TOPLINE:

Analysis of 2823 adult patients with acute myeloid leukemia (AML) revealed that overall survival decreases almost linearly with increasing age across all European LeukemiaNet (ELN) genetic-risk groups, with no clear age cutoff point for younger vs older patients.

METHODOLOGY:

• Researchers analyzed 2823 adult patients with AML enrolled in frontline chemotherapy-based clinical protocols from two cooperative study groups in the US and Germany, with molecular profiling via targeted sequencing platforms.
• Analysis included frequencies of gene mutations and cytogenetic findings depicted in 5-year age increments, with clinical outcomes examined for 2756 patients with AML regarding molecular features and genetic-risk groups.
• Treatment protocols included intensive cytarabine-based induction therapy, with allogeneic hematopoietic stem-cell transplantation considered an independent variable.
• Molecular profiling utilized targeted sequencing platforms containing 24 shared AML-associated genes, with a variant allele frequency cutoff ≥ 2%.

TAKEAWAY:

• Age-associated distributions of gene mutations and cytogenetic abnormalities showed similar patterns in both US and German cohorts, with certain mutations increasing or decreasing in frequency with age.
• Overall survival demonstrated significant decline with increasing age across all 2022 ELN risk groups (favorable-risk, intermediate-risk, and adverse-risk groups; P < .001 for all).
• In the 2022 ELN favorable genetic-risk group, 5-year survival rates ranged from 73% in patients aged 18-24 years to 21% for those aged ≥ 75 years.
• The 2022 ELN intermediate genetic-risk group showed similar age-related decline, with 5-year survival dropping from 53% in patients aged 18-24 years to 4% in those aged > 75 years.

IN PRACTICE:

“Although mutational profiles and outcomes of the youngest patients differed from those of older patients, there was no age cutoff identifying ‘younger’ and ‘older’ patients. These findings support more age-associated flexibility for drug approval and trial eligibility,” the authors of the study wrote.

SOURCE:

The study was led by Monica Cusan, MD, Laboratory for Leukemia Diagnostics, Department of Medicine III, University Hospital, LMU Munich, Munich, Germany, and Karilyn Larkin, MD, Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio. It was published online on September 19 in Leukemia.

LIMITATIONS:

According to the authors, the study is limited to patients who met eligibility requirements for clinical trials, excluding real-world patients with more severe organ dysfunction, uncontrolled infections, and concurrent malignancies. The relatively small sample size of Hispanic or Black patients limits the generalizability of findings to these populations. Additionally, incomplete data regarding performance status and comorbidity index, along with differences between US and German transplant protocols, prevented an unbiased analysis of transplant impact on outcomes.

DISCLOSURES:

The study received support from Deutsche José Carreras Leukämie-Stiftung, RO1 CA262496, RO1 CA284595-01, RO1 CA283574-01, RO1 LM013879, Leukemia & Lymphoma Society, and the American Cancer Society. The authors reported having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.