Comorbidity burden and outcomes of older adults with acute promyelocytic leukemia: a National Cancer Database analysis of 2221 patients

Abstract

Association between comorbidity burden and patient outcomes has not been adequately investigated in acute promyelocytic leukemia (APL). We utilized the National Cancer Database to evaluate the association of the Charlson–Deyo Comorbidity Index (CCI) with one-month mortality and overall survival (OS) in adults ≥60 years with APL. One-month mortality was 16%, 24%, and 32%, and 3-year OS was 61%, 53%, and 38% for patients with CCI 0, 1, and ≥2, respectively. One-month mortality was higher for patients with CCI 1 (OR 1.67, 95% CI 1.29–2.16, p < .001) and CCI ≥ 2 (OR 2.31, 95% CI 1.70–3.13, p < .001) compared to patients with CCI 0. Patients with CCI 1 (HR 1.27, 95% CI 1.10–1.46, p < .001) and CCI ≥ 2 (HR 1.74, 95% CI 1.48–2.06, p < .001) had worse OS compared to patients with CCI 0. In conclusion, CCI is an independent predictor of survival outcomes in patients with APL.

Keywords:

• Acute promyelocytic leukemia
• comorbidity
• National Cancer Database
• one-month mortality
• overall survival
• older adults

Disclosure statement

Kah Poh Loh reports serving as a consultant for Pfizer and Seattle Genetics and receiving honoraria from Pfizer. Heidi Klepin has contributed to UpToDate. Vijaya Raj Bhatt reports participating in Safety Monitoring Committee for Protagonist, and receiving consulting fees from Genentech, Incyte, Servier Pharmaceuticals LLC, and Abbvie, research funding (institutional) from Abbvie, Pfizer, Incyte, Jazz, and National Marrow Donor Program, and drug support (institutional) from Oncoceutics for a trial. There are no conflicts of interest for any other authors.

The study findings were published as a part of the proceedings of the American Society of Clinical Oncology Annual Meeting held in June 2022.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article.

Additional information

Funding

This study did not receive funds.