TY - JOUR
T1 - An Evaluation of Treatment Patterns and Outcomes in Elderly Patients Newly Diagnosed With Acute Myeloid Leukemia
T2 - A Retrospective Analysis of Electronic Medical Records From US Community Oncology Practices
AU - Ma, Esprit
AU - Bonthapally, Vijayveer
AU - Chawla, Anita
AU - Lefebvre, Patrick
AU - Swords, Ronan
AU - Lafeuille, Marie Hélène
AU - Fortier, Jonathan
AU - Emond, Bruno
AU - Duh, Mei Sheng
AU - Dezube, Bruce J.
N1 - Funding Information:
Esprit Ma and Vijayveer Bonthapally are former employees of Millennium Pharmaceuticals, Inc., Cambridge, MA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited. Bruce Dezube is an employee of Millennium Pharmaceuticals, Inc., Cambridge, MA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, and has stock ownership or options for Takeda Pharmaceutical Company Limited. Anita Chawla, Patrick Lefebvre, Marie-Hélène Lafeuille, Jonathan Fortier, Bruno Emond, and Mei Sheng Duh are employees of Analysis Group, Inc., which received research funding from Millennium Pharmaceuticals, Inc. to conduct this study. Ronan Swords has no conflicts to declare.
Publisher Copyright:
© 2016 The Author(s)
PY - 2016/11/1
Y1 - 2016/11/1
N2 - This retrospective observational study of data from the US community oncology setting evaluates real-world treatment patterns and outcomes for newly diagnosed, elderly patients with acute myeloid leukemia. The analysis focuses on those patients who did not receive standard induction therapy (“3 + 7”–type regimens). Background Many elderly patients with acute myeloid leukemia (AML) are considered ineligible for standard intensive induction therapy due to performance status and comorbidities. We analyzed treatment patterns and outcomes among elderly patients newly diagnosed with AML in the US community oncology setting. Methods A retrospective observational study was conducted using patient-level data from a network of US community oncology practices provided by Altos Solutions. Patients aged ≥ 60 years, diagnosed with AML between November 2005 and February 2014, with ≥ 1 recorded visit and ≥ 6 months between diagnosis and data cutoff, were included. Only patients who received active treatment or best supportive care (BSC) per National Comprehensive Cancer Network (NCCN) AML Guidelines were analyzed. Results Of 1139 patients meeting the inclusion criteria, 922 (median age 76 years) received NCCN-recommended treatments: standard induction (n = 5), low-intensity therapy (n = 425), BSC with hydroxyurea (HU) (n = 36), or BSC without HU (n = 455). For the low-intensity therapy cohort, median time from diagnosis to treatment initiation was 17 days; median duration of therapy was 5.1 months. Median overall survival (OS) from diagnosis in the low-intensity, BSC with HU, and BSC without HU groups was 12.3, 7.0, and 49.4 months, respectively. Median time to next therapy/death was 10.1 months in patients receiving low-intensity therapy. A higher proportion of patients receiving low-intensity therapy required transfusion or other supportive care versus those receiving BSC. Conclusions As expected, OS in patients receiving low-intensity therapy or BSC with HU is poor for elderly patients with AML. Remarkably, intensive induction strategies are rarely used for older patients in community oncology practice.
AB - This retrospective observational study of data from the US community oncology setting evaluates real-world treatment patterns and outcomes for newly diagnosed, elderly patients with acute myeloid leukemia. The analysis focuses on those patients who did not receive standard induction therapy (“3 + 7”–type regimens). Background Many elderly patients with acute myeloid leukemia (AML) are considered ineligible for standard intensive induction therapy due to performance status and comorbidities. We analyzed treatment patterns and outcomes among elderly patients newly diagnosed with AML in the US community oncology setting. Methods A retrospective observational study was conducted using patient-level data from a network of US community oncology practices provided by Altos Solutions. Patients aged ≥ 60 years, diagnosed with AML between November 2005 and February 2014, with ≥ 1 recorded visit and ≥ 6 months between diagnosis and data cutoff, were included. Only patients who received active treatment or best supportive care (BSC) per National Comprehensive Cancer Network (NCCN) AML Guidelines were analyzed. Results Of 1139 patients meeting the inclusion criteria, 922 (median age 76 years) received NCCN-recommended treatments: standard induction (n = 5), low-intensity therapy (n = 425), BSC with hydroxyurea (HU) (n = 36), or BSC without HU (n = 455). For the low-intensity therapy cohort, median time from diagnosis to treatment initiation was 17 days; median duration of therapy was 5.1 months. Median overall survival (OS) from diagnosis in the low-intensity, BSC with HU, and BSC without HU groups was 12.3, 7.0, and 49.4 months, respectively. Median time to next therapy/death was 10.1 months in patients receiving low-intensity therapy. A higher proportion of patients receiving low-intensity therapy required transfusion or other supportive care versus those receiving BSC. Conclusions As expected, OS in patients receiving low-intensity therapy or BSC with HU is poor for elderly patients with AML. Remarkably, intensive induction strategies are rarely used for older patients in community oncology practice.
KW - Community oncology practices
KW - Descriptive analysis
KW - Leukemia
KW - Observational study
KW - Treatment patterns
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U2 - 10.1016/j.clml.2016.08.006
DO - 10.1016/j.clml.2016.08.006
M3 - Article
C2 - 27686689
AN - SCOPUS:84994504390
SN - 2152-2650
VL - 16
SP - 625-636.e3
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 11
ER -