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Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy

Received: 29 March 2019     Accepted: 6 May 2019     Published: 4 June 2019
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Abstract

Therapy guidelines for acute leukemias (ALs) have focused on an arbitrary age cut-off as a guide for intensity of therapy. However, treatment outcomes depend on more important prognostic factors, such as performance status (PS) and the presence of comorbidities. This study aims to evaluate clinical scales as predictors of mortality in patients with acute leukemia during intensive induction therapy. This prospective cohort study included all patients diagnosed with Acute Myeloid Leukemia (AML) or Acute Lymphoblastic Leukemia (ALL) who received induction treatment at Ophir Loyola Hospital (HOL) in Belém-PA, from February 2018 to February 2019. The following scales were assessed: Eastern Cooperative Oncology Group (ECOG), Haematopoetic Cell Transplantation Comorbidity Index (HCT-CI), Cumulative Illness Rating Scale (CIRS), Charlson Comorbidity Index (CCI), Adult Comorbidity Evaluation 27 (ACE-27), Katz and Lawton scales, G8 Questionnaire and Mini Nutritional Assessment (MAN). The median age of the 40 patients included was 37 years old (range, 19-65) and sex distribution was equal. Univariate analysis showed that higher age (OR = 5.74, p 0.024), ACE 27 >0 (OR = 5.7, p 0.003) and HCT-CI >0 (OR = 3.87, p 0.02) were contributing factors to 40-day mortality, but no meaningful association was noticed with the other scales. Therefore, this study reaffirms the significant impact of comorbidities on the survival of patients with AL, suggesting that comorbidity assessment may be extremely helpful for making decisions on intensive induction therapy.

Published in International Journal of Clinical Oncology and Cancer Research (Volume 4, Issue 2)
DOI 10.11648/j.ijcocr.20190402.11
Page(s) 5-9
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Acute Leukemia, Induction Chemotherapy, Outcomes, Comorbidity

References
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[3] Righes CS, Garcia DVO, Silva PC, Almeida EB, Pellegrin JC. Epidemiological, hematological and imunophenotypic evaluation of adult patients with acute leukemia diagnosed at the Regional Hospital of Mato Grosso do Sul, Brazil. RBAC. 2017; 49 (3): 249-55.
[4] Sorror ML, Storer BE, Fathi AT, et al. Development And Validation Of A Novel Acute Myeloid Leukemia–Composite Model To Estimate Risks Of Mortality. JAMA Oncol. 2017; 1-8.
[5] Middeke JM, Herbst R, Parmentier S, et al. Long-Term Follow-Up and Impact of Comorbidity before Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Relapsed or Refractory Acute Myeloid Leukemia—Lessons Learned from the Prospective BRIDGE Trial. Biol Blood Marrow Transplant. 2017; 23: 1491–1497.
[6] Budziszewska BK, Pluta A, Sulek K, et al. Treatment of elderly patients with acute myeloid leukemia adjusted for performance status and presence of comorbidities: a Polish Adult Leukemia Group study. Leuk & Lymphoma. 2015; 1–8.
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Cite This Article
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    Camila Dias Pastana, Dafne Rosa Benzecry, Josy Marinho de Lima, Marcos Laércio Pontes Reis, Thiago Xavier Carneiro. (2019). Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy. International Journal of Clinical Oncology and Cancer Research, 4(2), 5-9. https://doi.org/10.11648/j.ijcocr.20190402.11

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    ACS Style

    Camila Dias Pastana; Dafne Rosa Benzecry; Josy Marinho de Lima; Marcos Laércio Pontes Reis; Thiago Xavier Carneiro. Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy. Int. J. Clin. Oncol. Cancer Res. 2019, 4(2), 5-9. doi: 10.11648/j.ijcocr.20190402.11

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    AMA Style

    Camila Dias Pastana, Dafne Rosa Benzecry, Josy Marinho de Lima, Marcos Laércio Pontes Reis, Thiago Xavier Carneiro. Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy. Int J Clin Oncol Cancer Res. 2019;4(2):5-9. doi: 10.11648/j.ijcocr.20190402.11

