Determinants of ten-year overall survival of acute myeloid leukemia: a large national cancer database analysis.
Nabin KhanalValerie ShostromPrajwal DhakalShristi Upadhyay BanskotaChakra ChaulagainFiona HeKailash MosalpuriaKrishna GundaboluVijaya Raj BhattPublished in: Leukemia & lymphoma (2021)
Clinical trials do not routinely capture long-term overall survival (OS) in acute myeloid leukemia (AML). We utilized a large National Cancer Database (NCDB) to determine different factors affecting 10-year OS in AML. For patients, 18-59 years who were treated with chemotherapy only without upfront hematopoietic cell transplant (HCT), younger age, female, CBF AML, higher income, and private insurance conferred higher 10-year OS. Among patients, 18-59 years treated with chemotherapy and upfront HCT, younger age and private insurance conferred higher 10-year OS. In a Cox proportional hazard model, the likelihood of death decreased with younger age, fewer comorbidities, treatment at an academic center, private insurance, and use of multiagent chemotherapy. Our results demonstrate poor long-term OS even among younger patients and highlights disparities in leukemia care based on insurance type.
Keyphrases
- acute myeloid leukemia
- health insurance
- affordable care act
- healthcare
- newly diagnosed
- clinical trial
- ejection fraction
- allogeneic hematopoietic stem cell transplantation
- prognostic factors
- bone marrow
- palliative care
- locally advanced
- physical activity
- randomized controlled trial
- radiation therapy
- squamous cell carcinoma
- mesenchymal stem cells
- signaling pathway
- study protocol
- free survival
- replacement therapy