TY - JOUR
T1 - Age and sex associate with outcome in older AML and high risk MDS patients treated with 10-day decitabine
AU - Hilberink, Jacobien R.
AU - van Zeventer, Isabelle A.
AU - Chitu, Dana A.
AU - Pabst, Thomas
AU - Klein, Saskia K.
AU - Stussi, Georg
AU - Griskevicius, Laimonas
AU - Valk, Peter J. M.
AU - Cloos, Jacqueline
AU - van de Loosdrecht, Arjan A.
AU - Breems, Dimitri
AU - van Lammeren-Venema, Danielle
AU - Boersma, Rinske
AU - Jongen-Lavrencic, Mojca
AU - Fehr, Martin
AU - Hoogendoorn, Mels
AU - Manz, Markus G.
AU - Söhne, Maaike
AU - van Marwijk Kooy, Rien
AU - Deeren, Dries
AU - van der Poel, Marjolein W. M.
AU - Legdeur, Marie Cecile
AU - Tick, Lidwine
AU - Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON)
AU - Chalandon, Yves
AU - Ammatuna, Emanuele
AU - Swiss Group for Clinical Cancer Research (SAKK)
AU - Blum, Sabine
AU - Löwenberg, Bob
AU - Ossenkoppele, Gert J.
AU - Chitu, D. A.
AU - Klein, S. K.
AU - Griskevicius, L.
AU - Valk, P. J. M.
AU - Cloos, J.
AU - van de Loosdrecht, A. A.
AU - Breems, D.
AU - van Lammeren-Venema, D.
AU - Boersma, R.
AU - Jongen-Lavrencic, M.
AU - Söhne, M.
AU - van Marwijk Kooy, R.
AU - Deeren, D.
AU - van der Poel, M. W. M.
AU - Legdeur, M. C.
AU - Tick, L.
AU - Ammatuna, E.
AU - Löwenberg, B.
AU - Ossenkoppele, G. J.
AU - Huls, G.
AU - Pabst, T.
AU - Stussi, G.
N1 - Funding Information: This investigator-sponsored trial was financially supported by Janssen Pharmaceutics, and they provided the decitabine and ibrutinib used in the trial free of charge. Publisher Copyright: © 2023, The Author(s).
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Treatment choice according to the individual conditions remains challenging, particularly in older patients with acute myeloid leukemia (AML) and high risk myelodysplastic syndrome (MDS). The impact of performance status, comorbidities, and physical functioning on survival is not well defined for patients treated with hypomethylating agents. Here we describe the impact of performance status (14% ECOG performance status 2), comorbidity (40% HCT-comorbidity index ≥ 2), and physical functioning (41% short physical performance battery < 9 and 17% ADL index < 6) on overall survival (OS) in 115 older patients (age ≥ 66 years) treated on a clinical trial with a 10-day decitabine schedule. None of the patient-related variables showed a significant association with OS. Multivariable analysis revealed that age > 76 years was significantly associated with reduced OS (HR 1.58; p = 0.043) and female sex was associated with superior OS (HR 0.62; p = 0.06). We further compared the genetic profiles of these subgroups. This revealed comparable mutational profiles in patients younger and older than 76 years, but, interestingly, revealed significantly more prevalent mutated ASXL1, STAG2, and U2AF1 in male compared to female patients. In this cohort of older patients treated with decitabine age and sex, but not comorbidities, physical functioning or cytogenetic risk were associated with overall survival.
AB - Treatment choice according to the individual conditions remains challenging, particularly in older patients with acute myeloid leukemia (AML) and high risk myelodysplastic syndrome (MDS). The impact of performance status, comorbidities, and physical functioning on survival is not well defined for patients treated with hypomethylating agents. Here we describe the impact of performance status (14% ECOG performance status 2), comorbidity (40% HCT-comorbidity index ≥ 2), and physical functioning (41% short physical performance battery < 9 and 17% ADL index < 6) on overall survival (OS) in 115 older patients (age ≥ 66 years) treated on a clinical trial with a 10-day decitabine schedule. None of the patient-related variables showed a significant association with OS. Multivariable analysis revealed that age > 76 years was significantly associated with reduced OS (HR 1.58; p = 0.043) and female sex was associated with superior OS (HR 0.62; p = 0.06). We further compared the genetic profiles of these subgroups. This revealed comparable mutational profiles in patients younger and older than 76 years, but, interestingly, revealed significantly more prevalent mutated ASXL1, STAG2, and U2AF1 in male compared to female patients. In this cohort of older patients treated with decitabine age and sex, but not comorbidities, physical functioning or cytogenetic risk were associated with overall survival.
UR - http://www.scopus.com/inward/record.url?scp=85162690927&partnerID=8YFLogxK
U2 - https://doi.org/10.1038/s41408-023-00850-6
DO - https://doi.org/10.1038/s41408-023-00850-6
M3 - Article
C2 - 37336890
SN - 2044-5385
VL - 13
JO - Blood Cancer Journal
JF - Blood Cancer Journal
IS - 1
M1 - 93
ER -