Patterns Of Healthcare Resource Utilization (Hru) In Unfit Patients With Acute Myeloid Leukemia (Aml) Receiving First-Line Systemic Treatment Or Best Supportive Care (Bsc): A Multicenter International Study (Current)

Until recently, treatment options for patients with AML unfit for intensive chemotherapy included hypomethylating agents (HMA), low-dose cytarabine (LDAC), and BSC. Primary analysis of CURRENT demonstrated clinical outcomes remain poor for patients (Kondo. ASH 2020). This analysis evaluates HRU burden with first-line treatment in CURRENT among unfit patients with AML. This retrospective chart review included unfit patients with primary/secondary AML who received HMA, LDAC, Other systemic therapies, or BSC. Unconfirmed AML, acute promyelocytic leukemia, or clinical trial patients were excluded. HRU endpoints, including hospitalizations, outpatient consultations, transfusions, and medications, were analyzed descriptively. The final data cutoff (31Mar2020) included 1762 patients (57% male; median age 75 years; 35% JAPAC, 27% WEC, 25% EEMEA, 13% LATAM): 809 HMA, 199 LDAC, 302 Other, and 452 BSC. Median (min−max) treatment durations were 118 (0−1450), 35 (1−1132), 33 (1−1124), and 57 (0−1680) days, respectively. Of those who received HMA/LDAC/Other, 18% received second-line systemic therapy. Hospitalizations were frequent (HMA 82%, LDAC 93%, Other 83%, BSC 83%): Median (min–max) number of hospitalizations was 6 (1−50), 5 (1−26), 4 (1−15), and 2 (1−21), respectively, with a median (min−max) of 8 (1−546), 16 (1−696), 18 (0−933), and 8 (1−157) days hospitalized, most commonly for treatment administration (HMA/Other 61%, LDAC 72%) and infection (BSC 49%). HMA had the most outpatient consultations (HMA 79%, LDAC 53%, Other 63%, BSC 66%; median 13, 6, 11, 6 visits, respectively), and transfusions (HMA 80%, LDAC 57%, Other 57%, BSC 71%); median RBC and platelet events ranged from 7−13 and 2−11, respectively. Antibiotics/antivirals were used more often than antifungals and growth factors (72–92%, 34–63%, 7–28%, respectively). Antibiotics/antivirals and growth factors were generally used responsively; antifungals were mainly used prophylactically. Unfit patients with AML require substantial HRU; novel therapies are needed to alleviate this burden and improve outcomes.