Improvement of relative survival in elderly patients with acute myeloid leukaemia emerging from population-based cancer registries in Switzerland between 2001 and 2013

Acute Myeloid Leukaemia (AML) is a rare and heterogeneous haematological malignancy with increasing incidence in the elderly. We performed a population-based, observational analysis of AML cases reported to the Cantonal Cancer Registries in Switzerland. Data was aggregated by the National Institute for Epidemiology and Cancer Registration and stratified for the two time periods 2001-2007 and 2008-2013. Overall, 2351 new AML cases were registered with a stable age-standardised incidence rate (3.0 [95 CI: 2.8-3.2] per 100,000 person-years). This indicates that our observed raise of annual AML cases (+10.9%) is mainly related to demographic ageing and not to an increase of age-specific risks. The fraction of non-classifiable AML cases decreased over time (54.6% to 41.8%) but remained high in elderly patients (65-74yrs: 44%; 75-84yrs: 54.2%, 85+yrs: 59.1%), suggesting less accurate diagnostics and reporting with increasing age. 5yrs relative survival (RS) correlated with AML risk class (favorable: 61.7%-68.4%; adverse risk: 11.4%-21.9%) and age (<65yrs: 42.6-43.3%; 75-84yrs: 2.0-3.0%), but improved only modestly overall (19.2% to 23.3%). Interestingly, we identified a significant improvement of RS in patients aged 65-74yrs (5yrs: 5.2% to 13.5%; p<0.001). As surrogate for changes in management, we found an increase of allogeneic haematopoietic stem cell transplantations (1.4 to 7%) and clinical trial activities (25 to 29%) for elderly AML patients during the observation period. Our analysis indicates that recent progress made in management of elderly AML patients results in an improvement of survival on a population-based level in Switzerland and that therapeutic nihilism is not justifiable

Hepatitis E Viruses : Emerging and Transboundary Animal Viruses

Hepatitis E virus (HEV), member of genus Orthohepevirus in the family Hepeviridae, is the leading cause of hepatitis E. More than 20 million cases of hepatitis E virus (HEV) infection have been reported globally, out of which 3.3 million suffered from symptomatic illness and 44,000 deaths were recorded. Hepatitis E is considered highly significant on account of its predominance in both developed and developing nations due to poor sanitation and low-grade drinking water. In India and Africa, the major cause of hepatitis E was water contaminated with faecal matter. Reports from East and Southeast Asia signified the role of animal reservoir, especially pigs, for HEV. In Western Asia, the major cases of hepatitis E were associated with blood transfusion. However, in Europe and South and North America, the significant causes of hepatitis E were associated with the consumption of pork products. Till date, major rely is on the enzyme immunoassays involving antibodies for detection and diagnosis purpose. Still, there is a need for the improvement and development of new approaches and methods for diagnosing hepatitis E virus as well as developing HEV vaccines