Contemporary Clinical Outcomes and Healthcare Utilization in Older Adults with Acute Myeloid Leukemia: Insights from a Single-Center Retrospective Cohort
- 1Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, MA 01655, USA
- 2Department of Medicine, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, MA 01655, USA
Abstract
Background: Acute myeloid leukemia (AML) predominantly affects older adults; however, patients 75 years of age and older are often not candidates for curative-intent treatments. Data on their treatment patterns, survival outcomes, and healthcare utilization are limited, and we evaluated these outcomes among patients 75 years of age and older with AML. Methods: We retrospectively analyzed 97 patients aged 75 years and older managed at our academic safety-net hospital between 2016 and 2025. Results: Median overall survival (mOS) was 95 days for all patients. Receipt of any AML-directed therapy was associated with longer mOS compared with no leukemia-directed treatment (144 days, 95% CI: 98–184 vs. 17 days, 95% CI: 7–50; p < 0.001). Among patients with 2024 ELN adverse-risk/TP53-mutated disease, mOS was 88 days (95% CI: 34-NE) with AML-directed therapy and 44 days (CI: 36-NE) without treatment (p = 0.2). Forty-four percent of patients were enrolled in a hospice at their time of death, and an additional 40% were managed with comfort measures as inpatients. Median duration of hospice or comfort care was 2 days (IQR: 1–5), with no difference based on whether patients received any AML-directed treatment. Fifty-one percent of patients died in the hospital. Conclusions: Our findings highlight real-world challenges for older adults with AML, including the need for more effective treatments for patients with TP53-mutated AML. AML-directed treatment was associated with longer survival without a decrease in the time spent in hospice care, and the risk of in-hospital mortality remains elevated for this population.
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BibTeX
@article{zhang2026contemporary,
title = {{Contemporary Clinical Outcomes and Healthcare Utilization in Older Adults with Acute Myeloid Leukemia: Insights from a Single-Center Retrospective Cohort}},
author = {Tina Y. Zhang and Alex Y. Ge and Shyam A. Patel and Poorva Bindal and Jan Cerny and Andrew Gillis-Smith and Muthalagu Ramanathan and Sakiko Suzuki and Laurie Pearson},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18193230},
url = {https://europepmc.org/article/PMC/PMC13664294},
note = {CC BY},
}
RIS
TY - JOUR
TI - Contemporary Clinical Outcomes and Healthcare Utilization in Older Adults with Acute Myeloid Leukemia: Insights from a Single-Center Retrospective Cohort
AU - Tina Y. Zhang
AU - Alex Y. Ge
AU - Shyam A. Patel
AU - Poorva Bindal
AU - Jan Cerny
AU - Andrew Gillis-Smith
AU - Muthalagu Ramanathan
AU - Sakiko Suzuki
AU - Laurie Pearson
PY - 2026
DA - 2026/10/01
JO - Cancers
DO - 10.3390/cancers18193230
UR - https://europepmc.org/article/PMC/PMC13664294
AB - Background: Acute myeloid leukemia (AML) predominantly affects older adults; however, patients 75 years of age and older are often not candidates for curative-intent treatments. Data on their treatment patterns, survival outcomes, and healthcare utilization are limited, and we evaluated these outcomes among patients 75 years of age and older with AML. Methods: We retrospectively analyzed 97 patients aged 75 years and older managed at our academic safety-net hospital between 2016 and 2025. Results: Median overall survival (mOS) was 95 days for all patients. Receipt of any AML-directed therapy was associated with longer mOS compared with no leukemia-directed treatment (144 days, 95% CI: 98–184 vs. 17 days, 95% CI: 7–50; p < 0.001). Among patients with 2024 ELN adverse-risk/TP53-mutated disease, mOS was 88 days (95% CI: 34-NE) with AML-directed therapy and 44 days (CI: 36-NE) without treatment (p = 0.2). Forty-four percent of patients were enrolled in a hospice at their time of death, and an additional 40% were managed with comfort measures as inpatients. Median duration of hospice or comfort care was 2 days (IQR: 1–5), with no difference based on whether patients received any AML-directed treatment. Fifty-one percent of patients died in the hospital. Conclusions: Our findings highlight real-world challenges for older adults with AML, including the need for more effective treatments for patients with TP53-mutated AML. AML-directed treatment was associated with longer survival without a decrease in the time spent in hospice care, and the risk of in-hospital mortality remains elevated for this population.
SN - 2072-6694
ER -