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 journalArticle

4 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 languageEnglish (US)
Pages (from-to)45-51
Number of pages7
JournalLeukemia Research
Volume78
DOIs
StatePublished - Mar 2019
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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