337O The changes in the treatment of elderly AML patients in Korea: A single center experience

Abstract

Background Decitabine have been used widely in the elderly AML patients, since the National Health Insurance system started to cover it in the November 2013 in Korea. This study was conducted to review the changes of the treatment pattern and draw the better treatment strategies. Methods This study enrolled patients who were newly diagnosed with AML aged ≥65 years between 2010 and 2015at Chungnam National University Hospital. The primary end point was overall survival, and the secondary end points were complete response(CR) rate,1-year survival rate, and early mortality (death within 2 months). Results In total, 42 patients were diagnosed with AML from Jan. 2011 to Oct. 2013 and26 patients from Nov. 2013toDec. 2015. After the insurance of decitabine, the patients were treated with any kind of chemotherapy more frequently than before (84.6% v54.8%, respectively,p<0.001). Patients who were treated by induction chemotherapy (IC) had slightly longer survival than patients who were treated by decitabine (medianOS;10.0(95% CI,7.0-2.9) v7.5(95% CI,3.8-11.2) months, respectively, p =0.315). Patient who had good performance status had significantly longer survival than those who had poor status (medianOS;11.5(95% CI,7.2-15.8) months inECOGPS0-1 v4.3(95% CI,3.0-5.5) monthsinECOGPS2 v1.5 (95%CI, 0-3.8) monthsinECOGPS3-4,p<0.001). ICgroup had more patients with good performance than deciatbine group (ECOG PS 0-1; 86.2% v37.5%, respectively, p < 0.001). The patient with WBC counts >30,000/uL had significantly poorer OS thanthosewithWBCcounts≥30,000/uL in decitabine group(medianOS;2.4(95%CI, 0.0-5.9) v13.0(95% CI, 5.3-20.7) months, respectively, p= 0.02). Inpatients with age ≥70 years and WBC counts <30,000/uL, IC group and decitabine group had similar OS (medianOS;8.0 (95%CI, 3.2-12.8) v7.0 (95%CI, 0.0-16.2) months, respectively, p =0.374). TheCRratewas62.1% with IC versus 25.0% with decitabine (p=0.017). But, the1-yearsurvivalrateandearlymortalityrateweresimilarbetween IC and decitabine group (58.6% v75.0%, p=0.272;6.9%v12.5%, respectively, p=0.527). Conclusions These results indicate that decitabine is a reasonable treatment option in patients with age ≥70 years and WBC counts <30,000/uL. Legal entity responsible for the study Chungnam National University Hospital IRB Funding Chungnam National University Hospital Disclosure All authors have declared no conflicts of interest.