Abstract
BackgroundThis study examined patient outcomes using real world data for acute myeloid leukemia (AML) patients initiating treatment.MethodsA retrospective, administrative claims-based, comparative analysis was developed to study outcomes for AML patients initiating treatment with decitabine or azacitidine between January 2006 and June 2012.ResultsTreatment with azacitidine was associated with a longer median overall survival (10.1 versus 6.9 mos., p = 0.007) and a lower risk of hospitalization (HR 0.787, p = 0.02) compared to treatment with decitabine.ConclusionsThis analysis of the outcomes of real-world treatment of AML patients with demethylating agents suggests that azacitidine may result in clinically superior outcomes than decitabine.
Highlights
This study examined patient outcomes using real world data for acute myeloid leukemia (AML) patients initiating treatment
The purpose of this study is to examine the real world translation of the use of hypomethylating agents to treat elderly patients with AML by assessing patient outcomes for those initiating treatment with azacitidine or decitabine
The median OS for AML patients treated with azacitidine in this study was shorter than what was reported in clinical trials [9,15,16], it was still longer than OS for patients treated with decitabine either in this retrospective study or previous trials [11,12]
Summary
This study examined patient outcomes using real world data for acute myeloid leukemia (AML) patients initiating treatment. The National Comprehensive Cancer Network (NCCN) guidelines consider patients aged 60 years or older eligible for highintensity induction therapy in limited circumstances [1] This is in part due to the finding that the percentage of patients who demonstrate clinical characteristics making them fit for high-intensity chemotherapy decreases with age [2]. The limitations noted are not without reason as intensive, chemotherapy-based induction carries a comparably higher risk of death in older patients compared with younger ones (overall survival [OS]; ranges from 3.5 months [>75 years of age] to 18.8 months [≥56 to ≤75 years of age]; overall mortality hazard ratio [HR] of 1.2-1.3) [6,7]. With a median age at diagnosis of AML in the US of 66 years [6], the challenge faced by clinicians in the treatment of elderly patients with newly diagnosed AML is quite real
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