Decision-making and quality of life in older adults with acute myeloid leukemia or advanced myelodysplastic syndrome

M. A. Sekeres, R. M. Stone, David Zahrieh, D. Neuberg, V. Morrison, D. J. De Angelo, I. Galinsky, S. J. Lee

Research output: Contribution to journalArticle

137 Citations (Scopus)

Abstract

Older patients with acute myeloid leukemia (AML) and advanced myelodysplastic syndrome (aMDS) must decide between receiving intensive induction chemotherapy (IC) or nonintensive chemotherapy/best supportive care (NIC). Little information exists about what factors influence treatment decisions and what quality of life (QOL) is associated with treatment choices. We prospectively examined 43 patients 60 years or older who were interviewed at diagnosis and periodically over 1 year. IC choice was associated with younger age (66 vs 76 years, P = 0.01) and AML diagnosis, but not with performance status, comorbidities, or QOL. In total, 63% of all patients reported not being offered other treatment options despite physician documentation of alternatives. Patient and physician estimates of cure differed significantly: 74% of patients estimated their chance of cure to be 50% or greater, yet for 89% of patients physician estimates of cure were 10% or less. IC patients experienced decreased QOL at 2 weeks, but rebounded to baseline and to NIC levels by 6 weeks. Initial QOL is not associated with treatment choice in older AML and aMDS patients. Regardless of treatment choice, patients report not being offered treatment options and overestimate their chances of cure. In IC patients, QOL decreases during hospitalization but rebounds after discharge.

Original languageEnglish (US)
Pages (from-to)809-816
Number of pages8
JournalLeukemia
Volume18
Issue number4
DOIs
StatePublished - Jan 1 2004
Externally publishedYes

Fingerprint

Myelodysplastic Syndromes
Acute Myeloid Leukemia
Decision Making
Quality of Life
Induction Chemotherapy
Physicians
Therapeutics
Documentation
Comorbidity
Hospitalization
Drug Therapy

Keywords

  • Acute myeloid leukemia
  • Decision-making
  • Older adults
  • Outcome
  • Quality of life

ASJC Scopus subject areas

  • Hematology
  • Cancer Research
  • Anesthesiology and Pain Medicine

Cite this

Sekeres, M. A., Stone, R. M., Zahrieh, D., Neuberg, D., Morrison, V., De Angelo, D. J., ... Lee, S. J. (2004). Decision-making and quality of life in older adults with acute myeloid leukemia or advanced myelodysplastic syndrome. Leukemia, 18(4), 809-816. https://doi.org/10.1038/sj.leu.2403289

Decision-making and quality of life in older adults with acute myeloid leukemia or advanced myelodysplastic syndrome. / Sekeres, M. A.; Stone, R. M.; Zahrieh, David; Neuberg, D.; Morrison, V.; De Angelo, D. J.; Galinsky, I.; Lee, S. J.

In: Leukemia, Vol. 18, No. 4, 01.01.2004, p. 809-816.

Research output: Contribution to journalArticle

Sekeres, MA, Stone, RM, Zahrieh, D, Neuberg, D, Morrison, V, De Angelo, DJ, Galinsky, I & Lee, SJ 2004, 'Decision-making and quality of life in older adults with acute myeloid leukemia or advanced myelodysplastic syndrome', Leukemia, vol. 18, no. 4, pp. 809-816. https://doi.org/10.1038/sj.leu.2403289
Sekeres, M. A. ; Stone, R. M. ; Zahrieh, David ; Neuberg, D. ; Morrison, V. ; De Angelo, D. J. ; Galinsky, I. ; Lee, S. J. / Decision-making and quality of life in older adults with acute myeloid leukemia or advanced myelodysplastic syndrome. In: Leukemia. 2004 ; Vol. 18, No. 4. pp. 809-816.
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