J Hematol

Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc

Journal website https://www.thejh.org

Original Article

Volume 12, Number 1, February 2023, pages 7-15

Survival in Elderly Patients Diagnosed With Acute Myeloid Leukemia: A Hospital-Based Study

Figure 1. Flowchart of patient selection in the study. ICD-10: the International Classification of Diseases, 10th Revision; AML: acute myeloid leukemia; AML-MR: acute myeloid leukemia myelodysplasia-related.

**Table 1.** Demographic and Clinical Characteristics of Patients Included in the Study (N = 53)
Characteristic	Type of leukemia	P value
AML-MR: acute myeloid leukemia myelodysplasia-related; ECOG: Eastern Cooperative Oncology Group; IQR: interquartile range.
Median age at diagnosis (IQR) (years)	70 (66 - 77)	73 (68 - 78)	0.270
Female sex	16 (51.6%)	10 (45.5%)	0.659
Extramedullary involvement	5 (16.1%)	1 (4.5%)	0.195
Median white blood count (IQR) (/µL)	12,010 (2,100 - 45,530)	3,995 (1,070 - 12,490)	0.080
ECOG performance status
1	20 (64.5%)	12 (54.5%)	0.070
2	1 (3.2%)	6 (27.3%)
3	6 (19.4%)	3 (13.6%)
4	4 (12.9%)	1 (4.5%)
Charlson comorbidity index (CCI)
4	8 (25.8%)	3 (13.6%)	0.282
≥ 5	23 (74.2%)	19 (86.4%)
Drug therapy
Intensive chemotherapy	17 (54.8%)	3 (13.6%)	0.001
Less-intensive chemotherapy	9 (29.0%)	17 (77.3%)
No chemotherapy	5 (16.1%)	2 (9.1%)
Support treatments
Erythropoietin	1 (3.2%)	8 (36.4%)	0.002
Blood component transfusion	16 (51.6%)	18 (81.8%)	0.024
Palliative care	17 (54.8%)	11 (50.0%)	0.728
ICU management	25 (80.6%)	17 (77.3%)	0.513
Median survival (IQR) (days)	222 (28 - 659)	200 (54 - 360)	0.801

Table 1. Demographic and Clinical Characteristics of Patients Included in the Study (N = 53)

Characteristic

Type of leukemia

P value

De novo, n (%) (n = 31)

AML-MR, n (%) (n = 22)

AML-MR: acute myeloid leukemia myelodysplasia-related; ECOG: Eastern Cooperative Oncology Group; IQR: interquartile range.

Median age at diagnosis (IQR) (years)

70 (66 - 77)

73 (68 - 78)

0.270

Female sex

16 (51.6%)

10 (45.5%)

0.659

Extramedullary involvement

5 (16.1%)

1 (4.5%)

0.195

Median white blood count (IQR) (/µL)

12,010 (2,100 - 45,530)

3,995 (1,070 - 12,490)

0.080

ECOG performance status

20 (64.5%)

12 (54.5%)

0.070

1 (3.2%)

6 (27.3%)

6 (19.4%)

3 (13.6%)

4 (12.9%)

1 (4.5%)

Charlson comorbidity index (CCI)

8 (25.8%)

3 (13.6%)

0.282

≥ 5

23 (74.2%)

19 (86.4%)

Drug therapy

Intensive chemotherapy

17 (54.8%)

3 (13.6%)

0.001

Less-intensive chemotherapy

9 (29.0%)

17 (77.3%)

No chemotherapy

5 (16.1%)

2 (9.1%)

Support treatments

Erythropoietin

1 (3.2%)

8 (36.4%)

0.002

Blood component transfusion

16 (51.6%)

18 (81.8%)

0.024

Palliative care

17 (54.8%)

11 (50.0%)

0.728

ICU management

25 (80.6%)

17 (77.3%)

0.513

Median survival (IQR) (days)

222 (28 - 659)

