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 Kota

Research output: Contribution to journalArticle

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 1 2019

Fingerprint

Acute Myeloid Leukemia
Retrospective Studies
Survival
Comorbidity
Confidence Intervals
Therapeutics
Disease-Free Survival
Anthracyclines
Cytarabine
Proxy
Guidelines

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

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; Blazer, Marlo; Murty, Sharanya; Ogbonnaya, Augustina; Eaddy, Michael; Fram, Robert J.; Faller, Douglas V.; Kota, Vamsi.

In: Leukemia Research, Vol. 78, 01.03.2019, p. 45-51.

Research output: Contribution to journalArticle

Bell, Jill A. ; Galaznik, Aaron ; Farrelly, Eileen ; Blazer, Marlo ; Murty, Sharanya ; Ogbonnaya, Augustina ; Eaddy, Michael ; Fram, Robert J. ; Faller, Douglas V. ; Kota, Vamsi. / 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. In: Leukemia Research. 2019 ; Vol. 78. pp. 45-51.
@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 Vamsi Kota",
year = "2019",
month = "3",
day = "1",
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",

}

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

PY - 2019/3/1

Y1 - 2019/3/1

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

UR - http://www.scopus.com/inward/record.url?scp=85060870149&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060870149&partnerID=8YFLogxK

U2 - 10.1016/j.leukres.2019.01.008

DO - 10.1016/j.leukres.2019.01.008

M3 - Article

C2 - 30716655

AN - SCOPUS:85060870149

VL - 78

SP - 45

EP - 51

JO - Leukemia Research

JF - Leukemia Research

SN - 0145-2126

ER -