Advertisement

Annals of Hematology

, Volume 96, Issue 3, pp 373–381 | Cite as

Real world epidemiology of myeloproliferative neoplasms: a population based study in Korea 2004–2013

  • Ja Min Byun
  • Young Jin Kim
  • Taemi Youk
  • John Jeongseok Yang
  • Jongha Yoo
  • Tae Sung Park
Original Article

Abstract

Myeloproliferative neoplasms (MPNs), with an expected increment in number, impose substantial economic and social burdens. To this end, we conducted a nationwide population-based descriptive epidemiology study. We also investigated medical cost associated with MPNs. Prevalence was the highest for essential thrombocythemia (ET) (range 4.1–9.0 per 100,000), followed by polycythemia vera (PV) (range 2.8–5.4 per 100,000) and primary myelofibrosis (PMF) (range 0.5–0.9 per 100,000). ET incurred the highest cumulative total cost at US$35 million and the most frequent hospital visits, while PMF incurred the highest average cost per person at US$5000. The mean hemoglobin level was 16.9 ± 2.2 g/dL for PV males and 15.5 ± 2.7 g/dL for PV females. Further analyses on hemoglobin levels showed the true positive rate of PV from the significantly elevated hemoglobin group (defined as >18.5 g/dL for men and >16.5 g/dL for women) was 3.01% and that of MPNs was 3.1%. Here, we provide the biggest population-based report on MPN epidemiology that can readily be used as a representative Asian data.

Keywords

Myeloproliferative neoplasm Epidemiology Asia Medical cost 

Notes

Acknowledgements

This research was supported by the National Health Insurance Service Ilsan Hospital Grant (NHIMC 2015-20-010). Also, this study used National Health Insurance Service National Sample Cohort (NHIS-NSC) data (NHIS-2016-1-114), made by the NHIS.

Authorship contributions

JMB, YJK, JY, and TSP designed the study concept, performed the research, analyzed the data, and wrote the manuscript; TY collected the data and maintained the database; JJY participated in designing the research; and all the authors approved the final version of the manuscript.

Compliance with ethical standards

This study design was reviewed and approved by the Institutional Review Board of the National Health Insurance Service Ilsan Hospital (IRB No. NHIMC 2015-02-029).

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

277_2016_2902_MOESM1_ESM.docx (38 kb)
ESM 1 (DOCX 38 kb)

