Early mortality in acute myeloid leukemia

Area of Science:

• Hematology
• Oncology
• Epidemiology

Background:

• The Southwest Oncology Group (SWOG) reported early mortality rates (EMR) for non-M3 acute myeloid leukemia (AML) patients in clinical trials.
• Generalizability of SWOG's EMR data to the broader patient population remains uncertain.

Purpose of the Study:

• To compare the EMR of non-M3 AML patients in the general population with SWOG's reported EMR.
• To identify predictors of higher EMR in non-M3 AML.

Main Methods:

• Utilized the SEER 18 database, matched to SWOG study accrual periods.
• Compared EMR between 26,272 patients in the SEER cohort and 968 patients in the SWOG cohort.
• Performed stepwise logistic regression to identify EMR predictors.

Main Results:

• The EMR was significantly higher in the SEER cohort (26.7%) compared to the SWOG cohort (12.2%).
• Higher EMR was observed across all age groups in the SEER cohort.
• Increasing age, Black race, and monocytic differentiation were identified as predictors of higher EMR.

Conclusions:

• Early mortality in non-M3 AML is substantially underestimated by data from SWOG clinical trials.
• Clinical trial data may not fully represent the mortality risks faced by the general non-M3 AML patient population.