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
ISSN: 01452126





LEUKEMIA RESEARCH
Editorial
PERGAMON-ELSEVIER SCIENCE LTD, THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND, Reino Unido
Tipo de documento: Article
Volumen: 92 Número:
Páginas: 106352-106352
WOS Id: 000536198400004
ID de PubMed: 32240863

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