Therapeutic Considerations for Patients With AML Older Than Age 80
Posted: Monday, September 21, 2020
For patients older than age 80 who are newly diagnosed with acute myeloid leukemia (AML), treatment with leukemia-directed therapies may provide a significant survival advantage over supportive care. These findings from a retrospective study were published in the American Journal of Hematology by Gabriel N. Mannis, MD, of Stanford School of Medicine, California, and colleagues, who believed that larger, prospective studies are necessary to better guide the choice of therapy for these older patients.
This study analyzed treatment patterns and survival outcomes for patients older than age 80 diagnosed with AML and seen at Stanford between 2016 and 2020. Researchers used the Stanford Medicine Research Data Repository to look at live electronic health record data from Stanford Health Care. A total of 41 patients were included in the analysis, with a median age of 82 at the time of AML diagnosis.
Within this cohort, 22.0% received best supportive care; 19.5%, a hypomethylating agent; and 58.5%, a novel therapy (eg, venetoclax, pevonedistat, magrolimab, ivosidenib, or gilteritinib). At the time of final analysis, 14 of the 41 patients remained alive, with a median overall survival of 336 days among the entire cohort. Patients receiving any treatment had a significant survival benefit compared with those who received supportive care alone (441 vs. 26 days).
Regarding specific therapies, patients who received a hypomethylating agent had a 30-day mortality rate of 0%, compared with 4.2% with novel therapies and 55.6% with supportive care. Overall survival was 261.5 days with hypomethylating agents, 441 days with novel therapies, and 26 days with supportive care. Response to treatment was assessed in 20 patients, with 40% in the hypomethylating group achieving a complete response to therapy in a median of 143 days and 62.5% of patients in the novel therapy group achieving a complete response in a median of 61 days.
Disclosure: The authors reported no conflicts of interest