Background We evaluated if the survival benefit of adding rituximab to
Background We evaluated if the survival benefit of adding rituximab to standard chemotherapy for non-Hodgkin lymphoma (NHL) observed in clinical trials has been experienced by an Australian NHL patient population. diagnosis of NHL. To give context to the survival pattern styles in incidence and mortality were also estimated. Results Compared with 1990-1994 after adjusting for age sex and NHL subtype the relative excess Salmeterol Xinafoate risk of death was significantly lower (p < 0.0001) in 1995-1999 (0.89) and 2000-2004 (0.74). A sharp fall in mortality was observed from 2000 to 2004 (annual percentage switch (APC) = -4.7 p = 0.009) while a small but significant rise in incidence was seen from 1990 to 2004 (APC = 0.5 p = 0.01). The number of occasions rituximab was dispensed in NSW increased rapidly from 1274 in 1999 to 9250 in 2004. Conclusion It is likely that some benefit of adding rituximab to the standard chemotherapy for NHL has been experienced at the population level. Background The incidence of non-Hodgkin lymphoma (NHL) experienced increased substantially in recent decades with smaller increases in recent years in many western countries including Australia. The mortality for NHL rose at a similar rate stabilised in the early 1990s and then started to fall at the end of the 1990s. The survival pattern for NHL had not changed significantly in over two decades up to the late 1990s  despite attempts to increase the efficacy of the standard treatment combination chemotherapy (CHOP) with the addition of other cytotoxic drugs . Two pivotal clinical trials in the late 1990s showed that this addition of the monoclonal antibody targeting the CD20 antigen expressed on almost all malignant B cells rituximab to standard chemotherapy regimens improved the survival for patients with indolent NHL and patients with diffuse large B-cell lymphoma (the two commonest NHL subtypes) . This revolutionary advance in the treatment of NHL was Salmeterol Xinafoate launched in Australia in Salmeterol Xinafoate around 2000 [3 4 The aim of this study was to evaluate if the introduction of this new treatment modality improved the prognosis of NHL patients in the State of New South Wales (NSW) Australia. Methods Data Data were obtained from the population-based NSW Central Malignancy Registry Australia for cases diagnosed with a single first main NHL between 1985 and 2004. Based on populace size NSW is the largest state comprising approximately one-third of the Australian populace. Notification of malignancy has been a statutory requirement for all NSW public and private hospitals radiotherapy departments and nursing homes since 1972 and for pathology departments since 1985 . Coding for main site and NHL subtype was carried out either by medical coders in the hospitals that notified the Registry or by medical coders in the Registry who generally assigned subtype based on pathology and hospital notifications. The proportion of cases that were histologically verified has been relatively constant (>85%) since 1985 . Cases aged less than 15 years old or those reported to the Registry through death certificate only or first recognized at post-mortem were excluded. All eligible cases were matched to death records from your State Registrar of Births Deaths and Marriages and the National Death Index to determine survival status at 31 December 2004. We obtained the Pharmaceutical Benefits claims data representing the number of occasions rituximab was dispensed including initial prescriptions and repeats  in NSW for 1999-2004 from your Medicare Australia website. The prescription codes for NHL patients only were used (8293L 8294 8665 and Mouse monoclonal to PR 8666D) so any increase in the number of claims is directly related to an increase in use for the treatment of NHL. As rituximab was outlined for subsidisation in mid 1998 we did not include claims data for the year. Styles in survival Relative survival a means of removing the effect of mortality from other causes  was used in this study because causes of death on death certificates are often inaccurate . Relative survival is the ratio of the observed proportion surviving Salmeterol Xinafoate in a group of patients to the expected proportion that would have survived in a comparable group of people (with the same distribution by age and sex) from the general populace . Observed survival was estimated by the life table method . The estimates of the expected survival proportions for each time period (1990-94 1995 and 2000-2004) were derived from the life tables for the general populace based on.