The Charlson Comorbidity Index Predicts Poor Prognosis in Elderly AML Patients

Abstract

Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults and patients older than 65 years have a poor prognosis. Patient-related factors, such as comorbid conditions that affect performance status, and insufficient organ functions, explain why elderly patients have a worse prognosis. The Charlson Comorbidity Index (CCI), is used to predict prognosis according to comorbidities. This retrospective study was conducted on patients diagnosed with AML between 2010 and 2019. Patients >60 years were included. Demographic information, comorbidities, CCI, ECOG ( Eastern Cooperative Oncology Group) score, cytogenetic characteristics, treatment regimens, treatment response, follow-up periods were recorded for all patients. Evaluation was made of a total of 82 patients with a mean age of 71.18 ± 7.67. The median follow-up was 6.7 months. The median number of comorbidities was 1 [0.0-4.0] with the median CCI score of 3 [2.0-6.0]. Median overall survival (OS) was 7.0 months [3.1-10.8] and PFS was 6.8 months [3.6-10.0]. As the median CCI score was 3, patients were divided into two groups as CCI > 3 and CCI ≤ 3. Age, gender, ECOG, cytogenetic risk profile, first-line treatment and CR1 achievement status were all similar in both groups (p > 0.05). Patients with CCI > 3 had significantly shorter OS than patients with CCI ≤ 3 (3.6 months [0.3-29.3] vs 8.6 months [0.2-60.2], p= 0.049). The results of the current study demonstrated that CCI, can be used as a prognostic index in elderly patients with AML independently of other patient and disease-related characteristics.