AML-208 Treatment Results in Patients With AML Between 60 and 75 Years of Age: Experience of a Center

Abstract

Acute myeloid leukemia (AML) patients aged 60 years or older have a 5-year overall survival (OS) of 3%-8%. Assess treatment outcomes in terms of global response (complete response [CR] and CR with incomplete recovery [CRi]) and identify the impact of clinical and therapeutic characteristics on OS. Retrospective cohort study between January 1st, 2010, and May 31st, 2021. Hospital Italiano de Buenos Aires. Patients aged 60-75 years with AML diagnosis. Summary measures were reported as mean and standard deviation or median and interquartile range (IQR). Categorical comparisons were made using the Chi-square test. Survival analysis was performed using Kaplan-Meier, and subgroups were compared using the log-rank test. Cox regression analysis was used for comparative analysis by covariates. Eighty-nine patients were included, and median follow-up was 6.8 months (IQR 1.5-20.1). Of these, 34 (38.2%) received intensive chemotherapy (CMT) as first line, 40 (44.9%) received hypomethylating agents (HMA), and 15 (16.9%) received best supportive care (BSC). CR reached 37.1% (33) and was achieved in 67.6% of patients who received CMT as first line versus 25% for those who underwent HMA (P<0.001). The median OS for those who underwent CMT was 14.7 months (95% CI 2.7-26.7), HMA 11.7 months (95% CI 7.8-15.6), and BSC 0.7 months (95% CI 0-1.4; P<0.001). The stratified Charlson CCI evaluation did not show significant differences in relation to OS. Median OS for patients who underwent BMT was 36.5 months (95% CI 10.4-68.5) versus 4.1 months (95% CI 2.1-6.1) in non-BMT patients (P<0.001); this difference was statistically significant regardless of the first-line treatment established in the analysis by stratum. In the multivariate analysis, variables associated with OS were PS (HR 1.5 [95% CI 1-2.1]; P=0.03), CR (HR 0.5 [95% CI 0.3-0.9]; P=0.04) and BMT (HR 0.3 [95% CI 0.1-0.7]; P=0.003). A subgroup of patients with better OS is recognized: those with better PS at diagnosis who achieve CR with first-line treatment and have access to BMT. Incorporating new therapeutic strategies that are less toxic but with potential benefits to achieve higher CR rates could improve access to BMT.