All content on this site is intended for healthcare professionals only. By acknowledging this message and accessing the information on this website you are confirming that you are a Healthcare Professional. If you are a patient or carer, please visit Know AML.

The AML Hub uses cookies on this website. They help us give you the best online experience. By continuing to use our website without changing your cookie settings, you agree to our use of cookies in accordance with our updated Cookie Policy

Introducing

Now you can personalise
your AML Hub experience!

Bookmark content to read later

Select your specific areas of interest

View content recommended for you

Find out more
  TRANSLATE

The AML Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the AML Hub cannot guarantee the accuracy of translated content. The AML Hub and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.

Steering CommitteeAbout UsNewsletterContact
LOADING
You're logged in! Click here any time to manage your account or log out.
LOADING
You're logged in! Click here any time to manage your account or log out.

The AML Hub is an independent medical education platform, sponsored by Daiichi Sankyo, Jazz Pharmaceuticals, Kura Oncology, Roche and Syndax and has been supported through a grant from Bristol Myers Squibb. The funders are allowed no direct influence on our content. The levels of sponsorship listed are reflective of the amount of funding given. View funders.

2019-07-05T14:18:55.000Z

Adverse events in acute myeloid leukemia (AML) treatment

Jul 5, 2019
Share:

Bookmark this article

AML treatment often includes intense chemotherapy regimes, at induction, through consolidation and possibly following allogeneic stem cell transplantation for treatment of relapse. The highly cytotoxic treatment of AML can lead to adverse effects (AE) that continue long-term.

In their 2019 publication, Crossnohere et al.,1 present the results of a national US survey of side effects during and after treatment for AML. The group used an instrument, previously developed and piloted under the leadership of the Leukemia and Lymphoma Society (LLS), to prioritize the concerns of AML patients.2,3 Data was collected on patient issues such as decision-making, treatment delivery, physical impacts, and psychosocial effects. The group aimed to report the prevalence and severity of these AE.

Study design and patient demographics:

  • A retrospective study of patients over 18 years old with an AML diagnosis, and/or current/former caregivers
  • Out of 6,841 survey-containing emails that were sent out, 1,182 individuals completed the survey including; 901 patients, 159 caregivers of living patients, and 122 caregivers of deceased patients

Table 1. Participant characteristics and clinical characteristics (1)

Survey participant characteristics

 

 

N(%)

Participant role

Patient

Caregiver of living patient

Caregiver of deceased patient

901 (76.2)

159 (13.5)

122 (10.3)

Age (mean years, range)

 

54.7 (19-87)

Gender

Female

689 (64.5)

Race/ethnicity

White/Caucasian

Black/African American

Other

939 (87.9)

40 (3.7)

80 (8.4)

Education

Less than college degree

College degree or higher

365 (34.2)

702 (65.8)

Insurance

Private insurance

820 (76.9)

Clinical characteristics of patients

Years since diagnosis (range)

 

7.3 (1-40)

Treatment (all that apply)

Chemotherapy

Allogeneic stem cell transplantation

1165 (99.0)

719 (57.7)

Disease status

In remission

1002 (86.0)

Results:

  • 87% of participants reported at least one severe short-term AE and 33% reported one or more severe long-term AE, 11% of participants reported no short or long-term AE

Figure 1. Prevalence and severity of AML treatment side effects
  • 87% of participants experienced severe short-term effects, 33% reported severe long-term effects
  • Only 11% of respondents did not have any severe effects
  • On average, the most severe short-term AE was hair loss and the most severe long-term AE was fatigue. Authors found a moderate correlation between short-term and long-term severity scores (r=0.41, p<0.001).
  • There were similarities between the prevalence of severe short-term AEs reported by patients and caregivers (mouth sores, diarrhea, nausea, rashes), patients reported more severe hair loss (p=0.01) and caregivers reported more severe infections (p<0.001)
  • Caregivers were significantly more likely than patients to report severe long-term AE (51% vs 29%, Chi2=43.9, p<0.001) and reported that fatigue, neuropathy and organ dysfunction as more severe, though reported a similar severity for chemobrain
  • Gender differences were noted in the AE profiles of AML patients, with females being more likely to have severe forms of nausea, diarrhea, infection, mouth sores, rashes and hair loss
  • Age differences were also noted, with those diagnosed at ≤55 years old being more likely to have severe forms of nausea, diarrhea, infection, mouth sores, and hair loss
  • Analysis of patients who were not in remission found that compared to patients in remission they were more likely to have a severe AE such as infection, organ damage, neuropathy, fatigue, and chemobrain
  • Patients who were diagnosed <5 years ago, when compared to patients diagnosed ≥5 years ago, were more likely to have severe forms of nausea, diarrhea, infection, rashes, and hair loss
  • The prevalence of severe AE showed no variation by patient race or patient insurance type

Conclusion

The authors found that severe short-term effects of chemotherapy were extremely common in AML patients. Severe long-term effects were more commonly reported by caregivers. The prevalence of certain AEs also showed significant gender and age bias. The researchers concluded that the study of patient experience in this way could aid in the identification of areas of unmet need and drive patient-centered treatment development, as the patients are the ‘true experts of their disease experiences’. Their work has highlighted that there are a significant patient and caregiver burden associated with AML treatments and that this should be a priority for further patient-focussed drug development.

  1. Crossnohere N.L. et al., Side effects from acute myeloid leukemia treatment: results from a national survey. Curr Med Res Opin. 2019 Jun 26; 1-6.  DOI: 10.1080/03007995.2019.1631149 [Epub ahead of print]
  2. Seo J. et al., Developing an instrument to assess patient preferences for benefits and risks of treating acute myeloid leukemia to promote patient-focused drug development. Curr Med Res Opin. 2018; 34(12):2031–2039.  DOI: 10.1080/03007995.2018.1456414
  3. Bridges J.F. et al., Developing and piloting an instrument to prioritize the worries of patients with acute myeloid leukemia. Patient Prefer Adherence. 2018 Apr 27; 12:647–655. DOI: 10.2147/PPA.S151752

Your opinion matters

HCPs, what is your preferred format for educational content on the AML Hub?
13 votes - 3 days left ...

Newsletter

Subscribe to get the best content related to AML delivered to your inbox