Predictors of Outcomes During Induction Chemotherapy for Patients With AML
Posted: Monday, July 13, 2020
During patients’ first inpatient stay for induction chemotherapy to treat acute myeloid leukemia (AML), 16% of patients were discharged to hospice or died, according to a recent study. Patients who were 65 or older and those at hospitals with lower volumes of induction chemotherapy had higher mortality. Rong Wang, PhD, of Yale University School of Medicine, and colleagues published these findings in Blood Advances.
“These rates are substantially higher than those reported in clinical trials,” wrote the authors.
The study included 6,442 patients who were treated for AML with cytarabine/anthracycline induction chemotherapy at 313 hospitals between 2010 and 2017. Patients’ median age was 61 years, and the median length of hospital stay was 29 days. The researchers used the Premier Healthcare database to determine mortality rates and identify factors associated with transfer to hospice or patient death.
During their first admission for induction chemotherapy, 16% of patients entered hospice or died. Of patients 65 years or older, 24.2% entered hospice or died. The authors found that patients treated at medical centers with a higher volume of induction chemotherapy were less likely to enter hospice or die (odds ratio = 0.80) than those at lower-volume medical centers. Patients in the Northeast were less likely to enter hospice or die (odds ratio = 0.72) than patients in the South. In the course of hospitalization, 28.0% of patients required ICU care, 12.6% needed mechanical ventilation, and 4.0% required dialysis.
One limitation of the study is its lack of data on financial and social support resources, which could be confounding factors. “Prior research suggests patients who travel to academic centers for second opinions or novel therapies are healthier and wealthier and have greater social supports,” the authors commented.
Disclosure: The study authors’ disclosure information may be found at ashpublications.org.