References

  1. 1.
    Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A et al (2009) The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood 114:937–951CrossRefPubMedGoogle Scholar
  2. 2.
    Titmarsh GJ, Duncombe AS, McMullin MF, O'Rorke M, Mesa R, De Vocht F et al (2014) How common are myeloproliferative neoplasms? A systematic review and meta-analysis. Am J Hematol 89:581–587CrossRefPubMedGoogle Scholar
  3. 3.
    Levine RL, Gilliland DG (2008) Myeloproliferative disorders. Blood 112:2190–2198CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Mesa RA, Schwager S, Radia D, Cheville A, Hussein K, Niblack J et al (2009) The Myelofibrosis Symptom Assessment Form (MFSAF): an evidence-based brief inventory to measure quality of life and symptomatic response to treatment in myelofibrosis. Leuk Res 33:1199–1203CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Scherber R, Dueck AC, Johansson P, Barbui T, Barosi G, Vannucchi AM et al (2011) The Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF): international prospective validation and reliability trial in 402 patients. Blood 118:401–408CrossRefPubMedGoogle Scholar
  6. 6.
    Kralovics R, Passamonti F, Buser AS, Teo SS, Tiedt R, Passweg JR et al (2005) A gain-of-function mutation of JAK2 in myeloproliferative disorders. N Engl J Med 352:1779–1790CrossRefPubMedGoogle Scholar
  7. 7.
    Wadleigh M, Tefferi A (2010) Classification and diagnosis of myeloproliferative neoplasms according to the 2008 World Health Organization criteria. Int J Hematol 91:174–179CrossRefPubMedGoogle Scholar
  8. 8.
    Kim DS (2010) Introduction: health of the health care system in Korea. Soc Work Public Health 25:127–141CrossRefPubMedGoogle Scholar
  9. 9.
    Kim DS (2010) Special issue on the national health care system of South Korea. Soc Work Public Health 25:125–126CrossRefPubMedGoogle Scholar
  10. 10.
    Moulard O, Mehta J, Fryzek J, Olivares R, Iqbal U, Mesa RA (2014) Epidemiology of myelofibrosis, essential thrombocythemia, and polycythemia vera in the European Union. Eur J Haematol 92:289–297CrossRefPubMedGoogle Scholar
  11. 11.
    Mehta J, Wang H, Iqbal SU, Mesa R (2014) Epidemiology of myeloproliferative neoplasms in the United States. Leuk Lymphoma 55:595–600CrossRefPubMedGoogle Scholar
  12. 12.
    Phekoo KJ, Richards MA, Moller H, Schey SA, South Thames Haematology specialist Committee (2006) The incidence and outcome of myeloid malignancies in 2,112 adult patients in southeast England. Haematologica 91:1400–1404PubMedGoogle Scholar
  13. 13.
    Buhr T, Georgii A, Choritz H (1993) Myelofibrosis in chronic myeloproliferative disorders. Incidence among subtypes according to the Hannover Classification. Pathol Res Pract 189:121–132CrossRefPubMedGoogle Scholar
  14. 14.
    Ania BJ, Suman VJ, Sobell JL, Codd MB, Silverstein MN, Melton LJ 3rd (1994) Trends in the incidence of polycythemia vera among Olmsted County, Minnesota residents, 1935-1989. Am J Hematol 47:89–93CrossRefPubMedGoogle Scholar
  15. 15.
    Roaldsnes C, Waage A, Nørgaard M, Ghanima W (2014) Epidemiology of myeloproliferative neoplasms in Norway. Blood 124:S634 (abstrac 1858)Google Scholar
  16. 16.
    Johansson P (2006) Epidemiology of the myeloproliferative disorders polycythemia vera and essential thrombocythemia. Semin Thromb Hemost 32:171–173CrossRefPubMedGoogle Scholar
  17. 17.
    Srour SA, Devesa SS, Morton LM et al. Incidence and patient survival of myeloproliferative neoplasms and myelodysplastic/myeloproliferative neoplasms in the United States, 2001-12. Br J Haematol. Prepublished on April 7, 2016, as doi:  10.1111/bjh.14061
  18. 18.
    Choi CW, Bang SM, Jang S, Jung CW, Kim HJ, Ki HY et al (2015) Guidelines for the management of myeloproliferative neoplasms. Korean J Intern Med 30:771–788CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Bang SM, Lee JS, Ahn JY, Lee JH, Hyun MS, Kim BS et al (2009) Vascular events in Korean patients with myeloproliferative neoplasms and their relationship to JAK2 mutation. Thromb Haemost 101:547–551PubMedGoogle Scholar
  20. 20.
    Mesa RA, Li CY, Ketterling RP, Schroeder GS, Knudson RA, Tefferi A (2005) Leukemic transformation in myelofibrosis with myeloid metaplasia: a single-institution experience with 91 cases. Blood 105:973–977CrossRefPubMedGoogle Scholar
  21. 21.
