Real-world prescribing patterns in acute myeloid leukemia in the United States.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18524-e18524 ◽  
Author(s):  
Bruno C. Medeiros ◽  
Bhavik J. Pandya ◽  
Anna Hadfield ◽  
Samuel Wilson ◽  
Cynthia Mueller ◽  
...  

e18524 Background: The effective treatment of patients with acute myeloid leukemia (AML) remains a challenge in clinical practice. This analysis describes the patient characteristics and real-world use of AML treatments in the United States for patients on high- and low-intensity treatment. Methods: Data from the Adelphi AML Disease-Specific Programme, a real-world, cross-sectional survey conducted between February–May 2015, were analysed. A total of 61 hematologist/hem-oncologists, across academic, non-academic and office-based practice locations, provided data on 457 AML patients. Patient characteristics were derived from physician-completed patient record forms where each physician was asked to provide treatment details, including the treatment intensity, for each line of therapy. Results: A total of 91% (n = 415) of patients included in this analysis were previously untreated for AML. Patients had a mean age of 60 years and been diagnosed with AML for a median of 5.0 months. At first-line induction therapy, over half (53%; n = 241) of the patients were initiated on a high-intensity treatment, the most common regimen being cytarabine plus anthracycline (61%; n = 147). The remaining 47% (n = 216) of patients received a low-intensity induction therapy such as low dose cytarabine monotherapy (28%, n = 61), azacitidine monotherapy (25%, n = 54), or decitabine monotherapy (21%, n = 45). Over half (55%, n = 62) of patients suited to high intensity treatment went on to receive cytarabine monotherapy during the consolidation phase of their first-line treatment. Conclusions: According to treating physicians, the large majority of patients receive traditional, well-established therapies at first-line induction for AML. Whilst cytarabine combinations dominate the high-intensity treatment setting, the hypomethylating agents, azacitidine and decitabine, are frequently used for those more suited to low-intensity treatment.

2019 ◽  
Vol 35 (5) ◽  
pp. 927-935 ◽  
Author(s):  
Bruno C. Medeiros ◽  
Bhavik J. Pandya ◽  
Anna Hadfield ◽  
James Pike ◽  
Samuel Wilson ◽  
...  

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 773 ◽  
Author(s):  
Sarah Bertoli ◽  
Pierre-Yves Dumas ◽  
Emilie Bérard ◽  
Laetitia Largeaud ◽  
Audrey Bidet ◽  
...  

A recent phase 3 trial showed that the outcome of patients with relapsed/refractory (R/R) FLT3-mutated acute myeloid leukemia (AML) improved with gilteritinib, a single-agent second-generation FLT3 tyrosine kinase inhibitor (TKI), compared with standard of care. In this trial, the response rate with standard therapy was particularly low. We retrospectively assessed the characteristics and outcome of patients with R/R FLT3-mutated AML included in the Toulouse–Bordeaux DATAML registry. Among 347 patients who received FLT3 TKI-free intensive chemotherapy as first-line treatment, 174 patients were refractory (n = 48, 27.6%) or relapsed (n = 126, 72.4%). Salvage treatments consisted of intensive chemotherapy (n = 99, 56.9%), azacitidine or low-dose cytarabine (n = 9, 5.1%), other low-intensity treatments (n = 17, 9.8%), immediate allogeneic stem cell transplantation (n = 4, 2.3%) or best supportive care only (n = 45, 25.9%). Among the 114 patients who previously received FLT3 TKI-free intensive chemotherapy as first-line treatment (refractory, n = 32, 28.1%; relapsed, n = 82, 71.9%), the rate of CR (complete remission) or CRi (complete remission with incomplete hematologic recovery) after high- or low-intensity salvage treatment was 50.0%, with a bridge to transplant in 34.2% (n = 39) of cases. The median overall survival (OS) was 8.2 months (interquartile range, 3.0–32); 1-, 3- and 5-year OS rates were 36.0% (95%CI: 27–45), 24.7% (95%CI: 1–33) and 19.7% (95%CI: 1–28), respectively. In this real-word study, although response rate appeared higher than the controlled arm of the ADMIRAL trial, the outcome of patients with R/R FLT3-mutated AML remains very poor with standard salvage therapy.


2018 ◽  
Vol 71 ◽  
pp. 27-33 ◽  
Author(s):  
Jill A. Bell ◽  
Aaron Galaznik ◽  
Eileen Farrelly ◽  
Marlo Blazer ◽  
Sharanya Murty ◽  
...  

