MYELOCYTIC LEUKEMIA: AN ANALYSIS OF INCIDENCE, DISTRIBUTION AND FATALITY, 1910-1948

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Abstract
Statistics are presented regarding the age of onset, sex, duration of illness and mortality of 212 patients with chronic myelocytic leukemia seen in 3 San Francisco hospitals, 1910-1948. The data are compared with nine similar reports in the literature, comprising a total of 975 patients. The data are further compared with U. S. mortality statistics for leukemia during the period 1910-1944. All data show a continually higher incidence of leukemia, although it is not possible to establish whether this represents a true increase or is due to improved recognition and reporting. From 1910 to 1948 there has been a progressive and consistent shift in the sex ratio toward a higher proportion of females in patients with myelocytic and other leukemias. From 1910 to 1948 there has been a progressive and consistent shift toward a higher age at onset or at death of patients with myelocytic and other leukemias. This is probably due to a progressively older living and dying population of the U. S. The duration of illness from chronic myelocytic leukemia, as determined from age of onset to death, shows no significant change during the past 30 yrs. The mean survival time is 3-4 yrs., with 20% living 5 yrs. or longer and 2% living 10 yrs. or longer. No form of therapy can be stated to increase the life span of patients with myelocytic leukemia, although such therapy is definitely ameliorative and palliative. Available statistics regarding evaluation of therapy involve selection which negates direct comparison of different methods. The implications of the study and recommendations for a nationwide therapeutic trial of various agents in leukemia are discussed.