Age and sex associate with outcome in older AML and high risk MDS patients treated with 10-day decitabine.

Publication

Age and sex associate with outcome in older AML and high risk MDS patients treated with 10-day decitabine.

Journal Paper/Review - Jun 19, 2023

Hilberink Jacobien R, van Zeventer Isabelle A, Chitu Dana A, Pabst Thomas, Klein Saskia K, Stussi Georg, Griskevicius Laimonas, Valk Peter J M, Cloos Jacqueline, van de Loosdrecht Arjan A, Breems Dimitri A, van Lammeren-Venema Daniëlle, Boersma Rinske, Jongen-Lavrencic Mojca, Fehr Martin, Hoogendoorn Mels, Manz Markus G, Söhne Maaike, van Marwijk Kooy Rien, Deeren Dries, van der Poel Marjolein W M, Legdeur Marie-Cecile J C, Tick Lidwine W, Chalandon Yves, Ammatuna Emanuele, Blum Sabine, Löwenberg Bob, Ossenkoppele Gert J, Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON), Swiss Group for Clinical Cancer Research (SAKK), Huls Gerwin

Citation

Hilberink J, van Zeventer I, Chitu D, Pabst T, Klein S, Stussi G, Griskevicius L, Valk P, Cloos J, van de Loosdrecht A, Breems D, van Lammeren-Venema D, Boersma R, Jongen-Lavrencic M, Fehr M, Hoogendoorn M, Manz M, Söhne M, van Marwijk Kooy R, Deeren D, van der Poel M, Legdeur M, Tick L, Chalandon Y, Ammatuna E, Blum S, Löwenberg B, Ossenkoppele G, Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON), Swiss Group for Clinical Cancer Research (SAKK), Huls G. Age and sex associate with outcome in older AML and high risk MDS patients treated with 10-day decitabine. Blood Cancer J 2023; 13:93.

Type

Journal Paper/Review (English)

Journal

Blood Cancer J 2023; 13

Publication Date

Jun 19, 2023

Issn Electronic

2044-5385

Brief description/objective

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.