2018 ◽  
Vol 2 (11) ◽  
pp. 1277-1282 ◽  
Author(s):  
Vijaya Raj Bhatt ◽  
Valerie Shostrom ◽  
Krishna Gundabolu ◽  
James O. Armitage

Key Points An analysis of 61 775 adults with AML diagnosed between 2003 and 2011 demonstrated that 25% did not receive any chemotherapy. Factors such as facility type, patients’ race, income, and insurance status were associated with the rates of use of chemotherapy.


2015 ◽  
Vol 94 (7) ◽  
pp. 1127-1138 ◽  
Author(s):  
Bruno C. Medeiros ◽  
Sacha Satram-Hoang ◽  
Deborah Hurst ◽  
Khang Q. Hoang ◽  
Faiyaz Momin ◽  
...  

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1691-1691
Author(s):  
Binay K. Shah ◽  
Amir Bista ◽  
Bahman Shafii

Abstract Background There is scarcity of data on differences in survival in acute myeloid leukemia (AML) patients by ethnicity. We utilized data from the Surveillance Epidemiology and End Result (SEER) database to investigate the ethnic disparities of survival in general U.S. population. Methods The SEER-18 Registry was used to identify adult (>=18) patients with AML as the only or the first primary cancer diagnosed from 1992 to 2010. We only included cases which were microscopically confirmed and actively followed. Cases that were alive without survival time, those resulted in death certificate/autopsy, and those with ethnicity recorded as unknown were excluded from this study. A total of 29,477 patients (54.5% males) were identified. For the subsequent analyses, various cohorts were formed. Age group cohorts included: 18-44 (5394; 18.3%), 45-54 (3751; 12.7%), 55-64 (4913; 16.7%), 65-74 (6513; 22.1%) and 75+ (8906; 30.2%). The total study period was divided into four groups, 1992-1995 (3409; 11.6%), 1996-2000 (5816; 19.7%), 2001-2005 (9984; 33.9%) and 2006-2010 (10268; 34.8%) for the survival analyses over time. Ethnic stratification used included White (21338; 72.4%), African American (AA: 2322; 7.9%), Asians/Pacific Islanders (A/PI: 2389; 8.1%), Native American/Alaskan Natives (NA/AN: 137; 0.5%) and Hispanics (3291; 11.2%). NA/AN categories were excluded from the final analysis due to their small numbers. Kaplan Meier (KM) curve and log rank test were used to evaluate association between patient characteristics and survival in overall population, OS, and AML-specific survival(AMLSS). Cox proportional hazards model was used for the analysis of association between patient characteristics and survival. Statistical analyses were carried out using SPSS version 16.0.0 Results Median age at diagnosis for the patient population was 66 years. Median follow-up period was 6.17 years for the whole population. Median OS for whole population was 6 months with highest survival among Hispanics and lowest among Whites (10 months versus 5 months, p <0.001). The AMLSS was highest for Hispanics and lowest for Whites (24 months versus 12 months, p <0.001). Median OS and AMLSS deteriorated significantly with advancing age (p<0.001). The median OS and AMLSS were the same for males and females (p>0.05), in overall population. OS for females were better than males among AA and Hispanic patients (p value <0.001). AMLS survival was better for A/PI females compared to males (median AMLSS 22 months vs. 17 months, p =0.015). When comparing survival among year of diagnosis cohorts, OS as well as AMLSS were comparable among 1992-1995 and 1996-2000 cohorts, (p>0.05); however, there was a gradual improvement in the more recent time period cohorts. Results of the proportional hazard models indicated that when compared to Whites, the OS was best for A/PI and worst for AA patients (HR= 0.933, p= 0.006, and HR = 1.139, p <0.001 ,respectively). The OS was higher for females, younger patients, and for patients diagnosed during recent time period cohorts. Similarly, AMLS survival among Hispanics and AA was comparable to whites and, best for Asians/PI (HR 0.911, p =0.003). Conclusions This study demonstrated significant differences in survival rates among AML patients belonging to various ethnic groups with highest OS and AMLSS among A/PI AML patients. Disclosures: No relevant conflicts of interest to declare.


2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e18516-e18516
Author(s):  
Peter G Kim ◽  
Tao Zou ◽  
Andrew Mark Brunner ◽  
Ashley M. Perry ◽  
Kristin L McGregor ◽  
...  

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