Home Time Among Older Adults With Acute Myeloid Leukemia Following Chemotherapy.

Autor:	Richardson DR; University of North Carolina School of Medicine, Chapel Hill.; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill., Zhou X; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill., Reeder-Hayes K; University of North Carolina School of Medicine, Chapel Hill.; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill., Jensen CE; University of North Carolina School of Medicine, Chapel Hill.; Cecil B. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill., Islam J; Moffitt Cancer Center, Tampa, Florida., Loh KP; Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York., Gupta A; University of Minnesota Masonic Cancer Center, Minneapolis., Basch E; University of North Carolina School of Medicine, Chapel Hill.; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill., Bennett AV; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill.; University of North Carolina Department of Health Policy and Management, Gillings School of Global Public Health, Chapel Hill., Bridges JFP; The Ohio State University, Columbus., Wheeler SB; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill.; University of North Carolina Department of Health Policy and Management, Gillings School of Global Public Health, Chapel Hill., Wood WA; University of North Carolina School of Medicine, Chapel Hill.; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill., Baggett CD; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill.; University of North Carolina Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill., Lund JL; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill.; University of North Carolina Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill.
Jazyk:	angličtina
Zdroj:	JAMA oncology [JAMA Oncol] 2024 Aug 01; Vol. 10 (8), pp. 1038-1046.
DOI:	10.1001/jamaoncol.2024.1823
Abstrakt:	Importance: Patients with acute myeloid leukemia (AML) recognize days spent at home (home time) vs in a hospital or nursing facility as an important factor in treatment decision making. No study has adequately described home time among older adults with AML. Objective: To describe home time among older adults with AML (aged ≥66 years) and compare home time between 2 common treatments: anthracycline-based chemotherapy and hypomethylating agents (HMAs). Design, Setting, and Participants: A cohort of adults aged 66 years or older with a new diagnosis of AML from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database in 2004 to 2016 was identified. Individuals were stratified into anthracycline-based therapy, HMAs, or chemotherapy, not otherwise specified (NOS) using claims. Main Outcomes and Measures: The primary outcome was home time, quantified by subtracting the total number of person-days spent in hospitals and nursing facilities from the number of person-days survived and dividing by total person-days. A weighted multinomial regression model with stabilized inverse probability of treatment weighting to estimate adjusted home time was used. Results: The cohort included 7946 patients with AML: 2824 (35.5%) received anthracyclines, 2542 (32.0%) HMAs, and 2580 (32.5%) were classified as chemotherapy, NOS. Median (IQR) survival was 11.0 (5.0-27.0) months for those receiving anthracyclines and 8.0 (3.0-17.0) months for those receiving HMAs. Adjusted home time for all patients in the first year was 52.4%. Home time was highest among patients receiving HMAs (60.8%) followed by those receiving anthracyclines (51.9%). Despite having a shorter median survival, patients receiving HMAs had more total days at home and 33 more days at home in the first year on average than patients receiving anthracyclines (222 vs 189). Conclusions and Relevance: This retrospective study of older adults with AML using SEER-Medicare data and propensity score weighting suggests that the additional survival afforded by receiving anthracycline-based therapy was entirely offset by admission to the hospital or to nursing facilities.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu