Incidence, Comorbidity and Treatment Survey of Chronic Myeoloid Leukemia in Germany.

Background and objectives Reliable epidemiological data about the incidence of CML, the treatment and the comorbidity profile of patients in Germany was not available. Methods Thus, we used the data base of the Bavarian association of statutory health insurance accredited physicians, which covers 83.5% of all outpatient care in Bavaria with 10.4 million people. A CML-patient was defined as the combination of an ICD 92.1 CML diagnosis plus treatment with either imatinib, interferon alfa, hydroxyurea or busulfan for at least one year. Results In 2004, there were 201 new CML cases seen which results in a crude incidence of 1.93 / 100,000 / year. Adjusted to the World Standard Population the figures are 1.357 for males and 1.063 for females. The median age was 63 (m) and 65 (f) years. Comparing the comorbidities of CML patients with all other patients > 60 years non infectious enteritis and colitis (RR: 2.99), diseases of the oral cavity, salivary glands or jaws (RR: 2.49); infectious of the skin or subcutis (RR: 2.28), surgical complications (RR: 2.13) and symptoms of the GI-tract or abdomen (RR: 2.09) occurred more often in CML-patients, whereas hypertension (RR: 0.81), IHD (RR: 0.93); other heart diseases (RR: 0.87) and cerebrovascular diseases (RR: 0.78) occurred less often. In 2006, 58.8% of the CML-patients received imatinib alone; 10.2% imatinib in combination either with HU or IFN alfa, 25.8% HU, and 7.6% IFN alfa. Discussion and conclusions The true incidence may be slightly lower (about 10%) as some chronic myeloproliferative diseases may have been miscoded as CML, but we may have missed some CML-patients who have been treated as inpatients only, too. Thus, we think that our incidence estimate, and the age and sex distribution is fairly accurate. In addition and for the first time, current treatment comorbidity data of CML-patients in Germany are available.