An 8-year pragmatic observation evaluation of the benefits of allogeneic HCT in older and medically infirm patients with AML

医学 生活质量(医疗保健) 共病 移植 内科学 萧条(经济学) 随机对照试验 队列 老年学 宏观经济学 护理部 经济
作者
Mohamed L. Sorror,Ted Gooley,Barry E. Storer,Aaron T. Gerds,Mikkael A. Sekeres,Bruno C. Medeiros,Eunice S. Wang,Paul J. Shami,Kehinde Adekola,Selina M. Luger,Maria R. Baer,David A. Rizzieri,Tanya M. Wildes,Jamie Koprivnikar,Julie Smith,Mitchell Garrison,Kiarash Kojouri,Tammy A. Schuler,Wendy Leisenring,Lynn Onstad,Pamela S. Becker,Stephanie J. Lee,Brenda M. Sandmaier,Frederick R. Appelbaum,Elihu H. Estey
出处
期刊:Blood [Elsevier BV]
卷期号:141 (3): 295-308 被引量:4
标识
DOI:10.1182/blood.2022016916
摘要

Abstract We designed a prospective, observational study enrolling patients presenting for treatment of acute myeloid leukemia (AML) at 13 institutions to analyze associations between hematopoietic cell transplantation (HCT) and survival, quality of life (QOL), and function in: the entire cohort, those aged ≥65 years, those with high comorbidity burden, intermediate cytogenetic risk, adverse cytogenetic risk, and first complete remission with or without measurable residual disease. Patient were assessed 8 times over 2 years. Time-dependent regression models were used. Among 692 patients that were evaluable, 46% received HCT with a 2-year survival of 58%. In unadjusted models, HCT was associated with reduced risks of mortality most of the subgroups. However, after accounting for covariates associated with increased mortality (age, comorbidity burden, disease risks, frailty, impaired QOL, depression, and impaired function), the associations between HCT and longer survival disappeared in most subgroups. Although function, social life, performance status, and depressive symptoms were better for those selected for HCT, these health advantages were lost after receiving HCT. Recipients and nonrecipients of HCT similarly ranked and expected cure as main goal of therapy, whereas physicians had greater expectations for cure than the former. Accounting for health impairments negates survival benefits from HCT for AML, suggesting that the unadjusted observed benefit is mostly owing to selection of the healthier candidates. Considering patients’ overall expectations of cure but also the QOL burdens of HCT motivate the need for randomized trials to identify the best candidates for HCT. This trial was registered at www.clinicaltrials.gov as #NCT01929408.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
2秒前
俊逸十八完成签到 ,获得积分10
2秒前
39hpl发布了新的文献求助10
3秒前
3秒前
lumos完成签到,获得积分20
3秒前
7秒前
Akim应助兴奋的果汁采纳,获得10
8秒前
淡然冬灵发布了新的文献求助10
8秒前
9秒前
科研通AI5应助yang采纳,获得10
10秒前
11秒前
11秒前
12秒前
jjjuq发布了新的文献求助10
12秒前
lihao关注了科研通微信公众号
13秒前
哈哈哈完成签到,获得积分20
14秒前
科研通AI5应助西门子云采纳,获得10
14秒前
科研通AI2S应助39hpl采纳,获得10
14秒前
14秒前
15秒前
晓晓雪发布了新的文献求助10
15秒前
mang_er发布了新的文献求助20
15秒前
lumos发布了新的文献求助10
15秒前
栩墨发布了新的文献求助10
18秒前
EasonYan发布了新的文献求助10
19秒前
Lucas应助山云采纳,获得10
20秒前
你阿姐完成签到,获得积分10
23秒前
24秒前
焦糖完成签到 ,获得积分10
24秒前
11111完成签到,获得积分10
25秒前
小乐儿~完成签到,获得积分10
27秒前
Daisykiller应助怕黑半仙采纳,获得20
28秒前
宋嘉新发布了新的文献求助10
29秒前
30秒前
肖sir666完成签到,获得积分10
30秒前
31秒前
32秒前
33秒前
33秒前
高分求助中
Production Logging: Theoretical and Interpretive Elements 2700
Ophthalmic Equipment Market 1500
Neuromuscular and Electrodiagnostic Medicine Board Review 1000
こんなに痛いのにどうして「なんでもない」と医者にいわれてしまうのでしょうか 510
いちばんやさしい生化学 500
Genre and Graduate-Level Research Writing 500
The First Nuclear Era: The Life and Times of a Technological Fixer 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 物理 生物化学 纳米技术 计算机科学 化学工程 内科学 复合材料 物理化学 电极 遗传学 量子力学 基因 冶金 催化作用
热门帖子
关注 科研通微信公众号,转发送积分 3673054
求助须知:如何正确求助?哪些是违规求助? 3229031
关于积分的说明 9783312
捐赠科研通 2939378
什么是DOI,文献DOI怎么找? 1611028
邀请新用户注册赠送积分活动 760771
科研通“疑难数据库(出版商)”最低求助积分说明 736242