TY - JOUR
T1 - Age disparity in the dissemination of imatinib for treating chronic myeloid leukemia
AU - Wiggins, Charles L.
AU - Harlan, Linda C.
AU - Nelson, Harold E.
AU - Stevens, Jennifer L.
AU - Willman, Cheryl L.
AU - Libby, Edward N.
AU - Hromas, Robert A.
N1 - Funding Information:
Funding: The National Cancer Institute (NCI) of the National Institutes of Health (NIH) and the Leukemia and Lymphoma Society supported this study. Dr Wiggins acknowledges the support of NCI Contracts NO1-PC-35138 , N01-PC-35133 , N01-PC-35135 , N01-PC-35141 , N01-PC-35136 , N01-PC-35137 , N01-PC-35139 , N01-PC-35142 , N01-PC-35143 , N01-PC-35145 , N01-PC-54402 , N01-PC-54404 , and N01-PC-54405 , and the University of New Mexico Cancer Center , a recipient of NCI Cancer Center Support Grant P30-CA118100 . Dr Willman was supported by LLS SCOR 7388-06 and the NCI 5UO1 CA88361 , and Dr Hromas was supported by LLS 7388-06 , NIH CA139429 , NIH CA100862 , NIH CA140442 , and NIH HL075783 .
PY - 2010/8
Y1 - 2010/8
N2 - Background: Imatinib is a highly effective treatment for chronic myeloid leukemia. It was approved by the Food and Drug Administration in 2001 and thereafter rapidly became front-line therapy. This study characterized the prevailing chronic myeloid leukemia therapies in the United States and assessed the impact of imatinib on chronic myeloid leukemia survival and mortality rates in the general population. Methods: Investigators with the National Cancer Institute's Patterns of Care study reviewed medical records and queried physicians regarding therapy for 423 patients with chronic myeloid leukemia diagnosed in 2003 who were randomly selected from cancer registries in the Surveillance, Epidemiology, and End Results Program. Characteristics associated with the receipt of imatinib were documented, as were survival differences between those who received imatinib and those who did not. Population-based data were used to assess chronic myeloid leukemia survival and mortality rates in time periods before and after the introduction of imatinib. Results: Imatinib was administered to 76% of patients in the Patterns of Care study. Imatinib use was inversely associated with age: 90%, 75%, and 46% for patients ages 20 to 59 years, 60 to 79 years, and 80 or more years, respectively. Elderly patients who received imatinib survived significantly longer than those who did not. After adjusting for age, imatinib use did not vary significantly by race/ethnicity, socioeconomic status, urban/rural residence, presence of comorbid conditions, or insurance status. Overall, chronic myeloid leukemia survival in the Surveillance, Epidemiology, and End Results population improved, and mortality in the United States declined dramatically during the period when imatinib became widely available; these improvements diminished with increasing age. Conclusion: Age disparities in treatment with imatinib likely contributed to worse survival for many elderly patients with chronic myeloid leukemia.
AB - Background: Imatinib is a highly effective treatment for chronic myeloid leukemia. It was approved by the Food and Drug Administration in 2001 and thereafter rapidly became front-line therapy. This study characterized the prevailing chronic myeloid leukemia therapies in the United States and assessed the impact of imatinib on chronic myeloid leukemia survival and mortality rates in the general population. Methods: Investigators with the National Cancer Institute's Patterns of Care study reviewed medical records and queried physicians regarding therapy for 423 patients with chronic myeloid leukemia diagnosed in 2003 who were randomly selected from cancer registries in the Surveillance, Epidemiology, and End Results Program. Characteristics associated with the receipt of imatinib were documented, as were survival differences between those who received imatinib and those who did not. Population-based data were used to assess chronic myeloid leukemia survival and mortality rates in time periods before and after the introduction of imatinib. Results: Imatinib was administered to 76% of patients in the Patterns of Care study. Imatinib use was inversely associated with age: 90%, 75%, and 46% for patients ages 20 to 59 years, 60 to 79 years, and 80 or more years, respectively. Elderly patients who received imatinib survived significantly longer than those who did not. After adjusting for age, imatinib use did not vary significantly by race/ethnicity, socioeconomic status, urban/rural residence, presence of comorbid conditions, or insurance status. Overall, chronic myeloid leukemia survival in the Surveillance, Epidemiology, and End Results population improved, and mortality in the United States declined dramatically during the period when imatinib became widely available; these improvements diminished with increasing age. Conclusion: Age disparities in treatment with imatinib likely contributed to worse survival for many elderly patients with chronic myeloid leukemia.
KW - Age discrimination
KW - Chronic myeloid leukemia
KW - Imatinib
KW - Socioeconomic status
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U2 - 10.1016/j.amjmed.2010.03.018
DO - 10.1016/j.amjmed.2010.03.018
M3 - Article
C2 - 20670732
AN - SCOPUS:77955496483
SN - 0002-9343
VL - 123
SP - 764.e1-764.e9
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 8
ER -