Validation of the 'fitness criteria' for the treatment of older patients with acute myeloid leukemia: A multicenter study on a series of 699 patients by the Network Rete Ematologica Lombarda (REL)
| Autor: | Chiara Pagani, Erika Borlenghi, Matteo Claudio Da Via, Chiara Cattaneo, Fabio Ciceri, Roberto Cairoli, Francesco Passamonti, Massimo Bernardi, Claudia Basilico, Nicola Stefano Fracchiolla, Valentina Mancini, Mauro Turrini, Mariarita Sciumè, Elisabetta Todisco, Giuseppe Rossi, Patrizia Zappasodi, Elisa Cerqui, Margherita Sciumé |
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| Přispěvatelé: | Borlenghi, E, Pagani, C, Zappasodi, P, Bernardi, M, Basilico, C, Cairoli, R, Fracchiolla, N, Todisco, E, Turrini, M, Cattaneo, C, Da Via, M, Ciceri, F, Passamonti, F, Mancini, V, Sciume, M, Cerqui, E, Rossi, G |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis Fitne Concordance Karyotype Comorbidity 03 medical and health sciences 0302 clinical medicine Internal medicine Fitness medicine Humans 030212 general & internal medicine Exercise Aged Retrospective Studies Acute myeloid leukemia Performance status business.industry Older Treatment Myeloid leukemia Retrospective cohort study medicine.disease Clinical trial Leukemia Myeloid Acute Leukemia Oncology 030220 oncology & carcinogenesis Geriatrics and Gerontology business |
| Zdroj: | Journal of Geriatric Oncology. 12:550-556 |
| ISSN: | 1879-4068 |
| Popis: | Objectives: Treatment of older patients with acute myeloid leukemia (AML) is still controversial. To facilitate treatment decisions, the “fitness criteria” proposed by Ferrara et al. (Leukemia, 2013), including age > 75 years, performance status and comorbidities, were verified retrospectively in 699 patients with AML (419 de-novo, 280 secondary AML), diagnosed at 8 Hematological Centers (REL). Methods: Patients were categorized in FIT to intensive chemotherapy (i-T) (292, 42.5%), UNFIT to i-T (289, 42.1%), or unfit even to non-intensive therapy (non i-T) (FRAIL) (105, 15.3%). Biological characteristics and treatment actually received by patients [i-T, 274 patients (39.2%); non i-T, 134 (19.2%), best-supportive care (BSC), 291 (41.6%)] were recorded. Results: “Fitness criteria” were easily applicable in 98.1% of patients. Overall concordance between “fitness criteria” and treatment actually received by patients was high (79.4%), 76% in FIT, 82.7% in UNFIT and 80% in FRAIL patients. Fitness independently predicted survival (median survival: 10.9, 4.2 and 1.8 months in FIT, UNFIT and FRAIL patients, respectively; p = 0.000), as confirmed also by multivariate analysis. In FRAIL patients, survival with any treatment was no better than with BSC, in UNFIT non i-T was as effective as i-T and better than BSC, and in FIT patients i-T was better than non i-T or BSC. In addition, a non-adverse risk AML, an ECOG PS |
| Databáze: | OpenAIRE |
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