Patient characteristics, treatment patterns, and mortality in elderly patients newly diagnosed with acute myeloid leukemia meeting ineligibility criteria for high intensity chemotherapy

Abstract

To describe patient characteristics, treatment patterns, and survival among elderly patients (≥66 years) newly diagnosed with acute myeloid leukemia (AML) meeting ≥1 ineligibility criteria for high-intensity chemotherapy (HIC; i.e. age >75 years, cardiac disease/prior anthracycline therapy, or secondary AML), we analyzed 2007–2017 100% Medicare hematologic cancer data. Patients were stratified based on whether they received HIC or low-intensity chemotherapy (LIC) or best supportive care (BSC) within 60 days after AML diagnosis. Of 4,152 patients, 43.2% received chemotherapy, 33.8% BSC, and 23.1% no therapy. Among chemotherapy-treated patients, HIC was more common than LIC (58.8 vs 41.2%), despite targeting patients meeting ≥1 ineligibility criteria for HIC. Poor overall survival was observed for patients receiving chemotherapy and BSC (median overall survival [interquartile range]: HIC, 1.9 [0.8, 6.6] months; LIC, 3.8 [1.4, 9.3] months; BSC, 1.0 [0.4, 2.5] months). Results highlight the need for additional effective and tolerable treatments for this population.

Keywords:

• Acute myeloid leukemia
• chemotherapy
• treatment patterns
• real-world evidence
• elderly
• survival outcomes

Acknowledgments

The authors thank Vicky Kanta, PhD and Lee Hohaia, PharmD (ICON, North Wales, PA), whose work was funded by Amgen Inc., for medical writing assistance in the preparation of this manuscript.

Disclosure statement

Shuling Li, Yuanyuan Ji, and Yi Peng are employees of Chronic Disease Research Group, Hennepin Healthcare Research Institute, which has received project funding from Amgen Inc.

Christopher Kim is an employee and stockholder of Amgen Inc. Vamsi Kota has received honoraria from Novartis and Pfizer, and research funding from Amgen and Incyte.

Additional information

Funding

The study was funded by Amgen Inc.