Home time among older adults with acute myeloid leukemia by therapy intensity

Jensen, Christopher E.; Deal, Allison M.; Wardell, Alexis C.; Heiling, Hillary M.; Beke, Konan E.; Richardson, Daniel R.

doi:10.3324/haematol.2023.284133

haematol

2023

DOI: 10.3324/haematol.2023.284133

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Home time among older adults with acute myeloid leukemia by therapy intensity

Christopher E. Jensen,

Allison M. Deal,

Alexis C. Wardell

et al.

Abstract: Not available.

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2024

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Cited by 1 publication

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“…12 Prior work found that patients with AML at our institution receiving HMA-based therapy spent a mean 58% of days not engaged in oncologic care. 13,14 To date, however, no study has sufficiently compared home time of adults with AML receiving anthracycline-based regimens with HMA-based regimens. Recently, methods have been refined to capitalize on administrative data to describe home time.…”

mentioning

confidence: 99%

Home Time Among Older Adults With Acute Myeloid Leukemia Following Chemotherapy

Richardson,

Zhou,

Reeder-Hayes

et al. 2024

JAMA Oncol

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ImportancePatients 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.ObjectiveTo 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 ParticipantsA 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 MeasuresThe 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.ResultsThe 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 RelevanceThis 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.

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confidence: 99%

Home Time Among Older Adults With Acute Myeloid Leukemia Following Chemotherapy

Richardson,

Zhou,

Reeder-Hayes

et al. 2024

JAMA Oncol

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Home time among older adults with acute myeloid leukemia by therapy intensity

Abstract: Not available.

Cited by 1 publication

References 10 publications

Home Time Among Older Adults With Acute Myeloid Leukemia Following Chemotherapy

Home Time Among Older Adults With Acute Myeloid Leukemia Following Chemotherapy

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