A longitudinal assessment of the quality of life (QOL) of older adults with newly diagnosed acute myeloid leukemia (AML): A pilot study

Abstract

8277 Background: Older patients with AML often have a poor prognosis and often do not tolerate intensive chemotherapy. When weighing alternate management strategies, impact upon QOL is an important consideration. However, there is limited published research in this area. Methods: Patients aged 60 or older with newly diagnosed AML were enrolled at diagnosis regardless of treatment intent. Patients were excluded if life expectancy was less than one month or they did not speak English. QOL was measured at baseline and at 1, 4, and 6 months. Questionnaires included the European Organization for the Research and Treatment of Cancer QLQ-C30 (global health, 5 QOL domains, 3 symptom domains) and the Functional Assessment of Cancer Therapy Anemia and Fatigue subscale. Demographic and clinical information was also recorded. Patients were stratified by intensive versus non-intensive treatment. Results: From June to December 2003, 14 patients (mean age 73) were enrolled. At baseline, global health, role function, and social function were the most affected domains. Fatigue was the predominant symptom. Among patients treated intensively, global health, role function, emotional function, cognitive function, and social function improved from baseline to 1-month and 4-month follow-up. Physical function and fatigue scores worsened at 1 month but improved by 4-months follow-up. Non-intensively managed patients had smaller improvements in global health, role function, cognitive function, and social function. Physical function and emotional function remained stable. Fatigue scores showed a similar pattern to intensively managed patients. Pain scores were higher in non-intensively managed patients. Conclusions: QOL in older patients appears to be significantly affected by AML. Intensive chemotherapy is associated with greater improvement or less decline in most domains of QOL and better control of pain but not fatigue. Further patient enrollment and follow-up may lead to an improved understanding of QOL in AML in older adults and may facilitate better symptom management and treatment decision-making. No significant financial relationships to disclose.