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Abstract
Objective: The aim of this analysis was to examine treatment patterns in patients with acute myeloid leukemia (AML) in routine clinical practice in the United States, including factors influencing the choice of front-line treatment intensity and the effect of age and treatment line.
Methods: We used data from the Adelphi AML Disease Specific Programme, a real-world, cross-sectional survey conducted in 2015. Physicians completed patient record forms providing patients’ demographic and clinical characteristics.
Results: In total, 61 academic, non-academic, and office-based hematologists and hematology/oncology specialists provided data on 457 patients with AML; 284 had ≥20% blasts (World Health Organization defined AML) and were included in the analysis. In the front-line setting, 60% of patients received high-intensity therapy, most commonly cytarabine plus anthracycline; the most common low-intensity treatments were hypomethylating agents. Primary drivers for selecting high-intensity versus low-intensity treatment were age, performance status and comorbidities; 67%, 64% and 61% of physicians stated they would prescribe high-intensity treatment to patients aged <65 years, with good performance status or no comorbidities, respectively. In practice, patients aged <60 years were more likely to receive high-intensity induction treatment (high vs. low intensity by age p < .0001). In a selected cohort of relapsed/refractory patients, 69% of patients received high-intensity therapy (78% of patients aged <60 years and 57% of patients aged ≥60 years).
Conclusions: Most patients in this analysis of real-world survey data received well established, front-line induction therapies. Treatment intensity was determined by age, comorbidities and performance status, as recommended by guidelines.
Transparency
Declaration of funding
This analysis was funded by Astellas Pharma, Inc.
Author contributions
Named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published. B.C.M. contributed to the design of the research, assisted in the analysis and interpretation of data, and developed and critically edited the manuscript. B.J.P., S.W., C.M., C.N.B. and L.E.H.W. contributed to the design of the research, assisted in the analysis and interpretation of data, and drafted, reviewed and approved the manuscript. A.H., J.P. and A.R. contributed to the design of the research, project managed the collection of the data, assisted in the analysis and interpretation of data, and drafted, reviewed and approved the manuscript. S.C.F. contributed to the design of the research, assisted in the analysis and interpretation of data, and drafted, reviewed, edited and approved the manuscript.
Declaration of financial/other relationships
B.C.M. has disclosed that he has received research funds from Astellas Pharma, Inc. B.J.P., S.W., and C.M., have disclosed that they are current employees of Astellas Pharma, Inc. C.N.B., L.E.H.W., and S.C.F. have disclosed that they were employed by Astellas Pharma, Inc. at the time of the study. J.P. and A.R. have disclosed that they are employees of Adelphi Real World. A.H. has disclosed that she was employed by Adelphi Real World at the time of the study.
CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Acknowledgments
Medical writing assistance was provided by Deirdre Carman PhD of Alispera Communications Ltd, and was funded by Astellas Pharma, Inc.
Data availability statement
The authors confirm that the questions relating directly to the analysis will be made available to scientific researchers (on request) by Adelphi Real World as a supplementary document. Access to anonymized individual participant level data will not be provided for this trial as it meets one or more of the exceptions described on www.clinicalstudydatarequest.com under “Sponsor Specific Details for Astellas”.
