POSTER 34
CHARACTERISTICS AND TREATMENT OF OLDER PATIENTS WITH ACUTE MYELOID
LEUKEMIA AT THE UNIVERSITY MEDICAL CENTRE MARIBOR
Nejc Pulko, Jasmina Hauptman and Zlatko Roškar
Department of Haematology and Haematological Oncology, Division of Internal Medicine, University
Medical Centre Maribor, Maribor, Slovenia
Objectives
Acute myeloid leukemia (AML) is an aggressive hematological malignancy. The adverse features of
AML, the frailties, and comorbidities are frequent among the elderly. Management of AML in older
patients is still a particularly difficult therapeutic challenge.1
Methods
Retrospective observational study was performed at University medical centre Maribor. Patients
with AML aged over 65 years that were diagnosed between 1st january 2014 and 31st december 2019
were included in the study.
Results
Eighty-nine (51.7% male) patients were included in the study. Median age was 78 years (95% CI=
76.5–79.8). We treated 71.9% of patients, out of those 10.5% recieved intensive treatment, 26.6%
were treated with decitabine and 54.5% with azacitidine.
Patients that did not receive treatment had shorter median survival(26 days; 95% CI 1-50 days)
compared to treated patients (167 days; 95% CI 84-250 days) (p<0.001). Longer median survival was
found for patients that received low intensity treatment regiments (145 days; 95% CI 94-196 days)
compared to the patients that received only supportive treatment (26 days; 95% CI 1-50 days)
(p=0.006).
Patients that received intensive chemotherapy had longer median survival (448 days; 95% CI 40-857
days) compared to azacitidine or decitabine treatment (82 days; 95% CI 20-144 days) (p=0.009).
No significant difference in survival has been found between patients that were treated with
azacitidine compared to patients with decitabine.
Patients with higher ECOG performance status had shorter median survival compared to patients
with lower ECOG performance status (p<0.001). Median survival for patients with ECOG 2 was 226
days (95% CI 76-376 days), 62 days (95% CI 9-115 days) for patients ECOG-3 and 25 days (95% CI 14-
36) for patients with ECOG-4.
Cox regression analysis was performed to identify prognostic factors for overal survival. Lower
percentage of blast in periferal blood, lower ECOG grade, and de novo AML were all associated with
increased survival.
Conclusions
Careful evaluation of both patient and disease is required in each individual case to make optimal
management decisions, and maximize the benefit to the patient. Our data supports the fact that
patients treated with low-intensity regimens live longer than those that received only supportive
therapy. Our data as the data from clinical trials has shown that performance status, percentage of
blasts in periferal blood, and type of AML are the most relevant prognostic factors.
1. Almeida AM, Ramos F. Acute myeloid leukemia in the older adults. LeukRes Rep. 2016 Jun 16;6:1-7. doi:
10.1016/j.lrr.2016.06.001. PMID:27408788; PMCID: PMC4927655.
SCIENTIFIC
PROGRAMME
RARE SUBSETS OF
ACUTE LEUKAEMIA
TRACKING LEUKAEMIC
STEM CELLS (LSCs)
ROUTINE DIAGNOSIS
GENE EXPRESSION
AND MUTATIONAL
PROFILING
DEBATE 1 – ALL
PATIENTS WITH
INTERMEDIATE-RISK
AML MUST BE
TRANSPLANTED
INTERACTIVE
CASES 1 – MUTATION-BASED
THERAPY
OFF-LABEL
ROUNDTABLE –
SHOULD WE REALLY
USE NEW TARGETED
INHIBITORS AS SINGLE
AGENTS ?
ADDITION OF A 3RD
AGENT TO FRONTLINE
7+3
ROUNDTABLE –
CURATIVE OPTIONS
FOR OLDER AML
INTERACTIVE CASES 2
DEBATE 2 - BEST
TREATMENT FOR
NPM1-MUTATED AML IN
THE NEXT FUTURE ?
ALLOGENEIC
HAEMATOPOIETIC
STEM CELL
TRANSPLANTATION
(HSCT)
IMMUNOTHERAPY FOR
ACUTE LEUKAEMIA
DEBATE 3 - T-ALL:
WHERE ARE WE GOING
NOW?
SELECTED ABSTRACTS
AND CLINICAL
CASES FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FOR A POSTER
PRESENTATION
DISCLOSURES