    Rollison DE, Howlader N, Smith MT, Strom SS, Merritt WD, Ries LA et al (2008) Epidemiology of myelodysplastic syndromes and chronic myeloproliferative disorders in the United States, 2001-2004, using data from the NAACCR and SEER programs. Blood 112:45–52CrossRefPubMedGoogle Scholar
  22. 22.
    Dan K, Yamada T, Kimura Y, Usui N, Okamoto S, Sugihara T et al (2006) Clinical features of polycythemia vera and essential thrombocythemia in Japan: retrospective analysis of a nationwide survey by the Japanese Elderly Leukemia and Lymphoma Study Group. Int J Hematol 83:443–449CrossRefPubMedGoogle Scholar
  23. 23.
    Bai J, Ai L, Zhang L, Yang F, Zhou Y, Xue Y (2015) Incidence and risk factors for myelofibrotic transformation among 272 Chinese patients with JAK2-mutated polycythemia vera. Am J Hematol 90:1116–1121CrossRefPubMedGoogle Scholar
  24. 24.
    Fu R, Xuan M, Lv C, Zhang L, Li H, Zhang X et al (2014) External validation and clinical evaluation of the International Prognostic Score of Thrombosis for Essential Thrombocythemia (IPSET-thrombosis) in a large cohort of Chinese patients. Eur J Haematol 92:502–509CrossRefPubMedGoogle Scholar
  25. 25.
    Kim JI (2013) Social factors associated with centenarian rate (CR) in 32 OECD countries. BMC Int Health HumRights 13:16CrossRefGoogle Scholar
  26. 26.
    Tefferi A (2008) Essential thrombocythemia, polycythemia vera, and myelofibrosis: current management and the prospect of targeted therapy. Am J Hematol 83:491–497CrossRefPubMedGoogle Scholar
  27. 27.
    Anderson LA, McMullin MF (2014) Epidemiology of MPN: what do we know? Curr Hematol Malig Rep 9:340–349CrossRefPubMedGoogle Scholar
  28. 28.
    Passamonti F, Rumi E, Pungolino E, Malabarba L, Bertazzoni P, Valentini M et al (2004) Life expectancy and prognostic factors for survival in patients with polycythemia vera and essential thrombocythemia. Am J Med 117:755–761CrossRefPubMedGoogle Scholar
  29. 29.
    Jensen MK, de Nully Brown P, Nielsen OJ, Hasselbalch HC (2000) Incidence, clinical features and outcome of essential thrombocythaemia in a well defined geographical area. Eur J Haematol 65:132–139CrossRefPubMedGoogle Scholar
  30. 30.
    Mehta J, Wang H, Fryzek JP, Iqbal SU, Mesa R (2014) Health resource utilization and cost associated with myeloproliferative neoplasms in a large United States health plan. Leuk Lymphoma 55:2368–2374CrossRefPubMedGoogle Scholar
  31. 31.
    Cervantes F, Dupriez B, Pereira A, Passamonti F, Reilly JT, Morra E et al (2009) New prognostic scoring system for primary myelofibrosis based on a study of the International Working Group for Myelofibrosis Research and Treatment. Blood 113:2895–2901CrossRefPubMedGoogle Scholar
  32. 32.
    Deadmond MA, Smith-Gagen JA (2015) Changing incidence of myeloproliferative neoplasms: trends and subgroup risk profiles in the USA, 1973-2011. J Cancer Res Clin Oncol 141:2131–2138CrossRefPubMedGoogle Scholar
  33. 33.
    Kim BJ, Heo C, Kim BK, Kim JY, Kim JG (2013) Effectiveness of gastric cancer screening programs in South Korea: organized vs opportunistic models. World J Gastroenterol 19:736–741CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Shim JI, Kim Y, Han MA, Lee HY, Choi KS, Jun JK et al (2010) Results of colorectal cancer screening of the national cancer screening program in Korea, 2008. Cancer Res Treat 42:191–198CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Kang MH, Park EC, Choi KS, Suh M, Jun JK, Cho E (2013) The National Cancer Screening Program for breast cancer in the Republic of Korea: is it cost-effective? Asian Pac J Cancer Prev 14:2059–2065CrossRefPubMedGoogle Scholar
  36. 36.
    Han MA, Choi KS, Lee HY, Jun JK, Jung KW, Kang S et al (2012) Performance of papanicolaou testing and detection of cervical carcinoma in situ in participants of organized cervical cancer screening in South Korea. PLoS One 7:e35469CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of Internal MedicineSeoul National University College of Medicine, Seoul National University HospitalSeoulRepublic of Korea
  2. 2.Department of Laboratory MedicineKyung Hee University School of MedicineSeoulRepublic of Korea
  3. 3.Research InstituteNational Health Insurance Service Ilsan HospitalSeoulRepublic of Korea
  4. 4.Yangpyeong Public Health CenterYangpyeongRepublic of Korea
  5. 5.Department of Laboratory MedicineNational Health Insurance Service Ilsan HospitalGoyangRepublic of Korea

Personalised recommendations