Table 5.
Factors associated with survival among older adults receiving chemotherapy for AML
Author (N) | Treatment | Tumor characteristics | Clinical variables | Patient Characteristics | Outcomes |
---|---|---|---|---|---|
Predictive models developed from treatment trials | |||||
Kantarjian et al. (N=446) [29] | Intensive | Complex karyotype | Creatinine >1.3mg/dl | Age>80 ECOG PS>1 |
Early mortality (8 week) |
Krug et al. (N=1406) [57] | Intensive | Secondary AML or prior hematologic disease Molecular/cytogenetic risk |
Body temperature Hemoglobin Platelets LDH Fibrinogen |
Age | Early mortality (60 day) Complete remission |
Rollig et al. (N=909) [58] | Intensive | Karyotype NPM1 mutation CD34 expression>10% |
White cell count>20/μL LDH>700U/L |
Age>65 | Survival |
Wheatley et al. (N=2208) [59] | Intensive | Cytogenetic risk group Secondary AML |
White cell count | Age ECOG PS |
Survival |
Predictors derived from geriatric assessment studies | |||||
Deschler et al. (N=107) [12] | Non-Intensive (prospective) | Bone marrow blast % Cytogenetic risk group |
Impaired ADLs KPS<80 High fatigue score HCT-CI≥3 |
Survival | |
Klepin et al. (N=74) [63] | Intensive (prospective) | Cytogenetic risk group Prior MDS |
Hemoglobin | Cognitive impairment (3MS<77) Impaired physical performance (SPPB<9) |
Survival |
Sherman et al.(N=101) [66] | Mixed (retrospective) | Adverse cytogenetics Secondary AML |
HCT-CI >1 Difficulty with strenuous activity Pain (more often versus less) ECOG PS>1 |
Survival |
Abbreviations: LDH=lactate dehydrogenase; ECOG=Eastern Cooperative Group; PS=performance status; CR=complete remission; 3MS=modified Mini Mental State Exam; SPPB=Short physical performance battery
Adapted from Klepin et al. J Clin Oncol 2014 2014 Aug 20;32(24):2541-52.