Real-World Treatment Patterns and Clinical Outcomes in Unfit AML Patients: Results of Current Retrospective Study in Romania

Abstract

Aim: The incidence of acute myeloid leukemia (AML) increases along with the aging population and its prognosis worsens with increasing age. Limited data is available on the real-world survival, clinical outcomes, and treatment patterns in Romanian AML patients unfit for intensive chemotherapy. Given the rapidly changing AML treatment landscape, this retrospective chart review aimed to understand historical AML treatment pathways, their associated outcomes, and the economic impact. Material and methods. Adult patients across Romania with primary or secondary AML, ineligible for intensive induction chemotherapy, for whom the first-line systemic therapy (FLST) or best supportive care (BSC) was initiated between January 2015 and December 2018 were evaluated. The outcomes assessed included overall survival (OS), progression-free survival (PFS), response rates and healthcare resource utilization (HRU). Results. Of the 98 patients included, 85.7% received FLST and 14.3% received BSC as first-line therapy. The median OS was 10.0 months in those who received a hypomethylating agent as FLST and 3.4 months in the BSC group. Median PFS was 8.0, 6.4, and 3.4 for hypomethylating agents and low-dose cytarabine as FLST, and BSC, respectively. During the first line therapy the best response was stable disease and was achieved in 20.2% of the FLST patients and 14.3% of the BSC patients. HRU was generally numerically higher in patients with FLST as compared to the ones who received BSC as first-line therapy. Conclusion. The survival and outcomes of unfit AML patients in Romania remain poor highlighting the unmet need for effective treatment options in this population.