A retrospective study evaluating treatment patterns and survival outcomes in elderly patients with acute myeloid leukemia treated in the United States with either 7+3 or a hypomethylating agent

Jill A. Bell; Aaron Galaznik; Eileen Farrelly; Marlo Blazer; Sharanya Murty; Augustina Ogbonnaya; Michael Eaddy; Robert J. Fram; Douglas V. Faller; Vamsi K. Kota

doi:10.1016/j.leukres.2019.01.008

A retrospective study evaluating treatment patterns and survival outcomes in elderly patients with acute myeloid leukemia treated in the United States with either 7+3 or a hypomethylating agent

Jill A. Bell, Aaron Galaznik, Eileen Farrelly, Marlo Blazer, Sharanya Murty, Augustina Ogbonnaya, Michael Eaddy, Robert J. Fram, Douglas V. Faller, Vamsi K. Kota

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

Intensive treatment for newly diagnosed acute myelogenous leukemia (ND-AML) patients are reserved for “fit” patients. While guidelines recommend evaluation of age, performance status and comorbidities, there is no consensus on the definition of “fitness” or optimal therapy for elderly AML patients. This retrospective study evaluated characteristics and survival outcomes of 274 patients (age ≥60 years) with ND-AML treated with 7 + 3 (cytarabine + an anthracycline) vs. hypomethylating agents (HMAs). Most patients received 7 + 3 (60.2%) vs. HMAs (39.8%) in first-line therapy (1 L T); more HMA patients were ≥75 years old and had more comorbidities. Median progression-free survival (PFS) following 1 L T was longer for patients who received 7 + 3 vs. HMAs (6.7 months [95% confidence interval (CI)]: 4.9, 11.1) vs. 4.1 months (95% CI: 2.8, 4.9, respectively). Median overall survival (OS) following 1 L T was also longer for patients who received 7 + 3 vs. HMAs (14.7 months [95% CI: 11.0, not estimated] vs. 4.3 months [95% CI: 3.2, 5.8], respectively). An age-adjusted Charlson Comorbidity Index score of ≥4 vs. < 4 negatively affected PFS and OS irrespective of treatment. Overall, choosing an HMA over 7 + 3 in elderly patients with ND-AML may be influenced by age and comorbidities; patients receiving 7 + 3 had longer survival than those on an HMA.

Original language	English (US)
Pages (from-to)	45-51
Number of pages	7
Journal	Leukemia Research
Volume	78
DOIs	https://doi.org/10.1016/j.leukres.2019.01.008
State	Published - Mar 2019
Externally published	Yes

Keywords

7+3
Acute myeloid leukemia
Elderly
Hypomethylating agents
Survival
Treatment patterns

ASJC Scopus subject areas

Hematology
Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.leukres.2019.01.008

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Bell, J. A., Galaznik, A., Farrelly, E., Blazer, M., Murty, S., Ogbonnaya, A., Eaddy, M., Fram, R. J., Faller, D. V., & Kota, V. K. (2019). A retrospective study evaluating treatment patterns and survival outcomes in elderly patients with acute myeloid leukemia treated in the United States with either 7+3 or a hypomethylating agent. Leukemia Research, 78, 45-51. https://doi.org/10.1016/j.leukres.2019.01.008

A retrospective study evaluating treatment patterns and survival outcomes in elderly patients with acute myeloid leukemia treated in the United States with either 7+3 or a hypomethylating agent. / Bell, Jill A.; Galaznik, Aaron; Farrelly, Eileen et al.
In: Leukemia Research, Vol. 78, 03.2019, p. 45-51.

Research output: Contribution to journal › Article › peer-review

Bell, JA, Galaznik, A, Farrelly, E, Blazer, M, Murty, S, Ogbonnaya, A, Eaddy, M, Fram, RJ, Faller, DV & Kota, VK 2019, 'A retrospective study evaluating treatment patterns and survival outcomes in elderly patients with acute myeloid leukemia treated in the United States with either 7+3 or a hypomethylating agent', Leukemia Research, vol. 78, pp. 45-51. https://doi.org/10.1016/j.leukres.2019.01.008

@article{989d168a6b3344f69085fb534adb2353,

title = "A retrospective study evaluating treatment patterns and survival outcomes in elderly patients with acute myeloid leukemia treated in the United States with either 7+3 or a hypomethylating agent",

abstract = "Intensive treatment for newly diagnosed acute myelogenous leukemia (ND-AML) patients are reserved for “fit” patients. While guidelines recommend evaluation of age, performance status and comorbidities, there is no consensus on the definition of “fitness” or optimal therapy for elderly AML patients. This retrospective study evaluated characteristics and survival outcomes of 274 patients (age ≥60 years) with ND-AML treated with 7 + 3 (cytarabine + an anthracycline) vs. hypomethylating agents (HMAs). Most patients received 7 + 3 (60.2%) vs. HMAs (39.8%) in first-line therapy (1 L T); more HMA patients were ≥75 years old and had more comorbidities. Median progression-free survival (PFS) following 1 L T was longer for patients who received 7 + 3 vs. HMAs (6.7 months [95% confidence interval (CI)]: 4.9, 11.1) vs. 4.1 months (95% CI: 2.8, 4.9, respectively). Median overall survival (OS) following 1 L T was also longer for patients who received 7 + 3 vs. HMAs (14.7 months [95% CI: 11.0, not estimated] vs. 4.3 months [95% CI: 3.2, 5.8], respectively). An age-adjusted Charlson Comorbidity Index score of ≥4 vs. < 4 negatively affected PFS and OS irrespective of treatment. Overall, choosing an HMA over 7 + 3 in elderly patients with ND-AML may be influenced by age and comorbidities; patients receiving 7 + 3 had longer survival than those on an HMA.",

