Real-World Treatment Patterns and Clinical Outcomes in Korean Patients With AML Ineligible for First-Line Intensive Chemotherapy: A Subanalysis of the CURRENT Study, a Non-Interventional, Retrospective Chart Review|RISS 상세보기

다국어 초록 (Multilingual Abstract)

Background: Although most elderly patients with acute myeloid leukemia (AML) are ineligible for intensive chemotherapy (ICT), treatment options remain limited. CURRENT (UMIN000037786), a real-world, non-interventional, retrospective chart review, evaluated clinical outcomes, clinicopathologic characteristics, and treatment patterns in these patients.
We present results from a subanalysis of Korean patients in this study.
Methods: Patients were aged ≥ 18 years with primary or secondary AML ineligible for ICT who initiated first-line systemic therapy or best supportive care (BSC) between 2015 and 2018 across four centers in Korea. Primary endpoint was overall survival (OS) from diagnosis.
Secondary endpoints included progression-free survival (PFS), time to treatment failure, and response rates. Data analyses were primarily descriptive, with time-to-event outcomes estimated using the Kaplan-Meier method, and Cox regression used to determine prognostic factors for survival.
Results: Among 194 patients enrolled, 84.0% received systemic therapy and 16.0% received BSC. Median age at diagnosis was 74 and 78 years, and Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 was reported in 73.0% and 48.4% of patients, respectively; poor cytogenetic risk was reported in 30.1% and 16.1% of patients. Median OS was 7.83 vs.
4.50 months, and median PFS was 6.73 vs. 4.50 months in the systemic therapy vs. BSC groups. Prognostic factors affecting OS included secondary AML (hazard ratio, 1.67 [95% confidence interval, 1.13–2.45]), ECOG performance status ≥ 2 (2.41 [1.51–3.83]), poor cytogenetic risk (2.10 [1.36–3.24]), and Charlson comorbidity index ≥ 1 (2.26 [1.43–3.58]).
Conclusion: Clinical outcomes are poor in Korean patients with AML ineligible for ICT who are prescribed current systemic therapies or BSC. There is a substantial unmet need for novel agents (monotherapy or in combination) to improve clinical outcomes in this patient population.

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참고문헌 (Reference)

1 DiNardo CD, "Venetoclax combined with decitabine or azacitidine in treatment-naive, elderly patients with acute myeloid leukemia" 133 (133): 7-17, 2019

2 Dhakal P, "Usefulness of Charlson comorbidity index to predict early mortality and overall survival in older patients with acute myeloid leukemia" 20 (20): 804-812, 2020

3 Ha H, "Treatment pattern, financial burden, and outcomes in elderly patients with acute myeloid leukemia in Korea : a nationwide cohort study" 19 (19): 2317-, 2022

4 Deschler B, "Treatment decision-making for older patients with high-risk myelodysplastic syndrome or acute myeloid leukemia : problems and approaches" 91 (91): 1513-1522, 2006

5 Oh SB, "Therapeutic decision-making in elderly patients with acute myeloid leukemia : conventional intensive chemotherapy versus hypomethylating agent therapy" 96 (96): 1801-1809, 2017

6 Palmieri R, "Therapeutic choice in older patients with acute myeloid leukemia: a matter of fitness" 12 (12): 120-, 2020

7 Chen Y, "The outcome and prognostic factors of 248 elderly patients with acute myeloid leukemia treated with standard-dose or low-intensity induction therapy" 95 (95): e4182-, 2016

8 Yi M, "The global burden and attributable risk factor analysis of acute myeloid leukemia in 195 countries and territories from 1990 to 2017 : estimates based on the global burden of disease study 2017" 13 (13): 72-, 2020

9 Ohanian M, "Sorafenib combined with 5-azacytidine in older patients with untreated FLT3-ITD mutated acute myeloid leukemia" 93 (93): 1136-1141, 2018

10 Papageorgiou SG, "Serum ferritin and ECOG performance status predict the response and improve the prognostic value of IPSS or IPSS-R in patients with high-risk myelodysplastic syndromes and oligoblastic acute myeloid leukemia treated with 5-azacytidine : a retrospective analysis of the Hellenic national registry of myelodysplastic and hypoplastic syndromes" 11 : 2040620720966121-, 2020