Performance of prognostic scoring systems in elderly patients with acute myeloid leukaemia on intensive chemotherapy: A PETHEMA registry study
Por:
Rodriguez-Medina, C, Martinez-Cuadron, D, Cano, I, Gil, C, Tormo, M, Martinez-Sanchez, M, del Castillo, T, Serrano-Lopez, J, Benavente, C, Herrera-Puente, P, Garcia-Boyero, R, Lavilla-Rubira, E, Amigo, M, Sayas-Llorisn, M, Bergua-Burgues, J, Perez-Simon, J, Rodriguez, G, Espadana, A, Vidriales-Vicente, B, Fernandez, R, Lopez-Lorenzo, J, Lopez, M, Garcia-Fortes, M, Gomez, J, Colorado-Araujo, M, Sossa-Melo, C, Aguilar, E and Fernandez, P
Publicada:
1 may 2020
Ahead of Print:
23 mar 2020
Resumen:
Selection of elderly patients (aged >= 60 years) for intensive chemotherapy treatment of acute myeloblastic leukaemia (AML) remains challenging. Several cooperative groups such as Acute Leukaemia French Association (ALFA), Haematological Oncology Clinical Studies Group (HOCSG) and MD Anderson Cancer Center (MDACC) have developed predictive models to select those patients who can benefit from intensive chemotherapy. Our purpose is to validate and compare these three models in a cohort of patients treated in real-life setting. For this, a total of 1724 elderly AML patients and treated with intensive chemotherapy regimens were identified in the PETHEMA registry. Median age was 67.2 years (range, 60-84,9) and median overall survival [OS] 9 months (95 % confidence interval [CI], 8.2-9.7). Taking into account the ALFA group's model, patients likely to benefit from intensive chemotherapy had longer OS (14 months, 95 % CI 12.3-15.7) than those unlikely to benefit (5 months, 95 % CI 4.1-5.9; p < 0.001). Significant differences in OS were observed between patients with favourable risk (17 months, 95 % CI 13.2-20.7), intermediate risk (11 months, 95 % CI 9.3-12.6) and adverse risk (6 months, 95 % CI 5.1-6.4; p < 0.001) according to the HOCSG model. No significant differences in OS were observed between patients with 0, 1, 2 or >= 3 points according to the MDACC model. However, when patients with >= 1 point were compared with those with 0 points, median OS was significantly longer in the latter [15 months (95 % CI 12.1-17.8) vs 7 (95 % CI 5.7-8.5)]. This retrospective study validates predictive models proposed by the ALFA, HOCSG and MDACC groups in this real-life cohort.
Filiaciones:
Rodriguez-Medina, C:
Hosp Univ Gran Canaria Doctor Negrin, Calle Barranco Ballena S-N, Las Palmas Gran Canaria 35010, Spain
Martinez-Cuadron, D:
Hosp Univ & Politecn La Fe, Avinguda Fernando Abril Martorell 106, Valencia 46026, Spain
Inst Carlos III, CIBERONC, Madrid, Spain
Cano, I:
Hosp Univ & Politecn La Fe, Avinguda Fernando Abril Martorell 106, Valencia 46026, Spain
:
Hosp Gen Univ Alicante, Pintor Baeza 11, Alicante 03010, Spain
Tormo, M:
INCLIVA Biomed Res Inst, Hosp Clin Univ, Av Blasco Ibanez 17, Valencia 46010, Spain
Martinez-Sanchez, M:
Hosp Univ 12 Octubre, Av Cordoba S-N, Madrid 28041, Spain
del Castillo, T:
Hosp Univ Cent Asturias, Calle Aldea Cerdeno Esquina Con,Av Hosp Univ, Oviedo 33011, Spain
Serrano-Lopez, J:
Hosp Univ Reina Sofia, Av Menendez Pidal S-N, Cordoba 14004, Spain
Benavente, C:
Hosp Clin San Carlos, C Prof Martin Lagos S-N, Madrid, Spain
Herrera-Puente, P:
Hosp Univ Ramon y Cajal, M-607,Km 9,100, Madrid 28034, Spain
Garcia-Boyero, R:
Hosp Gen Univ Castello, Avinguda Benicassim 128, Castellon de La Plana 12004, Spain
Lavilla-Rubira, E:
Hosp Univ Lucus Augusti, Rua Dr Ulises Romero 1, Lugo 27003, Spain
Amigo, M:
Hosp Gen Univ Morales Meseguer, Av Marques Velez S-N, Murcia 30008, Spain
Sayas-Llorisn, M:
Hosp Univ Doctor Peset, Av Gaspar Aguilar 90, Valencia 46017, Spain
Bergua-Burgues, J:
Hosp San Pedro Alcantara, Avda Pablo Naranjo S-N, Caceres 10003, Spain
Perez-Simon, J:
Hosp Univ Virgen Rocio, Av Manuel Siurot S-N, Seville 41013, Spain
Rodriguez, G:
Hosp Gregorio Maranon, Calle Dr Esquerdo 46, Madrid 28007, Spain
Espadana, A:
Ctr Hosp & Univ Coimbra, Sao Martinho Bispo 108, P-3041801 Coimbra, Portugal
Vidriales-Vicente, B:
Complejo Asistencial Univ Salamanca, Paseo San Vicente 182, Salamanca 37007, Spain
Fernandez, R:
Hosp Univ Insular Gran Canaria, Calle Francisco Hernandez Gonzalez 1, Las Palmas Gran Canaria 35016, Spain
Lopez-Lorenzo, J:
Hosp Univ Fdn Jimenez Diaz, Av Reyes Catolicos 2, Madrid 28040, Spain
Lopez, M:
Hosp Gen Valencia, Av Tres Creus 2, Valencia 46014, Spain
Garcia-Fortes, M:
Hosp Univ Virgen Victoria, Campus Teatinos S-N, Malaga 29010, Spain
Gomez, J:
Hosp Univ Burgos, Av Islas Baleares 3, Burgos 09006, Spain
Colorado-Araujo, M:
Hosp Univ Marques Valdecilla, Av Valdecilla 25, Santander 39008, Spain
Sossa-Melo, C:
Clin Carlos Ardila Lulle FOSCAL Int, Fdn Ofalmol Santander, Prod Unity Adv Therapy, Clin FOSCAL, Bucaramanga, Colombia
Aguilar, E:
Ctr Hosp Sao Joao, Alameda Prof Hernani Monteir, P-4200319 Porto, Portugal
Fernandez, P:
Hosp Univ & Politecn La Fe, Avinguda Fernando Abril Martorell 106, Valencia 46026, Spain
Inst Carlos III, CIBERONC, Madrid, Spain
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