keywords = "7+3, Acute myeloid leukemia, Elderly, Hypomethylating agents, Survival, Treatment patterns",

author = "Bell, {Jill A.} and Aaron Galaznik and Eileen Farrelly and Marlo Blazer and Sharanya Murty and Augustina Ogbonnaya and Michael Eaddy and Fram, {Robert J.} and Faller, {Douglas V.} and Kota, {Vamsi K.}",

note = "Funding Information: This study was funded by Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; JB, AG, RF, and DF are employees of Takeda Pharmaceuticals. VK received an honorarium from Takeda Pharmaceuticals for this study. Xcenda received funding from Takeda Pharmaceuticals to conduct this study and develop the manuscript; EF, MB, SM, AO, and ME are employees of Xcenda, LLC. Funding Information: This study and the manuscript development was funded by Millennium Pharmaceuticals, Inc., Cambridge, MA, USA , a wholly owned subsidiary of Takeda Pharmaceutical Company Limited. Publisher Copyright: {\textcopyright} 2019 The Authors",

year = "2019",

month = mar,

doi = "10.1016/j.leukres.2019.01.008",

language = "English (US)",

volume = "78",

pages = "45--51",

journal = "Leukemia Research",

issn = "0145-2126",

publisher = "Elsevier Limited",

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TY - JOUR

T1 - A retrospective study evaluating treatment patterns and survival outcomes in elderly patients with acute myeloid leukemia treated in the United States with either 7+3 or a hypomethylating agent

AU - Bell, Jill A.

AU - Galaznik, Aaron

AU - Farrelly, Eileen

AU - Blazer, Marlo

AU - Murty, Sharanya

AU - Ogbonnaya, Augustina

AU - Eaddy, Michael

AU - Fram, Robert J.

AU - Faller, Douglas V.

AU - Kota, Vamsi K.

N1 - Funding Information: This study was funded by Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; JB, AG, RF, and DF are employees of Takeda Pharmaceuticals. VK received an honorarium from Takeda Pharmaceuticals for this study. Xcenda received funding from Takeda Pharmaceuticals to conduct this study and develop the manuscript; EF, MB, SM, AO, and ME are employees of Xcenda, LLC. Funding Information: This study and the manuscript development was funded by Millennium Pharmaceuticals, Inc., Cambridge, MA, USA , a wholly owned subsidiary of Takeda Pharmaceutical Company Limited. Publisher Copyright: © 2019 The Authors

PY - 2019/3

Y1 - 2019/3

N2 - Intensive treatment for newly diagnosed acute myelogenous leukemia (ND-AML) patients are reserved for “fit” patients. While guidelines recommend evaluation of age, performance status and comorbidities, there is no consensus on the definition of “fitness” or optimal therapy for elderly AML patients. This retrospective study evaluated characteristics and survival outcomes of 274 patients (age ≥60 years) with ND-AML treated with 7 + 3 (cytarabine + an anthracycline) vs. hypomethylating agents (HMAs). Most patients received 7 + 3 (60.2%) vs. HMAs (39.8%) in first-line therapy (1 L T); more HMA patients were ≥75 years old and had more comorbidities. Median progression-free survival (PFS) following 1 L T was longer for patients who received 7 + 3 vs. HMAs (6.7 months [95% confidence interval (CI)]: 4.9, 11.1) vs. 4.1 months (95% CI: 2.8, 4.9, respectively). Median overall survival (OS) following 1 L T was also longer for patients who received 7 + 3 vs. HMAs (14.7 months [95% CI: 11.0, not estimated] vs. 4.3 months [95% CI: 3.2, 5.8], respectively). An age-adjusted Charlson Comorbidity Index score of ≥4 vs. < 4 negatively affected PFS and OS irrespective of treatment. Overall, choosing an HMA over 7 + 3 in elderly patients with ND-AML may be influenced by age and comorbidities; patients receiving 7 + 3 had longer survival than those on an HMA.

AB - Intensive treatment for newly diagnosed acute myelogenous leukemia (ND-AML) patients are reserved for “fit” patients. While guidelines recommend evaluation of age, performance status and comorbidities, there is no consensus on the definition of “fitness” or optimal therapy for elderly AML patients. This retrospective study evaluated characteristics and survival outcomes of 274 patients (age ≥60 years) with ND-AML treated with 7 + 3 (cytarabine + an anthracycline) vs. hypomethylating agents (HMAs). Most patients received 7 + 3 (60.2%) vs. HMAs (39.8%) in first-line therapy (1 L T); more HMA patients were ≥75 years old and had more comorbidities. Median progression-free survival (PFS) following 1 L T was longer for patients who received 7 + 3 vs. HMAs (6.7 months [95% confidence interval (CI)]: 4.9, 11.1) vs. 4.1 months (95% CI: 2.8, 4.9, respectively). Median overall survival (OS) following 1 L T was also longer for patients who received 7 + 3 vs. HMAs (14.7 months [95% CI: 11.0, not estimated] vs. 4.3 months [95% CI: 3.2, 5.8], respectively). An age-adjusted Charlson Comorbidity Index score of ≥4 vs. < 4 negatively affected PFS and OS irrespective of treatment. Overall, choosing an HMA over 7 + 3 in elderly patients with ND-AML may be influenced by age and comorbidities; patients receiving 7 + 3 had longer survival than those on an HMA.

KW - 7+3

KW - Acute myeloid leukemia

KW - Elderly

KW - Hypomethylating agents

KW - Survival

KW - Treatment patterns

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ER -

A retrospective study evaluating treatment patterns and survival outcomes in elderly patients with acute myeloid leukemia treated in the United States with either 7+3 or a hypomethylating agent

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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