Prevalence and effects of polypharmacy on overall survival in acute myeloid leukemia

Abstract

Polypharmacy, usually defined as taking ≥5 prescribed medications, increases chances of drug–drug interactions and toxicities, and may harm cancer patients who need multiple chemotherapeutic agents and supportive medications. We analyzed the effects of polypharmacy in overall survival (OS) in acute myeloid leukemia (AML). A total of 399 patients were divided into two groups: patients with polypharmacy (≥5 medications) versus without polypharmacy (<5 medications). Polypharmacy was associated with age ≥60 years, Karnofsky Performance Status of ≤80, hematopoietic cell transplant (HCT) comorbidity index of ≥5, and adverse cytogenetics. Patients with polypharmacy were less likely to receive intensity chemotherapy or HCT. One-year OS of patients with polypharmacy versus those without polypharmacy was 29 vs. 49% (p<.001). Polypharmacy conferred worse OS in patients <60 years (37 vs. 65% at 1 year, HR 1.95, 95% CI 1.21–3.15) but not in patients ≥60 years (26 vs. 27% at 1 year, HR 1.12, 95% CI 0.81–1.57). Thus, polypharmacy has negative impact on OS in AML, particularly among patients aged <60 years.

Keywords:

• Acute myeloid leukemia
• polypharmacy
• overall survival
• medications
• prognosis

Disclosure statement

No potential conflict of interest was reported by the author(s). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Additional information

Funding

This work was supported by the National Institute of General Medical Sciences, 1 U54 GM115458, which funds the Great Plains Institutional Development Award (IDeA) Clinical Translational Research (CTR) Network, and the Fred and Pamela Buffett Cancer Center Support Grant from the National Cancer Institute [P30 CA036727].