-Author name in bold denotes the presenting author
-Asterisk * with author name denotes a Non-ASH member
Clinically Relevant Abstract denotes an abstract that is clinically relevant.

PhD Trainee denotes that this is a recommended PHD Trainee Session.

Ticketed Session denotes that this is a ticketed session.

2567 Age-Based Probability of Ten-Year Overall Survival (OS) of Acute Myeloid Leukemia (AML): A National Cancer Database (NCDB) Analysis

Program: Oral and Poster Abstracts
Session: 906. Outcomes Research—Malignant Conditions (Myeloid Disease): Poster II
Hematology Disease Topics & Pathways:
AML, Adult, Diseases, Study Population, Myeloid Malignancies, Clinically relevant
Sunday, December 6, 2020, 7:00 AM-3:30 PM

Vijaya R. Bhatt, MD1, Valerie K Shostrom2*, Nabin Khanal, MBBS3, Chakra P Chaulagain, MD4, Fiona He, MD5 and Krishna Gundabolu, MBBS6

1Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE
2Univerisity of Nebraska Medical Center, Omaha, NE
3Franciscan Physician Network Oncology & Hematology Specialists, St Francis hospital, Indianapolis, IN
4Department of Hematology and Oncology, Maroone Cancer Center, Cleveland Clinic Florida, Weston, FL
5Unniversity of Minnesota, Minneapolis, MN
6Division of Oncology and Hematology, University of Nebraska Medical Center- Fred & Pamela Buffett Cancer Center, Omaha, NE

Background: Clinical trial data suggest excellent short-term outcomes for younger patients and a subset of fit older patients. Translating findings of clinical trials into the real-world practice has challenges, and longer-term data are often not available. Hence, we utilized NCDB to determine age-based probability of ten-year OS of unselected cohorts of adults with AML.

Methods: NCDB captures about 70% of all new diagnosis of cancer. We utilized NCDB to analyze ten-year OS of 15,646 patients aged ≥18 years, who were diagnosed with AML during the years 2004-2007. Univariate and multiple logistic regression models were used to determine factors associated with ten-year OS. Kaplan Meier curves were generated for OS analysis.

Results: Ten-year OS was 12.7% for patients aged 18-59 years treated with chemotherapy without hematopoietic cell transplant (HCT) (Table 1, Fig. 1). Older age, male, Charlson-Deyo comorbidity score >0, insurance other than private, subtypes other than core-binding factor AML were associated with lower ten-year OS. Ten-year OS was 24.3% for patients aged 18-59 years treated with chemotherapy and HCT (Fig 2). Older age, male, and insurance other than private were associated with lower ten-year OS. Ten-year OS was 16.1% and 2.2% for patients older than 60 years and treated with and without HCT, respectively; multivariate analysis was not performed for older patients because of low sample size (HCT group) or low survival (non-HCT group). Detailed analysis will be presented.

Conclusions: Long-term OS of adults with AML is low with less than a quarter of patients being alive at ten years. Ten-year OS is particularly poor for older patients who are treated with chemotherapy alone. Whereas recent advances and approval of eight new drugs will likely improve short-term OS at 2-3 years, innovative strategies are necessary to improve long-term OS and cure. Further study to identify the cause of death will be insightful.

Disclosures: Bhatt: Takeda: Consultancy; Partnership for health analytic research: Consultancy; Jazz: Research Funding; National Marrow Donor Program: Research Funding; Oncoceutics: Other; Abbvie: Consultancy, Research Funding; Incyte: Consultancy, Research Funding; Pfizer: Research Funding; Tolero: Research Funding; Rigel: Consultancy; Agios: Consultancy; Omeros: Consultancy. Chaulagain: Sanofi Genzyme: Honoraria. Gundabolu: BioMarin: Consultancy; Bristol Myers Squibb pharmaceuticals: Consultancy.

Previous Abstract | Next Abstract >>
*signifies non-member of ASH