Abstract
Abstract Background: Immunotherapy has been used to treat many cancers for years. It has been combined with other treatments such as chemotherapy and stem cell transplant. The purpose of the current study is to assess the impact of immunotherapy and payer status on Acute Myeloid Leukemia (AML) patient survival. Patients and Methods: Patients in the National Cancer Data Base who were registered between 2004 and 2012 and followed up to the end of 2013 were used in this research. We evaluated a cohort of 50272 AML patients between the ages of 18 to 65 years old who did not undergo radiation or hormonal therapy. The effect of treatments (immunotherapy, stem cell transplant, and adjuvant chemotherapy) on the survival of AML was investigated. Additional variables adjusted included sex, age, race, Charlson Comorbidity Index, education, income, payer status, distance traveled, facility type, diagnosing/treating facility, and treatment delay. Multivariate Cox regression was used to investigate the effect of immunotherapy on the survival of AML patients while adjusting for other factors. Results: The mean age of the patients was 49 years (SD = 12) old. The proportion of patients that received treatments were immunotherapy (1.47%), stem cell transplant (6.11%), and chemotherapy (74.43%). The median overall survival for all patients was 8.76 years. While using multivariate analysis to adjust for other factors, effects of treatment on survival were significant for chemotherapy (hazard ratio (HR) = 1.7, 95% CI: 1.49-2.0), immunotherapy (HR = 0.87, 95% CI: 0.76-0.99), and stem cell transplant (HR = 0.946, 95% CI: 0.88-1.01). While adjusting for other factors, patients who received immunotherapy had a reduced risk of death by 13% compared to patients without immunotherapy whereas patients who received chemotherapy had an increased risk of death by 70% compared to patients without chemotherapy. In addition, compared to patients with private insurance, the HR were 1.38, 1.43, and 1.2 for Medicaid, Medicare and uninsured patients, respectively and were all statistically significant. Compared to patients with a Comorbidity Index score of 0, the HR were 1.35 and 1.71 for Comorbidity Index score of 1 and 2+, respectively. Conclusion: Immunotherapy was found to be a significant benefactor in the survival of AML patients. In addition, payer status and Comorbidity index score were also significant predictors for the survival of AML patients. Citation Format: Runhua Shi, Teena Li, Lawrence Shi, Glenn Mills. Immunotherapy effect on survival of acute myeloid leukemia patients [abstract]. In: Proceedings of the Second CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival; 2016 Sept 25-28; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2016;4(11 Suppl):Abstract nr B138.
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