Performance of the frailty index in predicting complete remission, intensive care unit admission, and overall mortality in older and younger patients with acute myeloid leukemia receiving intensive chemotherapy

Abstract

The frailty index (FI) predicts clinical outcomes in oncology. However, in the acute myeloid leukemia (AML) setting, its predictive ability is poorly understood. We assessed whether the FI predicts complete remission (CR), intensive care unit (ICU) admission, and 1-year all-cause mortality in younger and older adults with AML receiving intensity chemotherapy. This was a secondary analysis of a prospective study. In total, 237 patients (n = 140 younger and n = 97 older adults) were classified as non-frail, prefrail, or frail. Frail younger adults were less likely to achieve CR compared with non-frail younger adults. Pre-frail and frail younger adults were more likely to be admitted to the ICU compared with their non-frail counterparts. The FI was not predictive of 1-year all-cause mortality. The FI predicts CR and ICU admission in younger but not older adults. Disease biology may be more important than frailty in predicting 1-year overall mortality in patients with AML undergoing chemotherapy.

Keywords:

• Frailty
• acute myeloid leukemia
• complete remission
• intensive care unit admission
• mortality

Disclosure statement

The authors report no conflict of interest. Dmitriy Petrov: Conceptualization, data acquisition, methodology, interpretation of the results, manuscript review.

Narhari Timilshina: Data acquisition and formal analysis, interpretation of the results, manuscript review.

Efthymios Papadopoulos: Interpretation of the results, writing of the manuscript – review, and editing.

Shabbir M.H. Alibhai: Conceptualization, methodology, interpretation of the results, manuscript review.