MDS Incidence Rate in the U.S by ktf14580

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									                                                                           9/22/2009




                 MDS: Why Me?


    Ron Paquette, MD
    UCLA Division of Hematology/Onocology




    MDS Incidence Rate in the U.S.

• Yearly incidence of 3.3 cases per 100,000

  Approximately 10 000 new cases per year
• A     i t l 10,000

• Median age is 76 years


  Ma X et al. Cancer 2007;109:1536. Rollison D et al. Blood 2008;112:45.




      MDS Incidence Rate: World
            Country                        Incidence/100,000
               U.S.                                    3.4
    England and Wales                                  3.6
           Germany                                     4.1
                                                       41
            Sweden                                     3.6
             France                                    3.2
             Japan*                                      1

*Median age of onset is 60 years
Provided by Mikkael Sekeres, MD, Cleveland Clinic Foundation




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     Affect of Age on MDS Risk
                           14

                           12
       MDS cases/100,000




                           10

                           8

                           6

                           4

                           2

                           0
                                <40   40-49    50-59         60-69   70-79   >80
                                                       Age



      Rollison D et al. Blood 2008;112:45.




    Affect of Gender and Race on
               MDS Risk
    • Gender
                – Male                        4.5/100,000
                – Female                      2.7/100,000
      Race
    • R
                – White                       3.5/100,000
                – Black                       3.0/100,000
                – Asian                       2.6/100,000


      Rollison D et al. Blood 2008;112:45.




  Risk Factors for Developing MDS
• Congenital
   – Down Syndrome, Fanconi’s anemia, others
• Chemotherapy – damages DNA
   – Recipients of alkylating agents and topoisomerase inhibitors
   – Lymphoma patients after autologous transplants
• Pre-existing blood disorders
   – Aplastic anemia, risk may be increased by G-CSF
• Radiation exposure
   – Recipients of radiation therapy
   – Occupational (radiation workers)
• Benzene exposure
   – Leather manufacturing, degreasing metal parts, petroleum
     products
• Other toxins?




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      Life Style Risk Factors for MDS
• Body Mass Index
   – Normal (<25 kg/m2 BSA)                      Relative risk: 1.0
   – Overweight (25 to <30 kg/m2 BSA)            Relative risk: 1.2
   – Obese (>30 kg/m   2 BSA)                    Relative risk: 2.2
• Cigarette Smoking
   – Never smoker                                Relative risk: 1.0
   – Former smoker                               Relative risk: 1.7
   – Active smoker
       • <1 pack/day                             Relative risk: 2.4
       • >1 pack/day                             Relative risk: 4.7
• Vigorous Physical Activity
   – >3 times/week                               Relative risk: 1.0
   – 1-2 times/week                              Relative risk: 1.2
   – <3 times/month                              Relative risk: 1.5
• Amount of alcohol intake, fruit and vegetable intake, and meat intake
  were not associated with risk of MDS

Ma X et al. Cancer 2007;109:1536.




      Risks for MDS - Conclusions
 •   Increasing age
 •   Male gender
 •   Residing in Europe or North America
 •   “White”
 •   Smoking
     S ki
 •   Obesity
 •   Inactivity
 •   Previous blood disorder (aplastic anemia)
 •   Chemotherapy/radiation exposure
 •   Exposure to benzene or petroleum products




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