METHODS: We used a validated database of 1974-2003 incident cases of hematologic malignancies among the resident population (all ages) of Sardinia, Italy, to describe the incidence of myeloid malignancies overall (N = 4389 cases) and by subtype. We investigated the time trend of acute myeloid leukemia (N = 1227 cases), chronic myeloid leukemia (N = 613 cases), and myelodysplastic syndrome (N = 1296 cases), and used Bayesian methods to explore their geographic spread, and Poisson regression analysis to estimate their association with environmental and socio-economic factors.
RESULTS: The annual standardized (world population) incidence rate (IR) of myeloid malignancies over the study period was 6.5 per 100,000 (95% CI 6.2-6.7). Myelodysplastic syndromes were the most prevalent subgroup (IR = 1.7, 95% CI 1.5-1.8). Incidence of all myeloid malignancies combined increased sharply during the study period with an annual percent change (APC) of 10.06% (95% CI 9.51-10.61), 19.77% for myelodysplastic syndromes (95% CI 19.63-19.91), and 3.18% (95% CI 2.99-3.37) for acute myeloid leukemia. Chronic myeloid leukemia did not show an upward trend. Apart from sporadic excesses in small rural communities and the major urban area, there was no evidence of spatial clustering. The risk of myeloid malignancies increased with increasing prevalence of sheep breeding.
CONCLUSIONS: Our results might prompt further research on the local genetic and environmental determinants of myeloid hematologic malignancies.
方法:我们使用了经过验证的1974-2003年撒丁岛常住人口(所有年龄段)中血液系统恶性肿瘤事件的数据库,意大利,描述髓系恶性肿瘤的总体发生率(N=4389例)和亚型。我们调查了急性髓系白血病(N=1227例)的时间趋势,慢性粒细胞白血病(N=613例),和骨髓增生异常综合征(N=1296例),并使用贝叶斯方法来探索它们的地理分布,和泊松回归分析,以估计它们与环境和社会经济因素的关系。
结果:研究期间髓系恶性肿瘤的年标准化(世界人群)发病率(IR)为6.5/100,000(95%CI6.2-6.7)。骨髓增生异常综合征是最普遍的亚组(IR=1.7,95%CI1.5-1.8)。在研究期间,所有髓系恶性肿瘤的发病率急剧增加,年变化百分比(APC)为10.06%(95%CI9.51-10.61),骨髓增生异常综合征为19.77%(95%CI19.63-19.91),急性髓系白血病为3.18%(95%CI2.99-3.37)。慢性粒细胞白血病未显示上升趋向。除了农村小社区和主要城市地区的零星过剩外,没有空间聚类的证据。随着绵羊繁殖的患病率增加,骨髓性恶性肿瘤的风险增加。
结论:我们的研究结果可能会促进对髓系血液系统恶性肿瘤的局部遗传和环境决定因素的进一步研究。