1995 to 2017. The age-standardized rate (ASR) for the incidence remained stable, while the ASR for mortality decreased by 50-80%, resulting in a five-year RS from 36% to 74% over all four age groups. Importantly, for patients <60 years (yrs), the five-year RS increased only in earlier time periods up to 92%, whereas for older patients (+80 yrs), the five-year RS continued to increase later, however, reaching only 53% until 2017.

Conclusions: This is the first population-based study of CML patients in Switzerland confirming similar data compared to other population-based registries in Europe. The RS increased significantly in all age groups over the last decades after the establishment of TKI therapy. Interestingly, we found a more prominent increase in RS of patients with older age at later observation periods (45%) compared to patients at younger age (10%), implicating a greater benefit from TKI treatment for elderly occurring with delay since the establishment of TKI therapy. Our findings suggest more potential to improve CML therapy, especially for older patients.

Keywords: CML; incidence; mortality; relative survival; tyrosine kinase inhibitor.

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Conflict of interest statement

The authors declare no conflict of interest for this article. Potentially perceived conflicts of interests according to the definitions and terms of International Committee of Medical Journal Editors are N.B.: Alexion: research funding to institution; Amgen: financial support for travel; Astellas: research funding to institution; Celgene/BMS: financial support for travel, research funding to institution; consultancy honoraria; Janssen: financial support for travel; Novartis: financial support for travel, research funding to institution, consultancy honoraria; Roche: financial support for travel, research funding to institution; Sandoz: research funding to institution; Servier: research funding to institution; Takeda: research funding to institution. M.D.: Amgen, Celgene/BMS, Gilead, Novartis, NovoNordisk, Roche: financial support for travel; Gilead Sciences, Novartis: advisory board. V.A.: Recipient of Lilly Quality of Life Award 2007 and 2021. A.F.: no conflicts of interest. J.N.: no conflicts of interest. G.M.B.: Incyte: advisory board, educational project funding; Geron Corporation: consultancy.

Figures

Figure 1
Figure 1
Age-specific incidence of CML patients in Swiss CCRs by sex and time period.
Figure 2
Figure 2
Mortality of CML patients in Swiss CCRs by sex and time period.
Figure 3
Figure 3
Age-standardized relative survival of CML patients in Swiss CCRs by time period. Significant statistical analysis is shown as follows: ***, <0.001; (see also Tables S3 and S4).
Figure 4
Figure 4
Relative five-year survival of CML patients in Swiss CCRs grouped by age and time periods. Significance of five-year relative survival of CML patients is shown as follows: **, <0.01; ***, <0.001; (see also Tables S3 and S4).
Figure 5
Figure 5
Relative five-year survival grouped by age and time periods of CML patients in Swiss CCRs (A), of CML patients from the Dutch population-based registry (B), and of CML patients from the Swedish population-based registry (C).
See this image and copyright information in PMC

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