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Overall survival and competing risks of death in patients with W aldenström macroglobulinaemia: an analysis of the S urveillance, E pidemiology and E nd R esults database
Author(s) -
Castillo Jorge J.,
Olszewski Adam J.,
Kanan Sandra,
Meid Kirsten,
Hunter Zachary R.,
Treon Steven P.
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13264
Subject(s) - medicine , hazard ratio , cohort , confidence interval , multivariate analysis , proportional hazards model , waldenstrom macroglobulinemia , cumulative incidence , incidence (geometry) , gastroenterology , lymphoma , physics , optics
Summary 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 S urveillance, E pidemiology and E nd R esults ( 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.