Incidence and survival of therapy related myeloid neoplasm in United States.

BACKGROUND: Therapy related myeloid neoplasm (t-MN) is an emerging challenge in the current era. However, real world data on its incidence and survival at the population level remains sparse.

METHODS: Using Surveillance Epidemiology and End Results (SEER-18) database, we identified patients aged ≥20 years with pathologically confirmed t-MN diagnosed between the years 2001-2014 and actively followed. Incidence rate per 100,000 population and incidence rate ratio (IRR) were calculated. Overall survival (OS) was calculated by Kaplan-Meier method with determinants analyzed by Cox proportional hazard regression method.

RESULTS: A total of 1093 patients with a median age of 65 years were identified. Overall incidence of t-MN was 0.13 cases/100,000 population and showed significant variations with age, race and the period of diagnosis. Two year OS significantly declined with increasing age (51.3% in age group 20-39, 33.9% in age group 40-59, 19.3% in age group 60-79 and 0% in age ≥ 80, p < 0.01). OS has improved over period (year 2001-2007 - 22.1% vs. year 2008-2014 -26.9%, p = 0.01). On multivariate analysis, increasing age was associated with significantly higher mortality. Compared to the period 2001-2007, a significantly lower risk for mortality was seen in the period 2008-2014 (HR 0.73, CI 0.58-0.92, p < 0.01).

CONCLUSIONS: Incidence of t-MN has significantly increased in the last decade. Although OS at the population level is improving over time, outcomes of this disorder continue to remain poor, highlighting the need for novel therapies.