Demographic and prognostic factors affecting survival in acute myelomonocytic leukemia with abnormal eosinophils

Acute myelomonocytic leukemia with abnormal eosinophils is an extremely rare, malignant acute myeloid leukemia subtype. Using the National Cancer Database, this study evaluated the demographic and prognostic factors affecting the overall survival and mortality rates of patients. To the extent of our knowledge, this is the most comprehensive study to date on the prognostic and socioeconomic factors of this leukemia subgroup.

Patients with acute myelomonocytic leukemia with abnormal eosinophils were identified in the National Cancer Database between 2004 and 2020 using the ICD-O-3 histology code 9871. Time-to-event outcomes were analyzed by the Kaplan-Meier method, log-rank tests, and multivariable Cox hazard regression models to understand the association of demographic and prognostic factors on survival.

A total of 2138 patients were identified. Patients with a Charlson-Deyo score of 2 or 3 had a 91% (Hazard Ratio = 1.91; 95% Confidence Interval: 1.52-2.39; p-value ≤0.001) and 79% (Hazard Ratio = 1.79; 95% Confidence Interval: 1.34-2.40; p-value ≤0.001) increased mortality risk, respectively, compared to those with a score of 0. Compared to patients with private insurance/managed care, those with other government insurance, Medicaid, and Medicare had a 46% (Hazard Ratio = 1.46; 95% Confidence Interval: 0.87-2.45; p-value ≤0.156), 57% (Hazard Ratio = 1.57; 95% Confidence Interval: 1.26-1.97; p-value ≤0.001), and 32% (Hazard Ratio = 1.32; 95% Confidence Interval: 1.11-1.58; p-value ≤0.001) greater mortality risk, respectively.

Generally, older patients with comorbidities who did not have private insurance had poorer overall survival. No significant difference in overall survival was associated with median household income quartiles.