Evidence map›Paper›PMID 30554278›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2019

Association between glycemic control, age, and outcomes among intensively treated patients with acute myeloid leukemia.

Patrick Kuhlman, Scott Isom, Timothy S Pardee, Cynthia Burns, Bernard Tawfik, Zanetta S Lamar, Bayard L Powell, Heidi D Klepin

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Patrick KuhlmanWake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
Scott IsomWake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
Timothy S PardeeWake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
Cynthia BurnsWake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
Bernard TawfikUniversity of Texas Southwestern Medical Center, Harry Hines Blvd, Dallas, TX, USA.
Zanetta S LamarWake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
Bayard L PowellWake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
Heidi D KlepinWake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA. hklepin@wakehealth.edu.ORCID http://orcid.org/0000-0002-6262-1123

Funding

Tumor Tissue CoreP30CA012197 · NCI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI Ruben A. Mesa · 1985 to 2026
$55.4M
Determining the Role of Metabolism in Resistance in Acute Myeloid LeukemiaR01CA197991 · NCI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI PARDEE, TIMOTHY SEBASTIAN · 2016 to 2020
$1.8M
Minimizing Physical Function Decline in Older Adults Receiving ChemotherapyK23AG038361 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KLEPIN, HEIDI DIANA · 2011 to 2014
$562k
National Cancer Institute P30CA012197National Institute on Aging K23AG038361NCI NIH HHS P30 CA012197NCI NIH HHS R01 CA197991NIA NIH HHS K23 AG038361
6 · The paper itself

Abstract

purposeTo investigate the impact of hyperglycemia and glycemic variability during intensive acute myeloid leukemia therapy (AML) on outcomes by age.

methodsRetrospective study of 262 consecutive patients with newly diagnosed AML hospitalized for intensive induction. Hyperglycemia was assessed by mean blood glucose (BG) (mg/dL) during hospitalization and glycemic variability was determined by the standard deviation (SD) of mean BG. Outcomes were complete remission ± incomplete count recovery (CR + CRi), and overall survival (OS). We used logistic regression to evaluate CR + CRi, and Cox proportional hazard models for OS, stratified by age (< 60 vs ≥ 60 years).

resultsOlder patients (N = 138, median age 70) had higher baseline comorbidity (CCI > 1 60.1% vs 25.8%) and prevalence of diabetes (20.3% vs 7.3%) compared to younger (N = 124, median age 47). The mean ± SD number of BG values obtained per patient during hospitalization was 61 ± 71. The mean (± SD) glucose (mg/dL) during hospitalization was 121.7 (25.9) in older patients (≥ 60 years) versus 111.6 (16.4) in younger. In older patients, higher mean glucose and greater glycemic variability were associated with lower odds of remission (OR 0.80, 95% CI 0.69-0.93 and OR 0.73, 95% CI 0.61-0.88 respectively, per 10-unit increase) and higher mortality rates (HR 1.13, 95% CI 1.05-1.21 and HR 1.17, 95% CI 1.09-1.26, respectively, per 10-unit increase) in multivariate analyses.

conclusionsOur observations that hyperglycemia and increased glycemic variability were associated with lower remission rates and increased mortality in older patients suggest glycemic control may be a potentially modifiable factor to improve AML outcomes.

Indexed as

AgedAge FactorsBlood GlucoseComorbidityDiabetes MellitusFemaleHospitalizationHumansHyperglycemiaLeukemia, Myeloid, AcuteMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateBlood GlucoseAcute myeloid leukemiaDiabetesGlycemic variabilityHyperglycemiaOlder

Identifiers

PMID30554278
PMCPMC6571065

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.