Hematological malignancies in the elderly: The epidemiological perspective

Alberto Quaglia, Marina Vercelli, Roberto Lillini, Guido Mazzoleni, Silvano Piffer, Diego Serraino, Sandro Tognazzo, Paolo Ricci, Luigi Bisanti, Paolo Crosignani, Michele Magoni, Gemma Gola, Maria Eugenia, Sanoja Gonzalez, Roberto Zanetti, Adriano Giacomin, Marina Vercelli, Maria Michiara, Lucia Mangone, Massimo FedericoStefano Ferretti, Fabio Falcini, Adele Caldarella, Susanna Vitarelli, Francesco La Rosa, Fabio Pannozzo, Ornelia Sechi, Mario Usala, Luigi Cremone, Antonella Sutera Sardo, Francesco Vitale, Giuseppina Candela, Salvatore Sciacca, Francesco Tisano, Rosario Tumino

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

In the more developed countries the total number of new cases with a hematological tumour was 415,433 for all ages, whilst 188,654 occurred in people aged 70 or more years, representing the 45 % of total cases, equally divided into two sexes. The most these malignancies is closely linked to age and incidence rates increased exponentially after 50 years of age. Aetiology of hematological tumours is largely unknown. However the basic causal mechanism could be a decline in adaptive immunity, strongly related with individual age. In addition to such immunodeficiency, some specific risk factors have been found: viral infections, overweight and obesity (particularly for non-Hodgkin’s lymphomas - NHL), ionising radiation and chemical compounds (particularly for leukemia). Moreover, it must to be taken into account that mortality and survival, more specifically in the elderly, are influenced negatively by socio-economic deprivation. Considering geographical distribution, substantial variations in incidence and mortality across the world were observed. Incidence of younger and older adults was for all hematological malignancies higher in more developed countries. As regards mortality, younger people showed rates higher in developing countries, while the elderly in Western and developed areas. The epidemic growth of NHL incidence was not finished in the first decade of 2000, even if in Italian and US old populations the rates started leveling off. Unlike incidence, mortality was descending in the elderly. Leukemia incidence trends were very often stable or weakly growing, without any tendency to decrease, but for leukemia mortality it was possible to highlight an encouraging general picture with rates often decreasing. The elderly had always survival rates lower than those of middle aged adults. The prognostic disadvantage was larger at 1 than 5 years from diagnosis. The gap was smaller for NHL and acute myeloid leukemia, whereas the difference in survival was much larger for chronic myeloid leukemia and Hodgkin’s lymphoma. Summarizing, elderly patients had a marked prognostic disadvantage with respect younger adults. However, if an elderly subject survives the first period immediately after detection and overcomes the first difficulties of access to healthcare, experiences a prognosis similar to that of a younger patient.

Original languageEnglish
Title of host publicationManagement of Hematological Cancer in Older People
PublisherSpringer-Verlag London Ltd
Pages1-34
Number of pages34
ISBN (Print)9781447128373, 9781447128366
DOIs
Publication statusPublished - Jan 1 2015

Keywords

  • Aetiology
  • Descriptive epidemiology
  • Elderly
  • Hematological tumours
  • Incidence
  • Mortality
  • Survival
  • Trend

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Quaglia, A., Vercelli, M., Lillini, R., Mazzoleni, G., Piffer, S., Serraino, D., Tognazzo, S., Ricci, P., Bisanti, L., Crosignani, P., Magoni, M., Gola, G., Eugenia, M., Gonzalez, S., Zanetti, R., Giacomin, A., Vercelli, M., Michiara, M., Mangone, L., ... Tumino, R. (2015). Hematological malignancies in the elderly: The epidemiological perspective. In Management of Hematological Cancer in Older People (pp. 1-34). Springer-Verlag London Ltd. https://doi.org/10.1007/978-1-4471-2837-3_1