The baseline comorbidity burden affects survival in elderly patients with acute myeloid leukemia receiving hypomethylating agents: Results from a multicentric clinical study

被引：2

作者：

Marconi, Giovanni ^{[1
,2
]}

Candoni, Anna ^{[3
,4
]}

Di Nicola, Roberta ^{[2
]}

Sartor, Chiara ^{[2
]}

Parisi, Sarah ^{[2
]}

Abbenante, Mariachiara ^{[5
,6
]}

Nanni, Jacopo ^{[2
]}

Cristiano, Gianluca ^{[2
]}

Zannoni, Letizia ^{[2
]}

Lazzarotto, Davide ^{[3
]}

Giannini, Benedetta ^{[1
]}

Baldazzi, Carmen

Bandini, Lorenza ^{[2
]}

Ottaviani, Emanuela ^{[7
]}

Testoni, Nicoletta ^{[2
]}

Bezzi, Chiara Di Giovanni ^{[8
]}

Abd-alatif, Rania ^{[8
]}

Ciotti, Giulia ^{[9
]}

Fanin, Renato

Martinelli, Giovanni

Paolini, Stefania ^{[7
]}

Ricci, Paolo ^{[8
]}

Cavo, Michele ^{[2
,7
,10
]}

Papayannidis, Cristina ^{[7
]}

Curti, Antonio

机构：

[1] IRCCS Ist Sci Romagnolo Studio & Cura Tumori Dino, Meldola, Italy

[2] Univ Bologna, Dept Expt Diagnost & Specialty Med, Bologna, Italy

[3] Univ Hosp ASUFC, Div Hematol, Udine, Italy

[4] Univ Modena & Reggio Emilia, Dept Med & Surg Sci, Sect Haematol, Modena, Italy

[5] IRCCS Casa Sollievo Sofferenza, Dept Haematol, San Giovanni Rotondo, Italy

[6] IRCCS Casa Sollievo Sofferenza, Stem Cell Transplantat Unit, San Giovanni Rotondo, Italy

[7] IRCCS Azienda Ospedaliero Univ Bologna, Ist Ematol Seragnoli, Bologna, Italy

[8] Assistenza Domiciliare Ail Bologna, Bologna, Italy

[9] IOV IRCCS, Veneto Inst Oncol, Dept Oncol, Onco Hematol, Padua, Italy

[10] Univ Bologna, IRCCS Azienda Ospedaliero Univ Bologna, Ist Ematol Seragnoli, Dept Expt Diagnost & Specialty Med, Via Massarenti 9, Bologna, Italy

来源：

CANCER MEDICINE | 2023年 / 12卷 / 10期

关键词：

acute myeloid leukemia; elderly; fitness; hypomethylating agents; prognosis; OLDER PATIENTS; INTENSIVE CHEMOTHERAPY; GERIATRIC ASSESSMENT; ADULTS; AZACITIDINE; RECOMMENDATIONS; CLASSIFICATION; MORTALITY; CONSENSUS; HEALTH;

D O I：

10.1002/cam4.5858

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BackgroundIn older patients with acute myeloid leukemia (AML), the definition of fitness, prognosis, and risk of death represents an open question. MethodsIn the present study, we tested the impact on survival of disease- and patient-related parameters in a large cohort of elderly AML patients homogeneously assigned to treatment with hypomethylating agents (HMAs). ResultsIn 131 patients with a median age of 76 years, we confirmed that early response (<0.001) and biology-based risk classification (p = 0.003) can select patients with better-predicted survival. However, a full disease-oriented model had limitations in stratifying our patients, prompting us to investigate the impact of baseline comorbidities on overall survival basing on a comorbidity score. The albumin level (p = 0.001) and the presence of lung disease (p = 0.013) had a single-variable impact on prognosis. The baseline comorbidity burden was a powerful predictor of patients' frailty, correlating with increased incidence of adverse events, especially infections, and predicted overall survival (p < 0.001). ConclusionThe comorbidity burden may contribute to impact prognosis in addition to disease biology. While the therapeutic armamentarium of elderly AML is improving, a comprehensive approach that combines AML biology with tailored interventions to patients' frailty is likely to fully exploit the anti-leukemia potential of novel drugs.

引用

页码：11838 / 11848

页数：11

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