Evidence map›Paper›PMID 36999931›Full record

ArticleCancer medicine2023

The baseline comorbidity burden affects survival in elderly patients with acute myeloid leukemia receiving hypomethylating agents: Results from a multicentric clinical study.

Giovanni Marconi, Anna Candoni, Roberta Di Nicola, Chiara Sartor, Sarah Parisi, Mariachiara Abbenante, Jacopo Nanni, Gianluca Cristiano, Letizia Zannoni, Davide Lazzarotto and 15 more

Abstract read
In one paragraph

Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
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

25 authors.

Giovanni MarconiIRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori "Dino Amadori" (IRST), Meldola, Italy.ORCID 0000-0001-6309-0515
Anna CandoniDivision of Hematology, University Hospital-ASUFC, Udine, Italy.
Roberta Di NicolaDepartment of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Chiara SartorDepartment of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Sarah ParisiDepartment of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Mariachiara AbbenanteDepartment of Haematology and Stem Cell Transplantation Unit, IRCCS "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy.
Jacopo NanniDepartment of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Gianluca CristianoDepartment of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Letizia ZannoniDepartment of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Davide LazzarottoDivision of Hematology, University Hospital-ASUFC, Udine, Italy.
Benedetta GianniniIRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori "Dino Amadori" (IRST), Meldola, Italy.
Carmen BaldazziDepartment of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Lorenza BandiniDepartment of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Emanuela OttavianiIRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.
Nicoletta TestoniDepartment of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Chiara Di Giovanni BezziAssistenza Domiciliare Ail Bologna, Bologna, Italy.
Rania Abd-AlatifAssistenza Domiciliare Ail Bologna, Bologna, Italy.
Giulia CiottiOnco Hematology, Department of Oncology-Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.ORCID 0000-0001-5332-4293
Renato FaninDivision of Hematology, University Hospital-ASUFC, Udine, Italy.
Giovanni MartinelliIRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori "Dino Amadori" (IRST), Meldola, Italy.
Stefania PaoliniIRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.
Paolo RicciAssistenza Domiciliare Ail Bologna, Bologna, Italy.
Michele CavoDepartment of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Cristina PapayannidisIRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.
Antonio CurtiIRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn older patients with acute myeloid leukemia (AML), the definition of fitness, prognosis, and risk of death represents an open question.

methodsIn the present study, we tested the impact on survival of disease- and patient-related parameters in a large cohort of elderly AML patients homogeneously assigned to treatment with hypomethylating agents (HMAs).

resultsIn 131 patients with a median age of 76 years, we confirmed that early response (<0.001) and biology-based risk classification (p = 0.003) can select patients with better-predicted survival. However, a full disease-oriented model had limitations in stratifying our patients, prompting us to investigate the impact of baseline comorbidities on overall survival basing on a comorbidity score. The albumin level (p = 0.001) and the presence of lung disease (p = 0.013) had a single-variable impact on prognosis. The baseline comorbidity burden was a powerful predictor of patients' frailty, correlating with increased incidence of adverse events, especially infections, and predicted overall survival (p < 0.001).

conclusionThe comorbidity burden may contribute to impact prognosis in addition to disease biology. While the therapeutic armamentarium of elderly AML is improving, a comprehensive approach that combines AML biology with tailored interventions to patients' frailty is likely to fully exploit the anti-leukemia potential of novel drugs.

Indexed as

FrailtyLeukemia, Myeloid, AcuteAgedComorbidityHumansPrognosisRetrospective Studiesacute myeloid leukemiaelderlyfitnesshypomethylating agentsprognosis

Identifiers

PMID36999931
PMCPMC10242854

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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.