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Effectiveness of induction regimens on survival outcome in acute myeloid leukemia patients: a real-world data from 2001 to 2015

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Abstract

Since patients with acute myeloid leukemia (AML) in the real world have a much different clinical picture than patients recruited in the clinical trials, obtaining real-world evidence of medication adoption is important for therapeutic efficiency and safety. This study used three population-based data in Taiwan, the National Health Insurance Research Database, Taiwan Cancer Registry, and National Death Registry, between 2001 and 2015, to investigate the effect of conventional chemotherapy (CCT) versus non-conventional chemotherapy (NCCT) on the overall survival (OS) of patients with AML (n = 7,763). Cox proportional hazard regression was used to estimate the hazard ratios (HR) of different treatments on the risk of mortality. To reduce the potential selection bias, we used the inverse probability of treatment weighting based on the propensity score to balance the baseline characteristics between patients receiving CCT and NCCT. The median survival time for CCT and NCCT arms was 10.2 months (95% confidence interval (95% CI): 9.7–10.9) and 4.1 months (95% CI: 3.8–4.5), respectively. Compared to the patients received NCCT, those receiving CCT had a lower risk of mortality (HR 0.63 (95% CI: 0.59–0.67, P < 0.001). Subgroup analysis showed that CCT did benefit patients in different gender, age, comorbidity, and socioeconomic status (SES) groups. In conclusion, the real-world population-based data exhibited CCT were more likely to be prescribed for patients with AML of younger age, fewer comorbidities, diagnosed recently (2011–2015), and higher SES. In fact, CCT had better treatment outcomes than NCCT in terms of OS for adult patients diagnosed with AML.

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Funding

This work was partially sponsored by grants MOST 108–2628-B-002–015 from the Ministry of Science and Technology (Taiwan) and MOHW 107-TDU-B-211–114009 from the Ministry of Health and Welfare (Taiwan) and Health and Clinical Research Data Center, Office of Data Science, Taipei Medical University.

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Authors and Affiliations

  1. Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Hsin-An Hou, Wen-Chien Chou & Hwei-Fang Tien

  2. Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan

    Huey-En Tzeng

  3. Health Data Analytics and Statistics Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan

    Hung-Yi Liu & Li-Nien Chien

  4. Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Wen-Chien Chou

  5. School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan

    Li-Nien Chien

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  1. Hsin-An Hou
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  2. Huey-En Tzeng
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  4. Wen-Chien Chou
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  5. Hwei-Fang Tien
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Contributions

H.-E.T., W.-C.C., and H.-F.T. were responsible for literature collection and data interpretation; H.-Y.L. was responsible for statistical analysis and interpretation of the statistical findings; H.-A.H. and L.-I.C. planned, designed, and analyzed statistics; wrote the manuscript; and coordinated the study over the entire period.

Corresponding author

Correspondence to Li-Nien Chien.

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Ethics approval

This study was approved by the National Taiwan University Hospital Institutional Review Board (NTUH-REC No: 202002071 W), and the informed consent of the participants was exempted under the full review process.

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The authors declare no competing interests.

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Hou, HA., Tzeng, HE., Liu, HY. et al. Effectiveness of induction regimens on survival outcome in acute myeloid leukemia patients: a real-world data from 2001 to 2015. Ann Hematol 101, 109–118 (2022). https://doi.org/10.1007/s00277-021-04670-1

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  • DOI: https://doi.org/10.1007/s00277-021-04670-1

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