Ege Üniversitesi hastanesi veri tabanında kayıtlı erişkin akut lösemi olgularının epidemiyolojik ve genel sağkalım özelliklerinin retrospektif olarak değerlendirilmesi
Öz
Amaç: Akut lösemi/lenfoma ve myeloid sarkom, hematopoietik prekürsör hücrelerden gelişen klonal neoplastik proliferasyonlardır. Bu çalışmada, olgularının epidemiyolojik analizlerinin yapılması, global sonuçlarla karşılaştırılarak değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezi veri tabanına kayıtlı, 1992-2017 yıllarında akut lösemi/lenfoma ve myeloid sarkom tanısı alan 2.046 erişkin olgu retrospektif olarak değerlendirilmiştir.
Bulgular: Olguların %58’i erkek olup; ortalama tanı yaşı 50,62, medyan tanı yaşı ise 52 idi. En sık (%62,5) akut myeloid lösemi (AML) izlendi. Olguların %95,8’i lösemik prezentasyon göstermekteydi. Sınıflandırılamayan lenfoblastik lösemi (ALL) olguları yıllara göre azalırken, diğer gruplarda yıllara göre lösemi tanısında artış dikkatimizi çekti. Çocukluk yaş grubunda daha sık karşımıza çıkan ALL olgularında yaş arttıkça görülme oranlarının azaldığı, hücre dizisi belirsiz akut lösemi olgularında ise yaş arttıkça görülme oranlarının da arttığı saptandı. AML ve tüm lösemi olguları ise en çok 40-64 yaş aralığında yer almaktaydı. Akut lösemi olgularında 1, 5, 10 ve 25 yıllık sağkalım sırasıyla %55,7, %29, %23 ve %15 olarak bulundu. Ayrıca sağkalım 18-39 yaş grubunda %52,3, 40-64 yaş grubunda %35,3, 65 yaş ve üstü grupta %20,9 idi.
Sonuç: Cinsiyet ve sağkalım arasında bir fark saptanmaz iken, lösemik prezentasyon gösterenlerde, tedavi almayan olgularda ve yaş arttıkça sağkalım daha kısa bulunmuş ve istatistiksel olarak da anlamlı saptanmıştır. Prognozda, histolojik tip, yaş ve tedavi bizim çalışmamızda da öne çıkan önemli parametrelerdendir.
Anahtar Kelimeler
Kaynakça
- Swerdlow SH, Campo E, Harris NL, et al. WHO classification of tumours of haematopoietic and lymphoid tissues, 4th edition (IARC WHO Classification of Tumours, Volume 2). International. agency for research on Cancer (IARC). Lyon, 2017:128-189.
- Siegel RL, Miller KD, Jemal A. Cancer Statistics , 2018. CA Cancer J Clin 2018;68(1):7–30.
- Zeidan AM, Podoltsev NA, Wang X, et al. Temporal patterns and predictors of receiving no active treatment among older patients with acute myeloid leukemia in the United States: A population-level analysis. Cancer 2019;125(23):4241–51.
- Utuama O, Mukhtar F, Pham YTH, et al. Racial/ethnic, age and sex disparities in leukemia survival among adults in the United States during 1973-2014 period. PLoS One 2019;14(8):1–12.
- Noone A, Howlader N, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2015, National Cancer Institute. Natl Cancer Inst 2018. Available from: www.seer.cancer.gov/archive/csr/1975_2015/
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2018;68(6):394–424.
- Podoltsev NA, Stahl M, Zeidan AM, Gore SD. Selecting initial treatment of acute myeloid leukaemia in older adults. Blood Rev 2017;31(2):43–62.
- Takaoka K, Koya J, Yoshimi A, et al. Nationwide epidemiological survey of familial myelodysplastic syndromes/acute myeloid leukemia in Japan: a multicenter retrospective study. Leuk Lymphoma 2020;61(7):1–7.
- Murthy GSG, Dhakal I, Lee JY, Mehta P. Acute Leukemia of Ambiguous Lineage in Elderly Patients: A SEER-Medicare Database Analysis. Clin Lymphoma, Myeloma Leuk 2017;17(2):100–7.
- Qasrawi A, Gomes V, Chacko CA, et al. Acute undifferentiated leukemia: data on incidence and outcomes from a large population-based database. Leuk Res 2020;89(1):106301. doi: https://doi.org/10.1016/j.leukres.2020.106301
- Appelbaum FR, Gundacker H, Head HR, et al. Age and acute myeloid leukemiak. Blood. 2006;107 (9): 3481–5.
