Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy

Camila Dias Pastana; Dafne Rosa Benzecry; Josy Marinho de Lima; Marcos Laércio Pontes Reis; Thiago Xavier Carneiro

doi:doi:10.11648/j.ijcocr.20190402.11

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Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy

Camila Dias Pastana, Dafne Rosa Benzecry, Josy Marinho de Lima, Marcos Laércio Pontes Reis, Thiago Xavier Carneiro

Published in International Journal of Clinical Oncology and Cancer Research (Volume 4, Issue 2)

Received: 29 March 2019 Accepted: 6 May 2019 Published: 4 June 2019

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Abstract

Therapy guidelines for acute leukemias (ALs) have focused on an arbitrary age cut-off as a guide for intensity of therapy. However, treatment outcomes depend on more important prognostic factors, such as performance status (PS) and the presence of comorbidities. This study aims to evaluate clinical scales as predictors of mortality in patients with acute leukemia during intensive induction therapy. This prospective cohort study included all patients diagnosed with Acute Myeloid Leukemia (AML) or Acute Lymphoblastic Leukemia (ALL) who received induction treatment at Ophir Loyola Hospital (HOL) in Belém-PA, from February 2018 to February 2019. The following scales were assessed: Eastern Cooperative Oncology Group (ECOG), Haematopoetic Cell Transplantation Comorbidity Index (HCT-CI), Cumulative Illness Rating Scale (CIRS), Charlson Comorbidity Index (CCI), Adult Comorbidity Evaluation 27 (ACE-27), Katz and Lawton scales, G8 Questionnaire and Mini Nutritional Assessment (MAN). The median age of the 40 patients included was 37 years old (range, 19-65) and sex distribution was equal. Univariate analysis showed that higher age (OR = 5.74, p 0.024), ACE 27 >0 (OR = 5.7, p 0.003) and HCT-CI >0 (OR = 3.87, p 0.02) were contributing factors to 40-day mortality, but no meaningful association was noticed with the other scales. Therefore, this study reaffirms the significant impact of comorbidities on the survival of patients with AL, suggesting that comorbidity assessment may be extremely helpful for making decisions on intensive induction therapy.

Published in	International Journal of Clinical Oncology and Cancer Research (Volume 4, Issue 2)
DOI	10.11648/j.ijcocr.20190402.11
Page(s)	5-9
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Acute Leukemia, Induction Chemotherapy, Outcomes, Comorbidity

References

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[4]	Sorror ML, Storer BE, Fathi AT, et al. Development And Validation Of A Novel Acute Myeloid Leukemia–Composite Model To Estimate Risks Of Mortality. JAMA Oncol. 2017; 1-8.
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APA Style

Camila Dias Pastana, Dafne Rosa Benzecry, Josy Marinho de Lima, Marcos Laércio Pontes Reis, Thiago Xavier Carneiro. (2019). Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy. International Journal of Clinical Oncology and Cancer Research, 4(2), 5-9. https://doi.org/10.11648/j.ijcocr.20190402.11

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ACS Style

Camila Dias Pastana; Dafne Rosa Benzecry; Josy Marinho de Lima; Marcos Laércio Pontes Reis; Thiago Xavier Carneiro. Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy. Int. J. Clin. Oncol. Cancer Res. 2019, 4(2), 5-9. doi: 10.11648/j.ijcocr.20190402.11

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AMA Style

Camila Dias Pastana, Dafne Rosa Benzecry, Josy Marinho de Lima, Marcos Laércio Pontes Reis, Thiago Xavier Carneiro. Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy. Int J Clin Oncol Cancer Res. 2019;4(2):5-9. doi: 10.11648/j.ijcocr.20190402.11

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@article{10.11648/j.ijcocr.20190402.11,
  author = {Camila Dias Pastana and Dafne Rosa Benzecry and Josy Marinho de Lima and Marcos Laércio Pontes Reis and Thiago Xavier Carneiro},
  title = {Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {4},
  number = {2},
  pages = {5-9},
  doi = {10.11648/j.ijcocr.20190402.11},
  url = {https://doi.org/10.11648/j.ijcocr.20190402.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20190402.11},
  abstract = {Therapy guidelines for acute leukemias (ALs) have focused on an arbitrary age cut-off as a guide for intensity of therapy. However, treatment outcomes depend on more important prognostic factors, such as performance status (PS) and the presence of comorbidities. This study aims to evaluate clinical scales as predictors of mortality in patients with acute leukemia during intensive induction therapy. This prospective cohort study included all patients diagnosed with Acute Myeloid Leukemia (AML) or Acute Lymphoblastic Leukemia (ALL) who received induction treatment at Ophir Loyola Hospital (HOL) in Belém-PA, from February 2018 to February 2019. The following scales were assessed: Eastern Cooperative Oncology Group (ECOG), Haematopoetic Cell Transplantation Comorbidity Index (HCT-CI), Cumulative Illness Rating Scale (CIRS), Charlson Comorbidity Index (CCI), Adult Comorbidity Evaluation 27 (ACE-27), Katz and Lawton scales, G8 Questionnaire and Mini Nutritional Assessment (MAN). The median age of the 40 patients included was 37 years old (range, 19-65) and sex distribution was equal. Univariate analysis showed that higher age (OR = 5.74, p 0.024), ACE 27 >0 (OR = 5.7, p 0.003) and HCT-CI >0 (OR = 3.87, p 0.02) were contributing factors to 40-day mortality, but no meaningful association was noticed with the other scales. Therefore, this study reaffirms the significant impact of comorbidities on the survival of patients with AL, suggesting that comorbidity assessment may be extremely helpful for making decisions on intensive induction therapy.},
 year = {2019}
}

