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- W2260696588 abstract "20576 Background: Treating the octogenarian and nonagenarianAML pts with intensive chemotherapy is controversial. Several models to predict outcome have been proposed including the use of a comorbidity index. However, it is unclear whether the Charlson Comorbidity Index (CCI) or the Hematopoietic Cell Transplant Comorbidity Index (HCTCI) is more sensitive. Methods: We analyzed our experience with 92 AML pts ≥80 years old evaluated at Roswell Park Cancer Institute between the years 1991 and 2007. We recorded pts’ age, gender, performance status, albumin, lactic dehydrogenase, hemoglobin, white blood cell and platelet counts, peripheral blood blast percentage, CD34 and CD56 positivity of the leukemic blasts, karyotype, de novo vs. secondary AML, CCI and HCTCI, and treatment outcome. Results: All pts were offered intensive treatment (IT); 59 (64%) pts were treated intensively with a variety of regimens while 33 (36%) pts elected to receive supportive care (SC). CCI and HCTCI had similar predictive ability for outcome in both groups. The 2 groups had similar pretreatment characteristics except that there were more pts with unfavorable karyotype in the IT group (P=0.0376). There was no significant difference between IT and SC pts in regards to overall survival (OS) though among the IT pts, those who achieved complete remission had a significantly longer OS (median 39.5 weeks) than those who did not (median 9 weeks; P=0.0024). A favorable group within the IT cohort with albumin ≥3.4g/L (51% of the treated pts) had a 1-year survival rate >33%; there was significant difference between the 2 albumin groups for OS in the IT cohort (P=0.0012). Similarly, a favorable group within the SC cohort with peripheral blood blasts <46% (50% of the pts) had a 1-year survival rate >20%; there was significant difference between the 2 peripheral blood blast percentage groups for OS in the SC cohort (P=0.0053). Conclusions: This retrospective analysis revealed no difference in outcome prediction between CCI and HCTCI for AML pts ≥80 years old. This analysis suggested an association between favorable outcome and near normal albumin level in IT elderly AML pts and low peripheral blood blast percentage in AML pts treated with SC. These findings require further validation in a prospective study. No significant financial relationships to disclose." @default.
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- W2260696588 date "2008-05-20" @default.
- W2260696588 modified "2023-10-14" @default.
- W2260696588 title "Treating octogenarian and nonagenarian acute myeloid leukemia (AML) patients (pts): Predictive prognostic models" @default.
- W2260696588 doi "https://doi.org/10.1200/jco.2008.26.15_suppl.20576" @default.
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