Real-World Treatment Patterns and Clinical Outcomes in Canadian Patients with AML Unfit for First-Line Intensive...

Area of Science:

• Hematology
• Oncology
• Geriatrics

Background:

• Acute myeloid leukemia (AML) predominantly affects the elderly, with poorer prognosis correlating with age.
• Established first-line treatments for chemotherapy-ineligible AML patients include hypomethylating agents (HMAs), low-dose cytarabine (LDAC), and best supportive care (BSC).
• Evolving standards of care necessitate understanding current treatment pathways, outcomes, and healthcare resource utilization in Canada for this patient group.

Purpose of the Study:

• To evaluate established first-line treatment pathways, clinical outcomes, and healthcare resource utilization for acute myeloid leukemia patients ineligible for intensive chemotherapy in Canada.
• To provide insights into the effectiveness of hypomethylating agents (HMAs), low-dose cytarabine (LDAC), and best supportive care (BSC) in this population.

Main Methods:

• A retrospective chart review was conducted involving 170 Canadian patients with acute myeloid leukemia (AML) not eligible for intensive chemotherapy.
• Patients initiated first-line treatment between January 1, 2015, and December 31, 2018, at six hematology centers.
• Data included treatment received (systemic therapy vs. BSC), overall survival, outpatient visits, hospital admissions, and transfusion requirements.

Main Results:

• Median overall survival was 8.58 months, ranging from 2.96 months for BSC to 13.31 months for HMAs.
• Over 80% of patients required outpatient visits, and a significant proportion (67-71%) were hospitalized during first-line therapy.
• Blood product transfusions were common, with 81.4% of systemic therapy patients and 75.0% of BSC patients receiving them.

Conclusions:

• Current first-line treatments for elderly AML patients unfit for intensive chemotherapy offer limited survival benefits.
• Significant healthcare resources, including hospitalizations and transfusions, are utilized in managing these patients.
• There is a critical unmet need for novel therapeutic strategies to improve outcomes for acute myeloid leukemia patients ineligible for intensive chemotherapy.