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TY  - JOUR
T1  - Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy
AU  - Camila Dias Pastana
AU  - Dafne Rosa Benzecry
AU  - Josy Marinho de Lima
AU  - Marcos Laércio Pontes Reis
AU  - Thiago Xavier Carneiro
Y1  - 2019/06/04
PY  - 2019
N1  - https://doi.org/10.11648/j.ijcocr.20190402.11
DO  - 10.11648/j.ijcocr.20190402.11
T2  - International Journal of Clinical Oncology and Cancer Research
JF  - International Journal of Clinical Oncology and Cancer Research
JO  - International Journal of Clinical Oncology and Cancer Research
SP  - 5
EP  - 9
PB  - Science Publishing Group
SN  - 2578-9511
UR  - https://doi.org/10.11648/j.ijcocr.20190402.11
AB  - Therapy guidelines for acute leukemias (ALs) have focused on an arbitrary age cut-off as a guide for intensity of therapy. However, treatment outcomes depend on more important prognostic factors, such as performance status (PS) and the presence of comorbidities. This study aims to evaluate clinical scales as predictors of mortality in patients with acute leukemia during intensive induction therapy. This prospective cohort study included all patients diagnosed with Acute Myeloid Leukemia (AML) or Acute Lymphoblastic Leukemia (ALL) who received induction treatment at Ophir Loyola Hospital (HOL) in Belém-PA, from February 2018 to February 2019. The following scales were assessed: Eastern Cooperative Oncology Group (ECOG), Haematopoetic Cell Transplantation Comorbidity Index (HCT-CI), Cumulative Illness Rating Scale (CIRS), Charlson Comorbidity Index (CCI), Adult Comorbidity Evaluation 27 (ACE-27), Katz and Lawton scales, G8 Questionnaire and Mini Nutritional Assessment (MAN). The median age of the 40 patients included was 37 years old (range, 19-65) and sex distribution was equal. Univariate analysis showed that higher age (OR = 5.74, p 0.024), ACE 27 >0 (OR = 5.7, p 0.003) and HCT-CI >0 (OR = 3.87, p 0.02) were contributing factors to 40-day mortality, but no meaningful association was noticed with the other scales. Therefore, this study reaffirms the significant impact of comorbidities on the survival of patients with AL, suggesting that comorbidity assessment may be extremely helpful for making decisions on intensive induction therapy.
VL  - 4
IS  - 2
ER  -

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Author Information

Camila Dias Pastana

Faculty of Medicine, University of State of Pará, Belém, Brazil
Dafne Rosa Benzecry

Faculty of Medicine, University of State of Pará, Belém, Brazil
Josy Marinho de Lima

Department of Oncology and Hematology, University of State of Pará, Belém, Brazil
Marcos Laércio Pontes Reis

Department of Oncology and Hematology, University of State of Pará, Belém, Brazil
Thiago Xavier Carneiro

Department of Oncology and Hematology, University of State of Pará, Belém, Brazil

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Plain Text BibTeX RIS

APA Style

Camila Dias Pastana, Dafne Rosa Benzecry, Josy Marinho de Lima, Marcos Laércio Pontes Reis, Thiago Xavier Carneiro. (2019). Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy. International Journal of Clinical Oncology and Cancer Research, 4(2), 5-9. https://doi.org/10.11648/j.ijcocr.20190402.11

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ACS Style

Camila Dias Pastana; Dafne Rosa Benzecry; Josy Marinho de Lima; Marcos Laércio Pontes Reis; Thiago Xavier Carneiro. Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy. Int. J. Clin. Oncol. Cancer Res. 2019, 4(2), 5-9. doi: 10.11648/j.ijcocr.20190402.11

