Contributions
Abstract: PB1699
Type: Publication Only
Background
There is limited real-world data in patients with acute myeloid leukemia (AML) that looks at presenting disease characteristics and subsequent treatment decisions made for patients <60 and ≥60 years of age in the United States (US).
Aims
This analysis examined the characteristics of patients <60 years of age and ≥60 years of age at the point of AML diagnosis and further investigated subsequent treatments.
Methods
Data from the Adelphi AML Disease Specific Programme, a real-world, cross-sectional survey conducted between February–May 2015, were analyzed. A total of 61 hematologist/oncologists provided data on their 457 AML patients treated at various stages of AML. Disease characteristics upon initial AML diagnosis including symptoms, performance status, and physician-determined prognostic category were taken from physician-completed patient record forms. Details about subsequently prescribed AML treatment were also taken from this data source. Treatments for n=15 (3.3%) patients were reassigned as high or low intensity following evaluation of physician treatment selection. Post-hoc T-tests and Chi-Squared/Fisher’s exact tests were used to determine differences between groups.
Results
Table 1 shows key presenting characteristics of AML patients <60 and ≥60 years old. According to physicians, those patients <60 years of age were significantly more likely than those ≥60 years of age to have de novo AML, a performance score of 0 versus ≥1 at diagnosis, more tests conducted to establish the diagnosis and a more favorable prognosis at baseline, according to physician perception. Following initial diagnosis, patients <60 years of age were 1.65 times more likely than patients ≥60 years of age to be initiated on high-intensity induction treatment: 67% (n=143) of patients <60 years of age compared to 40% (n=98) of patients ≥60 years of age (high versus low intensity by age group P <0.001). All other patients received low intensity treatment. Irrespective of age, the most common high intensity treatment given was a cytarabine-based regimen and the most common low intensity treatments were low dose cytarabine-, decitabine- or azacitidine-based regimens.
Disease characteristics | <60 years old (n=214) | ≥60 years old (n=243) | P-value | |
Gender | Male | 128 (60%) | 127 (52%) | 0.106 |
Pathophysiology | De novo | 206 (96%) | 209 (86%) | <0.001 |
Symptoms | No. of symptoms at diagnosis [mean (SD)] | 3.5 (3.3) | 3.2 (2.9) | 0.307 |
Performance status | ECOG score at diagnosis – 0 (Fully active, able to carry on all pre-disease performance without restriction) | 81 (38%) | 43 (18%) | <0.001 |
Diagnostic tests | No. of tests used to establish AML diagnosis [mean (SD)] | 5.5 (3.6) | 4.7 (3.6) | 0.025 |
Physician-defined prognostic category | Favorable | 101 (47%) | 54 (22%) | <0.001 |
Intermediate | 84 (39%) | 122 (50%) | ||
Poor | 22 (10%) | 55 (23%) | ||
Not determined | 7 (3%) | 12 (5%) |
Conclusion
The age of an AML patient at initial diagnosis appeared to play a significant role in the diagnostic, prognostic and treatment intensity decisions made by AML-treating physicians in the US. The estimated performance and prognostic status’ tend to be considerably better for younger patients and consequently, they were more likely to receive the most aggressive yet more effective high intensity treatments currently available to treat AML.
Session topic: 4. Acute myeloid leukemia - Clinical
Keyword(s): Age, AML
Abstract: PB1699
Type: Publication Only
Background
There is limited real-world data in patients with acute myeloid leukemia (AML) that looks at presenting disease characteristics and subsequent treatment decisions made for patients <60 and ≥60 years of age in the United States (US).
Aims
This analysis examined the characteristics of patients <60 years of age and ≥60 years of age at the point of AML diagnosis and further investigated subsequent treatments.
Methods
Data from the Adelphi AML Disease Specific Programme, a real-world, cross-sectional survey conducted between February–May 2015, were analyzed. A total of 61 hematologist/oncologists provided data on their 457 AML patients treated at various stages of AML. Disease characteristics upon initial AML diagnosis including symptoms, performance status, and physician-determined prognostic category were taken from physician-completed patient record forms. Details about subsequently prescribed AML treatment were also taken from this data source. Treatments for n=15 (3.3%) patients were reassigned as high or low intensity following evaluation of physician treatment selection. Post-hoc T-tests and Chi-Squared/Fisher’s exact tests were used to determine differences between groups.
Results
Table 1 shows key presenting characteristics of AML patients <60 and ≥60 years old. According to physicians, those patients <60 years of age were significantly more likely than those ≥60 years of age to have de novo AML, a performance score of 0 versus ≥1 at diagnosis, more tests conducted to establish the diagnosis and a more favorable prognosis at baseline, according to physician perception. Following initial diagnosis, patients <60 years of age were 1.65 times more likely than patients ≥60 years of age to be initiated on high-intensity induction treatment: 67% (n=143) of patients <60 years of age compared to 40% (n=98) of patients ≥60 years of age (high versus low intensity by age group P <0.001). All other patients received low intensity treatment. Irrespective of age, the most common high intensity treatment given was a cytarabine-based regimen and the most common low intensity treatments were low dose cytarabine-, decitabine- or azacitidine-based regimens.
Disease characteristics | <60 years old (n=214) | ≥60 years old (n=243) | P-value | |
Gender | Male | 128 (60%) | 127 (52%) | 0.106 |
Pathophysiology | De novo | 206 (96%) | 209 (86%) | <0.001 |
Symptoms | No. of symptoms at diagnosis [mean (SD)] | 3.5 (3.3) | 3.2 (2.9) | 0.307 |
Performance status | ECOG score at diagnosis – 0 (Fully active, able to carry on all pre-disease performance without restriction) | 81 (38%) | 43 (18%) | <0.001 |
Diagnostic tests | No. of tests used to establish AML diagnosis [mean (SD)] | 5.5 (3.6) | 4.7 (3.6) | 0.025 |
Physician-defined prognostic category | Favorable | 101 (47%) | 54 (22%) | <0.001 |
Intermediate | 84 (39%) | 122 (50%) | ||
Poor | 22 (10%) | 55 (23%) | ||
Not determined | 7 (3%) | 12 (5%) |
Conclusion
The age of an AML patient at initial diagnosis appeared to play a significant role in the diagnostic, prognostic and treatment intensity decisions made by AML-treating physicians in the US. The estimated performance and prognostic status’ tend to be considerably better for younger patients and consequently, they were more likely to receive the most aggressive yet more effective high intensity treatments currently available to treat AML.
Session topic: 4. Acute myeloid leukemia - Clinical
Keyword(s): Age, AML