The prognostic importance of polypharmacy in older adults treated for acute myelogenous leukemia (AML)

Leuk Res. 2014 Oct;38(10):1184-90. doi: 10.1016/j.leukres.2014.06.018. Epub 2014 Jul 7.

Abstract

We retrospectively evaluated the prognostic significance of polypharmacy and inappropriate medication use among 150 patients >60 years of age receiving induction chemotherapy for acute myelogenous leukemia (AML). After adjustment for age and comorbidity, increased number of medications at diagnosis (≥ 4 versus ≤ 1) was associated with increased 30-day mortality (OR=9.98, 95% CI=1.18-84.13), lower odds of complete remission status (OR=0.20, 95% CI=0.06-0.65), and higher overall mortality (HR=2.13, 95% CI=1.15-3.92). Inappropriate medication use (classified according to Beers criteria) was not significantly associated with clinical outcomes. Polypharmacy warrants further study as a modifiable marker of vulnerability among older adults with AML.

Keywords: Elderly; Leukemia; Medications; Mortality; Older; Polypharmacy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Female
  • Humans
  • Induction Chemotherapy
  • Kaplan-Meier Estimate
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Myeloid, Acute / mortality
  • Male
  • Middle Aged
  • Polypharmacy*
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies

Substances

  • Antineoplastic Agents