Work

Hematologic Malignancies Survival Patterns in Elderly Patients: Disparities in Martinique, a Caribbean Population-Based Registry Study, 2008-2021

Year: 2026

Type: article

Abstract: Background: Disparities in Hematologic Malignancies (HM) including Leukemia, Non-Hodgkin Lymphoma, Myeloproliferative/Myelodysplastic Syndromes, and Myeloma, management based on geographic location and ethnicity remain a pressing global challenge. In the French Caribbean, HM are poorly understood, and elderly patients face significant disparities in survival and treatment access. This study aimed to characterize survival patterns and prognostic factors in elderly patients with HM in Martinique using population-based registry data. Methods: Overall survival was estimated by Kaplan-Meier methods (95% CI) in 1,309 patients with HM aged ≥65 years, stratified by age, sex, histology, and chemotherapy. A Cox proportional hazards regression model was constructed to assess survival disparities incorporating age, sex, HM category, and geographic residency as covariates. Results: Across 2008-2021 the median survival of patients with HM was 2.86 years. Marked variability was observed across diagnostic periods: median survival was 2.58 years in 2008-2012, 3.48 years in 2013-2017, and 2.76 years in 2018-2021. Myeloproliferative/Myelodysplastic Syndromes and Non-Hodgkin Lymphoma showed age-specific survival declines in the 75-84 age group during 2018-2021. For Myeloma, five-year survival improved from 49% (2008-2012) to 58% (2018-2021) in the 65-74 age group, while declining from 48% to 34% in the 75-84 age group. In Leukemia, five-year survival in the 75-84 age group increased from 7% (2008-2012) to 22% (2018-2021), while no clear change was observed in the 65-74 age group and estimates for the ≥85 age group were not calculable in all periods due to small case numbers. Conclusion: This study offers novel insights into survival patterns of elderly patients with HM in the French Caribbean. Survival outcomes remain inferior to those reported in mainland France and high-income countries, possibly consistent with compounded healthcare interruptions and socioeconomic barriers. These findings underscore the urgent need for region-specific strategies, equitable care, and future research addressing the socioeconomic and genomic factors driving these disparities.

Source: Clinical Epidemiology

DOI: 10.2147/clep.s629807