Abstract
Understanding how patient‐reported quality of life (QoL) and socioeconomic status (SES) relate to survival of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) may improve prognostic information sharing. This study explores associations among QoL, SES, and survival through administration of the Euro‐QoL 5‐Dimension, 3‐level and Functional Assessment of Cancer Therapy‐Leukemia and financial impact questionnaires to 138 adult participants with newly diagnosed AML or MDS in a longitudinal, pan‐Canadian study. Cox regression and lasso variable selection models were used to explore associations among QoL, SES, and established predictors of survival. Secondary outcomes were changes in QoL, performance of the QoL instruments, and lost income. We found that higher QoL and SES were positively associated with survival. The Lasso model selected the visual analog scale of the EQ‐5D‐3L as the most important predictor among all other variables (P = .03; 92% selection). Patients with AML report improved QoL after treatment, despite higher mean out‐of‐pocket expenditures compared with MDS (up to $599 CDN/month for AML vs $239 for MDS; P = .05), greater loss of productivity‐related income (reaching $1786/month for AML vs $709 for MDS; P < .05), and greater caregiver effects (65% vs 35% caregiver productivity losses for AML vs MDS; P < .05). Our results suggest that including patient‐reported QoL and socioeconomic indicators can improve the accuracy of survival models.
Highlights
Acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) are malignancies of myeloid lineage, affecting around 10 individuals per 100 000, every year
When all variables were allowed to compete for inclusion in the least absolute shrinkage and selection operator (Lasso) model, the quality of life (QoL) and socioeconomic status (SES) variables were always selected along with the established risk factors used for the National Comprehensive Cancer Network (NCCN) guidelines and International Prognostic Scoring System for MDS (IPSS)
The results from this study suggest that data on patient-reported QoL and SES can improve the accuracy of risk models and that scores from the EQ-5D-3L’s visual analogue scale are the most important predictor to include in post-remission survival models
Summary
Acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) are malignancies of myeloid lineage, affecting around 10 individuals per 100 000, every year. Incidence rates nearly triple for those 70 and older and survival outcomes are poorer with increased age [1,2]. Decisions to offer curative treatments with allogeneic stem cell transplants (alloSCT) are guided by risk factors that are a function of increased age and/or disease progression [3,4]. The National Comprehensive Cancer Network (NCCN) guidelines consider cytogenetic abnormalities, leukemogenic mutations, co-morbidities, and geriatric conditions with established prognostic value [5,6,7,8]. Less is known about the contribution of other risk factors that are independent of age or disease progression, such as quality of life (QoL) and socioeconomic status (SES). If other risk factors independently contribute to survival outcomes, the accuracy of prognostic risk models may be improved through standardized data collection and incorporation into real-world models
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
