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Pre-Treatment Risk Assessment for Elderly Patients with Acute Myeloid Leukemia

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dc.contributor.authorArévalo Zambrano, Mónica
dc.contributor.authorAbello Polo, Virginia
dc.contributor.authorOmaña Orduz, Olga Paola
dc.contributor.authorVillamizar Gómez, Liceth
dc.date.accessioned2021-08-24T14:53:43Z
dc.date.available2021-08-24T14:53:43Z
dc.date.issued2018-09
dc.description.abstractThe treatment of AML in older adults is limited by the high mortality related with induction chemotherapy; however, those who tolerate an intensive treatment will have better outcomes; therefore, selecting this group of patients through the use of functionality scales is a fundamental part of the initial therapeutic approach. Risk assessment scales have been designed and validated by other authors; in our country they have not been routinely used until now. Objective: To describe 8-week treatment related and 1- year mortality in AML patients, older than 60 years, after selecting treatment based on functionality risk scores (FRS), at two hospitals in Bogotá. Design: An observational study was performed, analyzing early mortality in two cohorts; a retrospective, including patients treated from 2010-2015 and a prospective one, from 2015 to 2018, in which the treatment was selected according FRS (SPPB, CCI and MD Anderson Predictive Score). Setting: Patients were treated in two university hospitals in Bogotá, Colombia. Patients: AML patients older than 60 years; acute promyelocytic leukemia patients were excluded. Interventions: FRS were assessed at diagnosis, high risk patients received supportive care, intermediate risk received 5-Azacitidine or low dose ARA-C, low risk patient wereconsidered eligible for standard induction chemotherapy (7+3). Main Outcomes Measures: We evaluated 8-week mortality as predicted by a combination of 3 different scales and compared it with a control retrospective cohort. Results: Sixty patients were included, median age 72 years (range: 62 - 84), 78% had intermediate cytogenetic risk and 20% high risk. 35% had a history of another hematological neoplasm. Only 38.3% received high intensity chemotherapy. Survival at 8 weeks was 70% without differences between treatment groups. One-year mortality was high, 73.9% of patients treated with 7x3 died, 80% in the low intensity group and 85.7% in the best support treatment. The ICC scale was predictive of 1-year mortality, but not the MD Anderson scale. Conclusions: In this high-risk group, 7+3 was well tolerated when patients were selected using FRS. The CCI scale was predictive of one-year mortality and could be used to optimize the selection of elderly patients with AML.eng
dc.format.extent2 p.spa
dc.format.mimetypeapplication/pdfspa
dc.identifier.urihttps://repositorio.fucsalud.edu.co/handle/001/1729
dc.language.isoengspa
dc.publisherElsevierspa
dc.publisher.placeEstados Unidosspa
dc.relation.citationendpageS206spa
dc.relation.citationissue1spa
dc.relation.citationstartpageS205spa
dc.relation.citationvolume18spa
dc.relation.citesClinical lymphoma, myeloma and leukemia ISSN:2152-2650 Vol.18 Núm.1 (2018)
dc.relation.ispartofjournalClinical lymphoma, myeloma and leukemiaspa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.coarhttp://purl.org/coar/access_right/c_abf2spa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nd/4.0/spa
dc.sourcehttps://ur.booksc.eu/book/72643886/222f84spa
dc.subject.decsTrasplante de médula osea
dc.subject.decsAzacitidina
dc.subject.decsSíndromes mielodisplásicos
dc.subject.decsLeucemia mieloide aguda
dc.subject.proposalAcute myeloid leukemiaeng
dc.subject.proposalMyelodysplastic syndromeeng
dc.subject.proposalAzacitidineeng
dc.subject.proposalBone marrow transplantationeng
dc.titlePre-Treatment Risk Assessment for Elderly Patients with Acute Myeloid Leukemiaeng
dc.typeArtículo de revistaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.coarversionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.redcolhttps://purl.org/redcol/resource_type/WPspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa
dspace.entity.typePublication

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