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AMA Style

Camila Dias Pastana, Dafne Rosa Benzecry, Josy Marinho de Lima, Marcos Laércio Pontes Reis, Thiago Xavier Carneiro. Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy. Int J Clin Oncol Cancer Res. 2019;4(2):5-9. doi: 10.11648/j.ijcocr.20190402.11

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@article{10.11648/j.ijcocr.20190402.11,
  author = {Camila Dias Pastana and Dafne Rosa Benzecry and Josy Marinho de Lima and Marcos Laércio Pontes Reis and Thiago Xavier Carneiro},
  title = {Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {4},
  number = {2},
  pages = {5-9},
  doi = {10.11648/j.ijcocr.20190402.11},
  url = {https://doi.org/10.11648/j.ijcocr.20190402.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20190402.11},
  abstract = {Therapy guidelines for acute leukemias (ALs) have focused on an arbitrary age cut-off as a guide for intensity of therapy. However, treatment outcomes depend on more important prognostic factors, such as performance status (PS) and the presence of comorbidities. This study aims to evaluate clinical scales as predictors of mortality in patients with acute leukemia during intensive induction therapy. This prospective cohort study included all patients diagnosed with Acute Myeloid Leukemia (AML) or Acute Lymphoblastic Leukemia (ALL) who received induction treatment at Ophir Loyola Hospital (HOL) in Belém-PA, from February 2018 to February 2019. The following scales were assessed: Eastern Cooperative Oncology Group (ECOG), Haematopoetic Cell Transplantation Comorbidity Index (HCT-CI), Cumulative Illness Rating Scale (CIRS), Charlson Comorbidity Index (CCI), Adult Comorbidity Evaluation 27 (ACE-27), Katz and Lawton scales, G8 Questionnaire and Mini Nutritional Assessment (MAN). The median age of the 40 patients included was 37 years old (range, 19-65) and sex distribution was equal. Univariate analysis showed that higher age (OR = 5.74, p 0.024), ACE 27 >0 (OR = 5.7, p 0.003) and HCT-CI >0 (OR = 3.87, p 0.02) were contributing factors to 40-day mortality, but no meaningful association was noticed with the other scales. Therefore, this study reaffirms the significant impact of comorbidities on the survival of patients with AL, suggesting that comorbidity assessment may be extremely helpful for making decisions on intensive induction therapy.},
 year = {2019}
}

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TY  - JOUR
T1  - Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy
AU  - Camila Dias Pastana
AU  - Dafne Rosa Benzecry
AU  - Josy Marinho de Lima
AU  - Marcos Laércio Pontes Reis
AU  - Thiago Xavier Carneiro
Y1  - 2019/06/04
PY  - 2019
N1  - https://doi.org/10.11648/j.ijcocr.20190402.11
DO  - 10.11648/j.ijcocr.20190402.11
T2  - International Journal of Clinical Oncology and Cancer Research
JF  - International Journal of Clinical Oncology and Cancer Research
JO  - International Journal of Clinical Oncology and Cancer Research
SP  - 5
EP  - 9
PB  - Science Publishing Group
SN  - 2578-9511
UR  - https://doi.org/10.11648/j.ijcocr.20190402.11
AB  - Therapy guidelines for acute leukemias (ALs) have focused on an arbitrary age cut-off as a guide for intensity of therapy. However, treatment outcomes depend on more important prognostic factors, such as performance status (PS) and the presence of comorbidities. This study aims to evaluate clinical scales as predictors of mortality in patients with acute leukemia during intensive induction therapy. This prospective cohort study included all patients diagnosed with Acute Myeloid Leukemia (AML) or Acute Lymphoblastic Leukemia (ALL) who received induction treatment at Ophir Loyola Hospital (HOL) in Belém-PA, from February 2018 to February 2019. The following scales were assessed: Eastern Cooperative Oncology Group (ECOG), Haematopoetic Cell Transplantation Comorbidity Index (HCT-CI), Cumulative Illness Rating Scale (CIRS), Charlson Comorbidity Index (CCI), Adult Comorbidity Evaluation 27 (ACE-27), Katz and Lawton scales, G8 Questionnaire and Mini Nutritional Assessment (MAN). The median age of the 40 patients included was 37 years old (range, 19-65) and sex distribution was equal. Univariate analysis showed that higher age (OR = 5.74, p 0.024), ACE 27 >0 (OR = 5.7, p 0.003) and HCT-CI >0 (OR = 3.87, p 0.02) were contributing factors to 40-day mortality, but no meaningful association was noticed with the other scales. Therefore, this study reaffirms the significant impact of comorbidities on the survival of patients with AL, suggesting that comorbidity assessment may be extremely helpful for making decisions on intensive induction therapy.
VL  - 4
IS  - 2
ER  -

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