Clarifying patient needs that affect treatment decisions among older individuals with acute myeloid leukemia (AML) may improve treatment rates, according to research presented during the ASCO20 Virtual Scientific Program.

While many AML treatment options are available, about 60% of elderly patients in the Unite States do not receive treatment. As the reasons for this were previously unestablished, researchers conducted semistructured interviews to help explain the factors predicting treatment decisions in this patient group.

Participants, including clinicians and patient-family member dyads, attended 60-minute interviews and were asked to rate treatment decision–relevant factors on a scale of not important to very important. At baseline, 13 of the 15 patients with AML had not received any treatment.

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Among the 15 patients, the mean age was 72.2 years, 10 patients were women, 7 were white, and the mean time since diagnosis at the time of interview was 5.1 months.

Nine of the 13 patients listed fear of side effects as the primary reason for not receiving treatment; the 2 patients who had previously undergone treatment rated the side effects of therapy as the worst part of their clinical experience.

Eleven of the 15 patients and their family members — as well as all 10 physicians — noted that age and patient comorbidities affected the decision of whether to undergo treatment. Patients viewed low-intensity treatment as being less likely to be effective.

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The physicians noted that patients receiving best supportive care were more likely to be interested in low-intensity treatments if the risk for side effects was lower.

“The treatment decision-making process for older adults with AML is complex and multifactorial,” the authors wrote. “Understanding factors that influence treatment decisions is important if drug developers and prescribers are to ensure the availability of therapies that better align with individual patients’ needs.”


LeBlanc TW, Walter RB, Hernandez-Aldama L, et al. A fork in the road: a mixed methods study exploring why older adults with acute myeloid leukemia choose different treatment paths. Presented at: ASCO20 Virtual Scientific Program. J Clin Oncol. 2020;38(suppl): abstr 7520.

This article originally appeared on Hematology Advisor