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  • @article{10.11648/j.ijcocr.20190402.11,
      author = {Camila Dias Pastana and Dafne Rosa Benzecry and Josy Marinho de Lima and Marcos Laércio Pontes Reis and Thiago Xavier Carneiro},
      title = {Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy},
      journal = {International Journal of Clinical Oncology and Cancer Research},
      volume = {4},
      number = {2},
      pages = {5-9},
      doi = {10.11648/j.ijcocr.20190402.11},
      url = {https://doi.org/10.11648/j.ijcocr.20190402.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20190402.11},
      abstract = {Therapy guidelines for acute leukemias (ALs) have focused on an arbitrary age cut-off as a guide for intensity of therapy. However, treatment outcomes depend on more important prognostic factors, such as performance status (PS) and the presence of comorbidities. This study aims to evaluate clinical scales as predictors of mortality in patients with acute leukemia during intensive induction therapy. This prospective cohort study included all patients diagnosed with Acute Myeloid Leukemia (AML) or Acute Lymphoblastic Leukemia (ALL) who received induction treatment at Ophir Loyola Hospital (HOL) in Belém-PA, from February 2018 to February 2019. The following scales were assessed: Eastern Cooperative Oncology Group (ECOG), Haematopoetic Cell Transplantation Comorbidity Index (HCT-CI), Cumulative Illness Rating Scale (CIRS), Charlson Comorbidity Index (CCI), Adult Comorbidity Evaluation 27 (ACE-27), Katz and Lawton scales, G8 Questionnaire and Mini Nutritional Assessment (MAN). The median age of the 40 patients included was 37 years old (range, 19-65) and sex distribution was equal. Univariate analysis showed that higher age (OR = 5.74, p 0.024), ACE 27 >0 (OR = 5.7, p 0.003) and HCT-CI >0 (OR = 3.87, p 0.02) were contributing factors to 40-day mortality, but no meaningful association was noticed with the other scales. Therefore, this study reaffirms the significant impact of comorbidities on the survival of patients with AL, suggesting that comorbidity assessment may be extremely helpful for making decisions on intensive induction therapy.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy
    AU  - Camila Dias Pastana
    AU  - Dafne Rosa Benzecry
    AU  - Josy Marinho de Lima
    AU  - Marcos Laércio Pontes Reis
    AU  - Thiago Xavier Carneiro
    Y1  - 2019/06/04
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ijcocr.20190402.11
    DO  - 10.11648/j.ijcocr.20190402.11
    T2  - International Journal of Clinical Oncology and Cancer Research
    JF  - International Journal of Clinical Oncology and Cancer Research
    JO  - International Journal of Clinical Oncology and Cancer Research
    SP  - 5
    EP  - 9
    PB  - Science Publishing Group
    SN  - 2578-9511
    UR  - https://doi.org/10.11648/j.ijcocr.20190402.11
    AB  - Therapy guidelines for acute leukemias (ALs) have focused on an arbitrary age cut-off as a guide for intensity of therapy. However, treatment outcomes depend on more important prognostic factors, such as performance status (PS) and the presence of comorbidities. This study aims to evaluate clinical scales as predictors of mortality in patients with acute leukemia during intensive induction therapy. This prospective cohort study included all patients diagnosed with Acute Myeloid Leukemia (AML) or Acute Lymphoblastic Leukemia (ALL) who received induction treatment at Ophir Loyola Hospital (HOL) in Belém-PA, from February 2018 to February 2019. The following scales were assessed: Eastern Cooperative Oncology Group (ECOG), Haematopoetic Cell Transplantation Comorbidity Index (HCT-CI), Cumulative Illness Rating Scale (CIRS), Charlson Comorbidity Index (CCI), Adult Comorbidity Evaluation 27 (ACE-27), Katz and Lawton scales, G8 Questionnaire and Mini Nutritional Assessment (MAN). The median age of the 40 patients included was 37 years old (range, 19-65) and sex distribution was equal. Univariate analysis showed that higher age (OR = 5.74, p 0.024), ACE 27 >0 (OR = 5.7, p 0.003) and HCT-CI >0 (OR = 3.87, p 0.02) were contributing factors to 40-day mortality, but no meaningful association was noticed with the other scales. Therefore, this study reaffirms the significant impact of comorbidities on the survival of patients with AL, suggesting that comorbidity assessment may be extremely helpful for making decisions on intensive induction therapy.
    VL  - 4
    IS  - 2
    ER  - 

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Author Information
  • Faculty of Medicine, University of State of Pará, Belém, Brazil

  • Faculty of Medicine, University of State of Pará, Belém, Brazil

  • Department of Oncology and Hematology, University of State of Pará, Belém, Brazil

  • Department of Oncology and Hematology, University of State of Pará, Belém, Brazil

  • Department of Oncology and Hematology, University of State of Pará, Belém, Brazil

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