- Juliusson G, Antunovic P, Derolf A, et al. Age and acute myeloid leukemia: Real world data on decision to treat and outcomes from the Swedish Acute Leukemia Registry. Blood. 2009;113(18):4179–87.
Retrospective evaluation of the epidemiological and overall survival characteristics of adult acute leukemia cases registered in the database of Ege University hospital
Öz
Aim: Acute leukemia/lymphoma and myeloid sarcoma originated from hematopoietic precursor cells are clonal neoplastic proliferations. The aim of this study was to evaluate the epidemiological analysis of patients and compare them to global findings.
Materials and Methods: The data, including 2,046 adult patients diagnosed as acute leukemia/lymphoma, and myeloid sarcoma recorded at Ege University Cancer Control and Research Center, within 1992-2017, were evaluated retrospectively.
Results: Of the patients, 58% was male; the mean age was 50.62, the median age was 52. The most common type of leukemia (62.5%) was acute myeloid leukemia (AML). Leukemic presentation was seen in 95.8% of the patients. While the non-specified type of lymphoblastic leukemia (ALL) decreased in years, the diagnosis of leukemia in other groups increased in years. It was found that the incidence of ALL, which are more common in the pediatric age, decreased with age, and the incidence of acute leukemia with ambiguous lineage increased with age. Most of the AML and all leukemia patients were in the age range of 40-64. Overall survival for 1, 5, 10, and 25-year in patients with acute leukemia were 55.7%, 29%, 23%, and 15%, respectively. In addition, it was 52.3% in the 18-39 age range, 35.3% in the 40-64 age range, and 20.9% in the 65 age and over.
Conclusion: While there was no significant difference between gender and survival, leukemic presentation, untreatment and older age was statistically significantly correlated with poor overall survival. Histologic type, age, and treatment of the disease were found to be among the most important prognostic parameters in our study.
Anahtar Kelimeler
Kaynakça
- Swerdlow SH, Campo E, Harris NL, et al. WHO classification of tumours of haematopoietic and lymphoid tissues, 4th edition (IARC WHO Classification of Tumours, Volume 2). International. agency for research on Cancer (IARC). Lyon, 2017:128-189.
- Siegel RL, Miller KD, Jemal A. Cancer Statistics , 2018. CA Cancer J Clin 2018;68(1):7–30.
- Zeidan AM, Podoltsev NA, Wang X, et al. Temporal patterns and predictors of receiving no active treatment among older patients with acute myeloid leukemia in the United States: A population-level analysis. Cancer 2019;125(23):4241–51.
- Utuama O, Mukhtar F, Pham YTH, et al. Racial/ethnic, age and sex disparities in leukemia survival among adults in the United States during 1973-2014 period. PLoS One 2019;14(8):1–12.
- Noone A, Howlader N, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2015, National Cancer Institute. Natl Cancer Inst 2018. Available from: www.seer.cancer.gov/archive/csr/1975_2015/
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2018;68(6):394–424.
- Podoltsev NA, Stahl M, Zeidan AM, Gore SD. Selecting initial treatment of acute myeloid leukaemia in older adults. Blood Rev 2017;31(2):43–62.
- Takaoka K, Koya J, Yoshimi A, et al. Nationwide epidemiological survey of familial myelodysplastic syndromes/acute myeloid leukemia in Japan: a multicenter retrospective study. Leuk Lymphoma 2020;61(7):1–7.
- Murthy GSG, Dhakal I, Lee JY, Mehta P. Acute Leukemia of Ambiguous Lineage in Elderly Patients: A SEER-Medicare Database Analysis. Clin Lymphoma, Myeloma Leuk 2017;17(2):100–7.
- Qasrawi A, Gomes V, Chacko CA, et al. Acute undifferentiated leukemia: data on incidence and outcomes from a large population-based database. Leuk Res 2020;89(1):106301. doi: https://doi.org/10.1016/j.leukres.2020.106301
- Appelbaum FR, Gundacker H, Head HR, et al. Age and acute myeloid leukemiak. Blood. 2006;107 (9): 3481–5.
- Juliusson G, Antunovic P, Derolf A, et al. Age and acute myeloid leukemia: Real world data on decision to treat and outcomes from the Swedish Acute Leukemia Registry. Blood. 2009;113(18):4179–87.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 26 Ekim 2020 |
| Gönderilme Tarihi | 28 Ağustos 2020 |
| Yayımlandığı Sayı | Yıl 2020 |