Evidence map›Paper›PMID 32665186›Full record

SynthesisJournal of geriatric oncology2020

Benchmarking treatment effects for patients over 70 with acute myeloid leukemia: A systematic review and meta-analysis.

Tea Reljic, Marina Sehovic, Jeffrey Lancet, Jongphil Kim, Najla Al Ali, Benjamin Djulbegovic, Martine Extermann

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of geriatric oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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

7 authors.

Tea ReljicProgram for Comparative Effectiveness Research, University of South Florida, Tampa, FL, USA.
Marina SehovicSenior Adult Oncology Program, Moffitt Cancer Center, Tampa, FL, USA.
Jeffrey LancetDepartment of Oncology Sciences, University of South Florida, Tampa, FL, USA; Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA.
Jongphil KimDepartment of Oncology Sciences, University of South Florida, Tampa, FL, USA; Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA.
Najla Al AliDepartment of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA.
Benjamin DjulbegovicProgram for Evidence-based Medicine & Comparative Effectiveness Research, Departments of Supportive Medicine and Hematology, City of Hope, Duarte, CA, USA.
Martine ExtermannSenior Adult Oncology Program, Moffitt Cancer Center, Tampa, FL, USA; Department of Oncology Sciences, University of South Florida, Tampa, FL, USA. Electronic address: martine.extermann@moffitt.org.

Funding

TRANSLATIONAL RESEARCHP30CA076292 · NCI · UNIVERSITY OF SOUTH FLORIDA · PI Christine O'Connell · 1998 to 2026
$93.5M
Decision Models to Compare Treatments in Older Patients with AMLR01CA168677 · NCI · H. LEE MOFFITT CANCER CTR & RES INST · PI EXTERMANN, MARTINE · 2013 to 2016
$1.4M
NCI NIH HHS P30 CA076292NCI NIH HHS R01 CA168677
6 · The paper itself

Abstract

objectivesThe majority of patients with acute myeloid leukemia (AML) are aged 70 and over. However, there is uncertainty about how and whether older patients with AML should receive cytotoxic treatment. MATERIALS AND

methodsMedline and Cochrane library search was performed for studies in newly diagnosed AML which enrolled at least 20 patients per arm (for randomized controlled trials), or 50 patients (for non-randomized studies) over the age of 70. References were hand searched for additional eligible studies. Study investigators were contacted to maximize relevant data. Dual independent data extraction was done using standardized data collection forms. Data was collected on study and treatment characteristics, baseline patient information, and outcomes. Study methodological quality was assessed. The primary outcome was 1 year overall survival (OS). Impact of treatment [intensive chemotherapy (INT), low-dose chemotherapy (LOW), hypomethylating agents (HMA), or best supportive care (BSC)], cytogenetics, performance status, and comorbidity were assessed.

resultsThe search produced 11,846 references of which 38 randomized controlled trials and 30 non-randomized studies met inclusion criteria, representing 13,381 patients, with a worldwide distribution. One-year OS with INT was 37% (31-42%), with LOW 11% (6-18%), with HMA 35% (18-54%) and with BSC 17%(13-21%). Two-year OS was 22% (18-26%), 11% (7-15%), 22% (16-28%), 6% (2-12%), respectively. We present subgroup data based on the studies including cytogenetics, performance status, and comorbidity. Formal direct comparisons with adjustment for all prognostic factors were not possible.

conclusionsIn this largest to date series of AML patients aged 70 and older, we provide benchmarks for treatment efficacy and effectiveness that may be used for decision analysis models and for the future development of clinical trials focusing on these patients.

Indexed as

Antineoplastic AgentsLeukemia, Myeloid, AcuteAgedAged, 80 and overBenchmarkingHumansTreatment OutcomeAntineoplastic AgentsAcute myeloid leukemiaBest supportive careComorbidityCytogeneticsFunctional statusHypomethylating agentsIntensive chemotherapyLow-dose chemotherapyOlder adultsSystematic review

Identifiers

PMID32665186
PMCPMC7864384

What OpenQuestion holds

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Registered trials

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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.