Abstract
Limited evidence exists related to quality of life (QOL) and survival between treatment intensities of patients with acute myelogenous leukemia (AML). The American Society of Hematology recommends shared decision-making when treating older adults with newly diagnosed AML according to individual goals of care. The objective of this study is to provide patient characteristics and goals of treatment from the initial one hundred enrolled patients in the development of a patient decision-making aid comparing intensive with non-intensive treatment. This is a prospective exploratory observational study. The study team recruited older (≥60 years) AML patients from inpatient and outpatient areas of Moffitt Cancer Center from 7/8/20 - 12/17/21. Survival of the first 100 participants ≥ 60 years of age with newly diagnosed AML presented. Each patient defined their goals of care with treatment at baseline. The primary outcome is the development of a decision aid for older newly diagnosed AML patients based on QOL and survival data in efforts to improve goal concordant care. Patient survival and treatment goals are presented. Of the one hundred patients forty-two are living (24 had intensive chemotherapy, eighteen had non-intensive regimens); most men, 59% (38/64) received intensive treatment, and 61% of women (22/36) received non-intensive treatment. Nine non-Caucasians were enrolled. Ages ranged from 61-77 for intensive compared to 62-86 for non-intensive. The most used intensive treatment was CPX-351 compared to azacitidine and venetoclax for non-intensive treatments. Seventy-three patients chose improved quality of life over survival as their treatment goal. Five patients died prior to starting non-intensive treatment. Treatment decisions are primarily based on survival data. For patients to participate in the decision-making process, quality of life data is needed to provide goal-concordant care. The current model in development will provide robust quality of life data from over two hundred patients based on survival and quality of life with two treatment intensities. Funding provided by NIN/NINR 5K23NR018488.
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