(1) Background: Haematological malignancies (HMs) represent a heterogeneous group of mostly rare cancers that differ in pathophysiology, incidence, and outcome. (2) Methods: Our study aims to understand the epidemiological situation and trends of 24 main types of HMs in Belgium over a 15-year period, with a focus on the impact of age. Age-standardised incidence, average annual percentage change (AAPC), 5- and 10-year relative survival (RS) and RS trends were estimated for all HMs (N = 94,415) diagnosed between 2004 and 2018. (3) Results: Incidence rates of HM increased, mainly in the 70+ age group (AAPC: 3%). RS varied by age and HM type. For each HM type, outcome decreased with age. The greatest decrease with age in 5-year RS is observed for aggressive HM, acute myeloid leukaemia (AML), acute lymphoblastic leukaemia, and Burkitt lymphoma, from 67%, 90%, and 97% below 20 years, to 2%, 12%, and 16% above 80 years of age, respectively. The moderate improvement in 5-year RS over the 2004–2018 period for all HMs, of +5 percentage point (pp), masks highly heterogenous outcomes by HM type and age group. The most impressive improvements are observed in the 80+ group: +45, +33, +28, and +16 pp for Hodgkin lymphoma, immunoproliferative disorders, follicular lymphoma, and chronic myeloid leukaemia, respectively. (4) Conclusions: The increasing incidence and survival over the 2004–2018 period are likely explained by diagnostic and therapeutic innovations, which have spread to populations not targeted by clinical trials, especially older adults. This real-world population-based study highlights entities that need significant improvement, such as AML.
(1) 背景：血液系统恶性肿瘤是一组异质性较强的罕见癌症，其病理生理机制、发病率和预后存在显著差异。(2) 方法：本研究旨在分析比利时15年间24种主要血液系统恶性肿瘤的流行病学现状及变化趋势，重点关注年龄因素的影响。基于2004年至2018年确诊的94,415例患者数据，计算了所有血液系统恶性肿瘤的年龄标准化发病率、平均年度百分比变化、5年及10年相对生存率，并评估生存率变化趋势。(3) 结果：血液系统恶性肿瘤发病率呈上升趋势，尤以70岁以上年龄组最为显著（平均年度百分比变化：3%）。相对生存率随年龄和肿瘤类型呈现显著差异，各类血液系统恶性肿瘤的预后均随年龄增长而下降。侵袭性血液系统恶性肿瘤的5年相对生存率随年龄下降最为明显：急性髓系白血病、急性淋巴细胞白血病和伯基特淋巴瘤在20岁以下患者中分别为67%、90%和97%，而在80岁以上患者中骤降至2%、12%和16%。2004-2018年间所有血液系统恶性肿瘤的5年相对生存率仅呈现中度改善（+5个百分点），这一总体数据掩盖了不同肿瘤类型和年龄组间的巨大异质性。最显著的生存改善出现在80岁以上年龄组：霍奇金淋巴瘤、免疫增殖性疾病、滤泡性淋巴瘤和慢性髓系白血病的5年相对生存率分别提升45、33、28和16个百分点。(4) 结论：2004-2018年间发病率的上升和生存率的改善可能与诊疗技术的创新有关，这些创新已惠及临床试验未覆盖的人群（特别是老年患者）。这项基于真实世界人群的研究揭示了亟待改善的疾病类型，例如急性髓系白血病。
肿瘤(癌症)患者之家