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This Could Help Guide AML Treatment Decisions

JAMA Oncol; ePub 2017 Sep 7; Sorror, et al

Publish date:: September 17, 2017

Comorbidities impacted 1-year survival in patients with acute myeloid leukemia (AML), according to a retrospective cohort study involving 1,100 individuals. Researchers also found that augmenting the hematopoietic cell transplantation-comorbidity index (HCT-CI) could help guide treatment decisions.

Participants were treated for AML between 2008 and 2012 at 5 academic centers. Investigators evaluated a number of comorbidities (including those already used in the HCT-CI) in a training set (n=733) and a validation cohort (n=367). Among the results:

In the validation cohort, the original HCT-CI predicted 1-year mortality better than the AML comorbidity index.
Adding hypoalbuminemia, thrombocytopenia, and high lactate dehydrogenase level to the original HCT-CI predicted 1-year mortality even better.
A composite model comprising augmented HCT-CI, age, and cytogenetic/molecular risks provided the best estimates.

The authors noted that targeting comorbidities with interventions alongside specific AML therapy could improve survival.

Citation:

Sorror M, Storer B, Fathi A, et al. Development and validation of a novel acute myeloid leukemia-composite model to estimate risks of mortality. [Published online ahead of print September 7, 2017]. JAMA Oncol. doi:10.1001/jamaoncol.2017.2714.

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