Managing Acute Myeloid Leukemia in Older Patients: Are We Making Progress? An Analysis of Treatment Patterns and Healthcare Resource Utilization

BACKGROUND: Despite advances in the understanding of disease pathogenesis, improved treatment strategies, and evidence of better survival with treatment, a large proportion of older patients (pts) with acute myeloid leukemia (AML) remains untreated and has poor outcomes. The aim of this study is to describe current treatment patterns in pts with AML aged METHODS: AML pts were retrospectively identified in the MarketScan® Research Database (Truven Health) including both Commercial and Medicare Supplemental claims databases between 01/2011 to 07/2016. Pts with ≥2 AML diagnoses, ≥1 bone marrow procedure (the first AML diagnosis following the procedure was defined as the index date), and ≥12 months of continuous eligibility (baseline period) prior to the index date were included. Exclusion criteria were ≥1 diagnosis for AML relapse or remission on or before the bone marrow procedure, ≥2 diagnoses for another blood cancer, and ≥1 allogeneic hematopoietic stem cell transplantation before the bone marrow diagnosis procedure. Furthermore, pts aged ≥65 yrs at the index date were excluded if they had ≥1 claim for intensive chemotherapy at any time. The observation period spanned from index date up to the first of health plan disenrollment or the end of data availability. To accommodate different age cut-offs in accordance with National Comprehensive Cancer Network treatment guidelines, top treatments (excluding hormonal therapy agents) received post-AML diagnosis were reported in pts aged RESULTS: After applying the selection criteria, 2,954 AML pts were identified: 1,492 pts ≥65 yrs old (mean [SD] age: 76.8 [7.0]; 36.6% were ≥80 yrs old; mean [SD] follow-up: 212 [255] days) and 1,462 pts CONCLUSION: This study revealed that >40% of older AML pts (≥65 yrs) did not receive any antineoplastic therapy. This group also had fewer inpatient days compared to younger AML pts ( Disclosures Lafeuille: Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Ltd: Research Funding; Janssen Scientific Affairs, LLC: Research Funding. Sundaram: Johnson & Johnson, LLC: Equity Ownership; Janssen: Employment. Hoehn: Janssen: Employment; Johnson & Johnson, LLC: Equity Ownership. Emond: Janssen Scientific Affairs, LLC: Research Funding. Romdhani: Janssen Scientific Affairs, LLC: Research Funding. Lefebvre: Janssen Scientific Affairs, LLC: Research Funding.