Comorbidity burden is an independent predictor of survival in older patients with acute promyelocytic leukemia (APL), according to research published in Leukemia & Lymphoma.
Researchers examined data from the National Cancer Database to explore relationships between Charlson-Deyo Comorbidity Index (CCI) scores and survival outcomes in adults with APL who were 60 years of age and older. There were 2221 patients included in the study.
Patients were stratified into 3 CCI categories for analyses, with groups defined by CCI scores of 0, 1, and 2 or higher. The CCI score was 0 in 59% of patients, 1 in 27%, and 2 or higher in 14%. Patients with a CCI score of 0 more often had private insurance and a higher income than patients in the other CCI categories.
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The primary endpoints were 1-month mortality and overall survival (OS). The 1-month mortality rate was 16% in the group with a CCI score of 0, 24% in the group with a CCI score of 1, and 32% in the group with a CCI score of 2 or higher. In an adjusted analysis, the risk of 1-month mortality was higher for patients with a CCI score of 1 (odds ratio [OR], 1.67; 95% CI, 1.29-2.16; P <.001) and those with a CCI score of 2 or higher (OR, 2.31; 95% CI, 1.70-3.13; P <.001), compared with patients who had a CCI score of 0.
OS rates at 3 years were 61% for patients with a CCI score of 0, 53% for those with a CCI score of 1, and 38% for those with a CCI score of 2 or higher. In an adjusted analysis, a higher risk of death was seen in patients with a CCI score of 1 (hazard ratio [HR], 1.27; 95% CI, 1.10-1.46; P =.0008) and those with a CCI score of 2 or higher (HR, 1.74; 95% CI, 1.48-2.06; P <.0001), compared with patients who had a CCI score of 0.
“This large study . . . establishes that CCI is independently associated with outcomes in APL,” the researchers wrote. “The study results can inform estimates of mortality and OS based on comorbidity burden and facilitate patient counseling and education.”
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Dhakal P, Lyden E, Joshi U, et al. Comorbidity burden and outcomes of older adults with acute promyelocytic leukemia: a National Cancer Database analysis of 2221 patients. Leuk Lymphoma. Published online January 11, 2023. doi:10.1080/10428194.2023.2165394.
This article originally appeared on Oncology Nurse Advisor
