The burden of treatment in elderly AML-patients lives
Authors
Nielsen, Henriette Tranberg ; Sørensen, Mie Nybo
Term
5. Term (Master thesis)
Education
Publication year
2021
Abstract
Denne retrospektive enkeltcenterundersøgelse fra Aalborg Universitetshospital undersøgte behandlingsbyrden i de sidste 180 dage af livet hos ældre patienter (≥70 år) med akut myeloid leukæmi (AML), diagnosticeret i perioden 2010–2020 og efterfølgende afdøde. Formålet var at sammenligne antal indlæggelsesdage, ambulante besøg og transfusioner efter førstelinjebehandling (intensiv kemoterapi, ikke-intensiv behandling med low-dose cytarabin (L-DAC) eller azacitidin samt palliativ behandling) og at indhente oplysninger om palliativ indsats og hospice, hvilket dog ikke var muligt pga. manglende adgang til journaler. Data blev udtrukket fra regionens administrative systemer og grupperet i REDCap; indlæggelser og ambulante besøg blev opgjort, mens transfusionsdata viste sig ufuldstændige. Der blev ikke gennemført statistiske analyser pga. utilstrækkelig datakvalitet. I alt indgik 107 patienter. Patienter med intensiv behandling havde median 30 indlæggelsesdage og 4 ambulante besøg; L-DAC-gruppen havde 21 indlæggelsesdage og 8 ambulante besøg; azacitidin-gruppen havde 18 indlæggelsesdage og 16 ambulante besøg. På trods af numeriske forskelle kunne der ikke drages sikre konklusioner, og der er behov for bedre, systematisk registrerede data for at belyse behandlingsbyrden og palliativ indsats hos denne patientgruppe.
This retrospective single-center study from Aalborg University Hospital examined the treatment burden in the last 180 days of life among older patients (≥70 years) with acute myeloid leukemia (AML) diagnosed between 2010 and 2020 who subsequently died. The aim was to compare days of hospitalization, outpatient visits, and transfusions by first-line therapy (intensive chemotherapy, non-intensive low-dose cytarabine (L-DAC) or azacitidine, and palliative treatment) and to obtain information on hospice and palliative care, which was not possible due to lack of chart access. Data were extracted from regional administrative systems and organized in REDCap; hospitalizations and outpatient visits were enumerated, while transfusion data were incomplete. No statistical analyses were performed because of poor data quality. A total of 107 patients were included. Patients receiving intensive therapy had a median of 30 hospital days and 4 outpatient visits; those on L-DAC had 21 hospital days and 8 visits; those on azacitidine had 18 hospital days and 16 visits. Despite these numeric differences, firm conclusions could not be drawn, underscoring the need for better, systematically collected data to clarify treatment burden and palliative care use in this population.
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