200 (54 - 360)

0.801

**Table 2.** Factors Related to the Chemotherapy Scheme
Characteristic	Chemotherapy scheme	OR (95% CI)	P value
^aData available (n = 27). ECOG: Eastern Cooperative Oncology; IQR: interquartile range; CI: confidence interval.
Type of leukemia
De novo	17 (85%)	9 (34.6%)	1	< 0.001
Myelodysplasia-related	3 (15%)	17 (65.4%)	0.9 (0.014 - 0.47)
ECOG performance status
1	19 (95%)	12 (46.2%)	1	< 0.001
≥ 2	1 (5%)	14 (53.8%)	0.05 (0.001 - 0.39)
Charlson comorbidity index (CCI)
4	10 (50%)	1 (3.8%)	1	< 0.001
≥ 5	10 (50%)	25 (96.2%)	0.04 (0.0008 - 0.36)
Minimum residual disease (MRD)^a				0.276
Detected	8 (57.1%)	10 (76.9%)	0.4 (0.05 - 2.7)
Not detected	6 (42.9%)	3 (23.1%)	1
Salvage chemotherapy				0.086
Yes	12 (60%)	9 (34.6%)	2.8 (0.72 - 11.23)
No	8 (40%)	17 (65.4%)	1

Table 2. Factors Related to the Chemotherapy Scheme

Characteristic

Chemotherapy scheme

OR (95% CI)

P value

Intensive, n (%), (n = 20)

Less-intensive, n (%), (n = 26)

^aData available (n = 27). ECOG: Eastern Cooperative Oncology; IQR: interquartile range; CI: confidence interval.

Type of leukemia

De novo

17 (85%)

9 (34.6%)

< 0.001

Myelodysplasia-related

3 (15%)

17 (65.4%)

0.9 (0.014 - 0.47)

ECOG performance status

19 (95%)

12 (46.2%)

< 0.001

≥ 2

1 (5%)

14 (53.8%)

0.05 (0.001 - 0.39)

Charlson comorbidity index (CCI)

10 (50%)

1 (3.8%)

< 0.001

≥ 5

10 (50%)

25 (96.2%)

0.04 (0.0008 - 0.36)

Minimum residual disease (MRD)^a

0.276

Detected

8 (57.1%)

10 (76.9%)

0.4 (0.05 - 2.7)

Not detected

6 (42.9%)

3 (23.1%)

Salvage chemotherapy

0.086

Yes

12 (60%)

9 (34.6%)

2.8 (0.72 - 11.23)

8 (40%)

17 (65.4%)

**Table 3.** Overall Survival by Chemotherapy Scheme
	Chemotherapy (n = 46)	No chemotherapy (n = 7)	P value
^aAdjusted by ECOG performance status, Charlson comorbidity index (CCI), and type of diagnosis. IQR: interquartile range; ECOG: Eastern Cooperative Oncology.
Median overall survival (IQR), days^a	266.5 (137.5 - 565.5)	223.5 (54 - 477)	0.658	28 (2 - 36)	0.001
Probability of survival, %^a
30 days	78.6	75.4	0.938	< 1	0.006
First year	25.0	38.6		-
Second year	8.6	32.4		-
Third year	-	24.2		-

Table 3. Overall Survival by Chemotherapy Scheme

Chemotherapy (n = 46)

No chemotherapy (n = 7)

P value

Intensive

Less-intensive

P value

^aAdjusted by ECOG performance status, Charlson comorbidity index (CCI), and type of diagnosis. IQR: interquartile range; ECOG: Eastern Cooperative Oncology.

Median overall survival (IQR), days^a

266.5 (137.5 - 565.5)

223.5 (54 - 477)

0.658

28 (2 - 36)

0.001

Probability of survival, %^a

30 days

78.6

75.4

0.938

< 1

0.006

First year

25.0

38.6

Second year

8.6

32.4

Third year

24.2