Determinants of ten-year overall survival of acute myeloid leukemia: a large national cancer database analysis

Abstract

Clinical trials do not routinely capture long-term overall survival (OS) in acute myeloid leukemia (AML). We utilized a large National Cancer Database (NCDB) to determine different factors affecting 10-year OS in AML. For patients, 18–59 years who were treated with chemotherapy only without upfront hematopoietic cell transplant (HCT), younger age, female, CBF AML, higher income, and private insurance conferred higher 10-year OS. Among patients, 18–59 years treated with chemotherapy and upfront HCT, younger age and private insurance conferred higher 10-year OS. In a Cox proportional hazard model, the likelihood of death decreased with younger age, fewer comorbidities, treatment at an academic center, private insurance, and use of multiagent chemotherapy. Our results demonstrate poor long-term OS even among younger patients and highlights disparities in leukemia care based on insurance type.

Keywords:

• Acute myeloid leukemia
• leukemia
• overall survival
• chemotherapy
• transplant
• younger age

Acknowledgements

The National Cancer Data Base (NCDB) is a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The data used in the study are derived from a deidentified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology used or the conclusions drawn from these data by the investigators.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Previous presentation

This study was presented as an abstract at the American Society of Hematology Annual Meeting held on December 5–8, 2020.

Additional information

Funding

Vijaya Bhatt reports receiving consulting fees from Takeda, Omeros, Agios, Abbvie, Genentech, Partner therapeutics, Rigel, Incyte and Partnership for health analytic research, LLC (which receives funds from Jazz), and research funding (institutional) from Jazz, Abbvie, Pfizer, Incyte, Tolero Pharmaceuticals, Inc, and National Marrow Donor Program. Drug support for a trial is provided by Oncoceutics. Krishna Gundabolu reports serving as a consultant for Jazz pharmaceuticals, Pfizer and Novartis. Chakra Chaulagain reports receiving honoraria from Sanofi Genzyme. There are no conflicts of interest for any other authors.