Nonbiological factors affecting survival in younger patients with acute myeloid leukemia

Borate, Uma; Mineishi, Shin; Costa, Luciano J.

doi:10.1002/cncr.29436

Cited by 53 publications

(44 citation statements)

References 37 publications

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“…While our study did not observe differences in 60-day mortality between public and private health insurance, our findings that lack of health insurance was associated with 60-day mortality is consistent with a prior population-based cancer registry analysis of 19–64 year-old AML patients (Borate et al , 2015). Future research should continue to monitor the impact of health insurance on outcomes after the implementation of the Affordable Care Act (ACA) in 2014, as the ACA has resulted in a decrease in the population of uninsured,(Wherry & Miller, 2016) but it is not yet clear if this results in better health outcomes.…”

Section: Discussionsupporting

confidence: 91%

Early mortality and complications in hospitalized adult Californians with acute myeloid leukaemia

Jonas

et al. 2017

Br J Haematol

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SUMMARY Few studies have evaluated the impact of complications, sociodemographic and clinical factors on early mortality (death ≤ 60 days from diagnosis) in acute myeloid leukaemia (AML) patients. Using data from the California Cancer Registry linked to hospital discharge records from 1999–2012, we identified patients aged ≥ 15 years with AML who received inpatient treatment (N=6359). Multivariate logistic regression analyses were used to assess the association of complications with early mortality, adjusting for sociodemographic factors, comorbidities and hospital type. Early mortality decreased over time (25.3%, 1999–2000; 16.8%, 2011–2012) across all age groups, but was higher in older patients (6.9%, 15–39, 11.4%, 40–54, 18.6% 55–65, and 35.8%, > 65 years). Major bleeding (Odds ratio [OR] 1.5, 95% confidence interval [CI] 1.3–1.9), liver failure (OR 1.9, 95% CI 1.1–3.1), renal failure (OR 2.4, 95% CI 2.0–2.9), respiratory failure (OR 7.6, 95% CI 6.2–9.3) and cardiac arrest (OR 15.8, 95% CI 8.7–28.6) were associated with early mortality. Higher early mortality was also associated with single marital status, low neighbourhood socioeconomic status, lack of health insurance and comorbidities. Treatment at National Cancer Institute-designated cancer centres was associated with lower early mortality (OR 0.5, 95% CI 0.4–0.6). In conclusion, organ dysfunction, hospital type and sociodemographic factors impact early mortality. Further studies should investigate how differences in healthcare delivery affect early mortality.

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Section: Discussionsupporting

confidence: 91%

Early mortality and complications in hospitalized adult Californians with acute myeloid leukaemia

Jonas

et al. 2017

Br J Haematol

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“…In fact, being married was the only protective factor for patients with AML-RGA. This finding supports a growing body of evidence that outcomes after several types of cancer are significantly better for patients who are married rather than single [34-37]. Single patients are thought to have less support – emotionally, physically, or financially – and make different lifestyle choices, and these differences have an impact on their ability to survive a diagnosis of cancer [38].…”

Section: Discussionsupporting

confidence: 62%

Incidence, Survival, and Risk Factors for Adults with Acute Myeloid Leukemia Not Otherwise Specified and Acute Myeloid Leukemia with Recurrent Genetic Abnormalities: Analysis of the Surveillance, Epidemiology, and End Results (SEER) Database, 2001–2013

Song

Wang

et al. 2018

Acta Haematol

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Background/Aim: As the knowledgebase of acute myeloid leukemia (AML) has grown, classification systems have moved to incorporate these new findings. Methods: We assessed 32,941 patients with AML whose records are contained in the Surveillance, Epidemiology, and End Results (SEER) database. Results: Half of all patients diagnosed between 2001 and 2013 did not have a World Health Organization (WHO) classification. Acute promyelocytic leukemia and acute panmyelosis with myelofibrosis were associated with the longest leukemia-specific survival (110 and 115 months, respectively), and AML with minimal differentiation and acute megakaryoblastic leukemia with the shortest (30 and 28 months, respectively). For patients in the WHO groups AML not otherwise specified (AML-NOS) and AML with recurrent genetic abnormalities (AML-RGA), the risk of death was greater for older patients and less for married patients. Black patients with any type of AML-NOS also had a higher risk of death. Patients whose case of AML did not receive a WHO classification were older and this group had a higher risk of death when compared to patients with a WHO type of AML-NOS. Conclusion: Our findings highlight the divergent outcomes of patients with AML and the importance of using the WHO classification system and demographic factors to gauge their prognosis.

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“…Along the same lines, allotransplantation has been proposed for normal-karyotype AML patients who achieve a median survival of almost 18 months [13]. Nonbiological factors, including insurance status and county-level income, have also been associated with a poorer outcome [14], as in our series of patients in which we documented a 17.8% mortality rate during the aplasia period. Therefore, biomarkers related to predicted drug response are required in AML patients who are candidates for Ara-C treatment.…”

Section: Discussionsupporting

confidence: 59%

Expression Levels of Human Equilibrative Nucleoside Transporter 1 and Deoxycytidine Kinase Enzyme as Prognostic Factors in Patients with Acute Myeloid Leukemia Treated with Cytarabine

Candelaria¹,

Corrales-Alfaro²,

Gutiérrez-Hernández³

et al. 2016

Chemotherapy

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Background: Cytarabine (Ara-C) is the primary drug in different treatment schemas for acute myeloid leukemia (AML) and requires the human equilibrative nucleoside transporter (hENT1) to enter cells. The deoxycytidine kinase (dCK) enzyme limits its activation rate. Therefore, decreased expression levels of these genes may influence the response rate to this drug. Methods: AML patients without previous treatment were enrolled. The expression of hENT1 and dCK genes was analyzed using RT-PCR. Clinical parameters were registered. All patients received Ara-C + doxorubicin as an induction regimen (7 + 3 schema). Descriptive statistics were used to analyze data. Uni- and multivariate analyses were performed to determine factors that influenced response and survival. Results: Twenty-eight patients were included from January 2011 until December 2012. Median age was 36.5 years. All patients had an adequate performance status (43% with ECOG 1 and 57% with ECOG 2). Cytogenetic risk was considered unfavorable in 54% of the patients. Complete response was achieved in 53.8%. Cox regression analysis showed that a higher hENT1 expression level was the only factor that influenced response and survival. Conclusions: These results highly suggest that the pharmacogenetic analyses of Ara-C influx may be decisive in AML patients.

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Nonbiological factors affecting survival in younger patients with acute myeloid leukemia

Cited by 53 publications

References 37 publications

Early mortality and complications in hospitalized adult Californians with acute myeloid leukaemia

Early mortality and complications in hospitalized adult Californians with acute myeloid leukaemia

Incidence, Survival, and Risk Factors for Adults with Acute Myeloid Leukemia Not Otherwise Specified and Acute Myeloid Leukemia with Recurrent Genetic Abnormalities: Analysis of the Surveillance, Epidemiology, and End Results (SEER) Database, 2001–2013

Expression Levels of Human Equilibrative Nucleoside Transporter 1 and Deoxycytidine Kinase Enzyme as Prognostic Factors in Patients with Acute Myeloid Leukemia Treated with Cytarabine

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