Age and sex associate with outcome in older AML and high risk MDS patients treated with 10-day decitabine

Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON), Swiss Group for Clinical Cancer Research (SAKK), Jacobien R. Hilberink, Isabelle A. van Zeventer, D. A. Chitu, Thomas Pabst, S. K. Klein, G. Stussi, L. Griskevicius, Peter J.M. Valk, Jacqueline Cloos, Arjan A. van de Loosdrecht, Dimitri Breems, Danielle van Lammeren-Venema, Rinske Boersma, M. Jongen-Lavrencic, Martin Fehr, Mels Hoogendoorn, M. G. Manz, M. SöhneRien van Marwijk Kooy, Dries Deeren, Marjolein W.M. van der Poel, Marie Cecile Legdeur, Lidwine Tick, Yves Chalandon, E. Ammatuna, Sabine Blum, Bob Löwenberg, Gert J. Ossenkoppele, D. A. Chitu, S. K. Klein, L. Griskevicius, P. J.M. Valk, J. Cloos, A. A. van de Loosdrecht, D. Breems, D. van Lammeren-Venema, R. Boersma, M. Jongen-Lavrencic, M. Söhne, R. van Marwijk Kooy, D. Deeren, M. W.M. van der Poel, M. C. Legdeur, L. Tick, E. Ammatuna, B. Löwenberg, G. J. Ossenkoppele, Gerwin Huls*, T. Pabst, Gerwin Huls*

*Corresponding author for this work

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Treatment choice according to the individual conditions remains challenging, particularly in older patients with acute myeloid leukemia (AML) and high risk myelodysplastic syndrome (MDS). The impact of performance status, comorbidities, and physical functioning on survival is not well defined for patients treated with hypomethylating agents. Here we describe the impact of performance status (14% ECOG performance status 2), comorbidity (40% HCT-comorbidity index ≥ 2), and physical functioning (41% short physical performance battery < 9 and 17% ADL index < 6) on overall survival (OS) in 115 older patients (age ≥ 66 years) treated on a clinical trial with a 10-day decitabine schedule. None of the patient-related variables showed a significant association with OS. Multivariable analysis revealed that age > 76 years was significantly associated with reduced OS (HR 1.58; p = 0.043) and female sex was associated with superior OS (HR 0.62; p = 0.06). We further compared the genetic profiles of these subgroups. This revealed comparable mutational profiles in patients younger and older than 76 years, but, interestingly, revealed significantly more prevalent mutated ASXL1, STAG2, and U2AF1 in male compared to female patients. In this cohort of older patients treated with decitabine age and sex, but not comorbidities, physical functioning or cytogenetic risk were associated with overall survival.

Original languageEnglish
Article number93
Number of pages9
JournalBlood cancer journal
Publication statusE-pub ahead of print - 19-Jun-2023

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