Regimen‐intensity per count‐recovery and hospitalization index: A new tool to assign regimen intensity for AML

Autor: Ylinne Lynch, Elihu H. Estey, Jennifer E. Nyland, Pamela S. Becker, Megan Othus, Frederick R. Appelbaum, Mary Elizabeth Percival, Shirali Agarwal, Mohamed L. Sorror
Rok vydání: 2020
Předmět:
Blood Platelets
0301 basic medicine
Cancer Research
medicine.medical_specialty
Time Factors
Neutrophils
acute myeloid leukemia
Logistic regression
lcsh:RC254-282
Risk Assessment
Model validation
law.invention
Leukocyte Count
03 medical and health sciences
0302 clinical medicine
Older patients
Randomized controlled trial
Predictive Value of Tests
Risk Factors
law
Clinical Decision Rules
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
survey
Radiology
Nuclear Medicine and imaging
Original Research
Platelet Count
business.industry
Medical record
induction therapy
Clinical Cancer Research
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Intensive care unit
expert opinion
Intensity (physics)
Hospitalization
Leukemia
Myeloid
Acute
Regimen
Treatment Outcome
030104 developmental biology
Oncology
Health Care Surveys
030220 oncology & carcinogenesis
intensity
business
Zdroj: Cancer Medicine
Cancer Medicine, Vol 9, Iss 18, Pp 6515-6523 (2020)
ISSN: 2045-7634
Popis: Background Low‐intensity regimens have been increasingly used to treat older patients with acute myeloid leukemia (AML). Recent studies, however, suggest older patients can tolerate and potentially benefit from intensive chemotherapeutic regimens. The ability to compare the utility of varying regimen intensities in AML is hindered by the lack of a standardized definition of “regimen intensity.” Methods We conducted a survey asking AML physicians which of 38 regimens they would consider intensive vs less‐intensive. Electronic medical records of 592 patients receiving many of these regimens were used to design a model characterizing regimens as intensive vs less‐intensive as identified by ≥75% physician consensus. Variables included frequency and length of hospitalizations, intensive care unit admissions, severe gastrointestinal toxicities, time to nadir, and recovery of neutrophil/platelet count. Results Physicians agreed at a rate of 75%‐100% on the assignment of degree of intensity to the majority (n = 28) of these regimens, while the level of agreement was
Surveyed physicians reached ≥75% concordance on ratings of intensity for 28/38 regimens (74%) used in treatment of acute myeloid leukemia. We developed and validated the “Regimen‐Intensity per Count‐recovery and Hospitalization” (RICH) index, incorporating number and length of hospitalizations and count recovery, to characterize whether a regimen should be considered more‐ or less‐intensive.
Databáze: OpenAIRE
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