Survival of Myeloid Malignancies in EUROPE: Results of the HAEMACARE Project.

Updated ICD-O and WHO classifications of Haematological Malignancies (HMs) take into account cell lineage, genotype, morphological aspects, immuno-histochemical and genetic characteristics, and clinical behaviour of the disease, dividing Lymphoid and Myeloid neoplasms in subcategories with possible similar aetiology or prognosis. Thus, good quality of morphological data on HMs is capital. The HAEMACARE project aimed to increase standardization and the availability of Cancer Registries (CRs) morphological data on HMs, in order to improve comparability of incidence, survival and prevalence across Europe.

This study aims to present the HAEMACARE main results on survival of Myeloid Malignancies in Europe, by morphological subgroups, sex and geographical area.

We included 59,499 cases of Myeloid Malignancies occurred in the adult population (≥15 years old), both sexes, in 45 CRs from 16 European countries, over the period 1995-2002. CRs were grouped in 5 geographical areas: Northern Europe (Iceland, Norway, Sweden); Central Europe (Austria, France, Germany, The Netherlands, Switzerland); Southern Europe (Italy, Malta, Slovenia, Spain); Eastern Europe (Czech Republic, Poland); UK & Ireland. Morphological ICD-O-3 codes were grouped in 5 large categories: Acute Myeloid Leukaemia (AML); Myeloproliferative Neoplasms (MPN); Myelodysplastic Syndrome (MDS), Myelodysplastic/Myeloproliferative Neoplasms (MDS/MPN) and NOS cases in which were grouped AL of ambiguous lineage (9805/3), Myeloid Leukemia (9860/3), Acute Leukemia (9801/3) and Leukemia (9800/3). Time trends of NOS cases incidence were computed in order to check the quality and completeness of data. Relative survival was calculated using the SEER free software.

Among the 59,499 myeloid malignancies cases, they were 21,276 AML (38.4%), 20,049 MPN (35.5%), 8,480 MDS (14.2%) and 1,764 MDS/MPN (2.9%). 29,651 cases (52.6%) were diagnosed in male and 26,848 in female (47.4%). The geographical distribution of cases was not equivalent across Europe: 47.8% of the cases were from UK & Ireland, 14% from Central Europe, 2.4% from Eastern Europe, 17.4% from Northern Europe and 18.4% from Southern Europe. This figure was the same for all categories. They were 48.4% of AML and 49.6% of MPN up to 70 years-old instead of what this category represent 75.7% of MDS and 76.6% of MDS/MPN. Relative survival was evaluated by entity according to WHO classification, by area for main groups and morphology codes, by sex, by age and by period of time.

From Eurocare database, survival data are usually produced for large categories in which myeloid disease are not always identified. Within the HAEMACARE project we applied the WHO classification rules to identify cases and group them in a meaningful way. This allowed us to provided survival data from the largest series of myeloid malignancies from European countries. This study was presented on behalf the HAEMACARE working group;

No relevant conflicts of interest to declare.