دورية أكاديمية
أعرض في EDS

Frontline treatment patterns and outcomes among older adults with acute myeloid leukemia: A population-based analysis in the modern era.

التفاصيل البيبلوغرافية
العنوان: Frontline treatment patterns and outcomes among older adults with acute myeloid leukemia: A population-based analysis in the modern era.
المؤلفون: Kennedy VE; Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, California., Keegan THM; Center for Oncology Hematology Outcomes Research and Training, Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, California., Li Q; Center for Oncology Hematology Outcomes Research and Training, Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, California., Maguire FB; California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, Sacramento, California., Muffly LS; Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University Medical Center, Stanford, California.
المصدر: Cancer [Cancer] 2022 Jan 01; Vol. 128 (1), pp. 139-149. Date of Electronic Publication: 2021 Aug 26.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
اللغة: English
بيانات الدورية: Publisher: Wiley Country of Publication: United States NLM ID: 0374236 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-0142 (Electronic) Linking ISSN: 0008543X NLM ISO Abbreviation: Cancer Subsets: MEDLINE
أسماء مطبوعة: Publication: <2005- >: Hoboken, NJ : Wiley
Original Publication: New York [etc.] Published for the American Cancer Society by J. Wiley [etc.]
مواضيع طبية MeSH: Antineoplastic Agents*/therapeutic use , Leukemia, Myeloid, Acute*/drug therapy, Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Cohort Studies ; Humans ; Middle Aged ; National Cancer Institute (U.S.) ; Remission Induction ; United States/epidemiology
مستخلص: Background: Traditionally, conventional induction chemotherapy has been the primary frontline treatment for acute myeloid leukemia (AML); however, older adults are often poor chemotherapy candidates. Recently, several nonconventional frontline AML regimens, including hypomethylating agents, the BCL-2 inhibitor venetoclax, and targeted therapies, have emerged, and they may offer new options for older adults. This study was aimed at describing treatment patterns and outcomes of older adult AML in a modern population-based cohort.
Methods: This study evaluated patients aged ≥60 years with a first primary diagnosis of AML (2014-2017) in the California Cancer Registry linked to inpatient hospitalizations. Multivariable regression examined factors associated with the frontline treatment regimen and survival.
Results: In all, 3068 patients were included; 36% received frontline therapy with a conventional chemotherapy backbone, 42% received nonconventional therapy, and 22% received no treatment. The use of nonconventional therapy increased over time from 38% of patients in 2014 to 47% in 2017 (P < .001). In multivariable analyses, receipt of treatment was associated with an age younger than 80 years, fewer than 2 comorbidities, and care at a National Cancer Institute-designated cancer center (NCI-CC). Compared with conventional chemotherapy, nonconventional therapy was associated with Black race/ethnicity, public health insurance, fewer hospital admissions, and fewer inpatient days. Receiving frontline therapy at an NCI-CC was independently associated with superior overall survival.
Conclusions: Using a population-based approach, this study has demonstrated that patterns of care for frontline AML treatment in older adults are changing, with increasing use of nonconventional therapies. A significant proportion of older adults remain untreated. At the population level, there remain opportunities to increase therapy access for older adults with AML.
(© 2021 American Cancer Society.)
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فهرسة مساهمة: Keywords: acute myeloid leukemia; older adults; patterns of care
المشرفين على المادة: 0 (Antineoplastic Agents)
تواريخ الأحداث: Date Created: 20210826 Date Completed: 20220309 Latest Revision: 20220309
رمز التحديث: 20221213
DOI: 10.1002/cncr.33873
PMID: 34436782
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-0142
DOI:10.1002/cncr.33873