Improvement in Survival for Elderly Pts with AML over the Years: A NCDB Analysis

Objective: There has been significant changes in management of acute myeloid leukemia (AML) over past few years with bunch of new medications approved for AML management. We did a retrospective study to investigate if the recent improvement in AML management options have led to improved survival in elderly AML pts.

Subjects and Methods: Patients with AML from 2004-2014 between age from 60-90 years were included in the retrospective study. Chi-square analysis was used to assess the association between treatment and factors investigated. Kaplan-Meier method was used to assess overall survival. Log rank methods were used to determine factors significant for survival. Multivariable Cox regression analysis was used to determine the independent variables.

Results: 37,617 patients from the National Cancer Database were eligible for this study. Twenty-seven, thirty-six and thirty-seven percentage of pts were in the age group more than/equal to eighty, between 70-79 years and 60-69 years, respectively. The median survival in months of pts between 60-69 years, 70-79 years and >= 80 years was 9.5, 3.8 and 1.4 respectively. The median survival of pts did improve the years with median survival of 3.3 m, 3.7 m and 5 m in pts who got diagnosed between 2004-2007, 2008-2010 and 2011-2014 respectively. On multivariate analysis, after adjusting for all variable including age, gender, race, treatment received and comorbidity index, the year of AML diagnosis was statistically significant predictor of overall survival. The pts who got diagnosed between 2011-2014 were 19 % less likely to die compared to those diagnosed between 2004-2007.

Conclusion: Survival analysis on AML in the National Cancer Database showed that survival in elderly pts with AML has improved over the years with pts who were diagnosed between 2011-2014 were 19 % less likely to die compared to pts diagnosed between 2004-2007.