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

Author:

Marconi Giovanni12ORCID,Candoni Anna34,Di Nicola Roberta2,Sartor Chiara2,Parisi Sarah2,Abbenante Mariachiara5,Nanni Jacopo2,Cristiano Gianluca2,Zannoni Letizia2,Lazzarotto Davide3,Giannini Benedetta1,Baldazzi Carmen2,Bandini Lorenza2,Ottaviani Emanuela6,Testoni Nicoletta2,Bezzi Chiara Di Giovanni7,Abd‐alatif Rania7,Ciotti Giulia8ORCID,Fanin Renato3,Martinelli Giovanni1,Paolini Stefania6,Ricci Paolo7,Cavo Michele26,Papayannidis Cristina6,Curti Antonio6

Affiliation:

1. IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori “Dino Amadori” (IRST) Meldola Italy

2. Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy

3. Division of Hematology University Hospital‐ASUFC Udine Italy

4. Section of Haematology, Department of Medical and Surgical Sciences University of Modena and Reggio Emilia Modena Italy

5. Department of Haematology and Stem Cell Transplantation Unit IRCCS “Casa Sollievo della Sofferenza” Hospital San Giovanni Rotondo Italy

6. IRCCS Azienda Ospedaliero‐Universitaria di Bologna Istituto di Ematologia “Seràgnoli” Bologna Italy

7. Assistenza Domiciliare Ail Bologna Bologna Italy

8. Onco Hematology, Department of Oncology–Veneto Institute of Oncology IOV–IRCCS Padua Italy

Abstract

AbstractBackgroundIn 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.

Publisher

Wiley

Subject

Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3