Nonbiological factors affecting survival in younger patients with acute myeloid leukemia

Uma Borate, Shin Mineishi, Luciano Jose Costa

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

BACKGROUND Progress has been made in determining the biological variants of acute myelogenous leukemia (AML) and their prognostic implications. However, to the authors' knowledge, little is known regarding the impact of nonbiological factors (NBFs) on the survival of patients with AML. METHODS The impact of NBFs (marital status, insurance status, county-level income, and education) on survival was assessed along with biological factors (disease subtype, sex, age, and race/ethnicity) using a cohort of patients aged 19 to 64 years who were diagnosed with AML between 2007 and 2011 and reported to the Surveillance, Epidemiology, and End Results program registry (SEER 18). RESULTS There were 5541 patients included. The median overall survival for the entire study population was 16 months. On multivariate analysis, an increased risk of death was independently linked to being a Medicaid beneficiary, uninsured, single, divorced, and residing in a county within the lower 3 quintiles of median household income. NBFs affected the risk of early (<2 months) and late mortality and their impact was confirmed among patients known to have received chemotherapy. CONCLUSIONS Insurance status, marital status, and county-level income were found to independently affect the survival of younger patients with AML and should be integrated into outcome comparisons. Interventions are needed to mitigate the impact of social factors on survival among patients with AML. Cancer 2015;121:3877-3884.

Original languageEnglish (US)
Pages (from-to)3877-3884
Number of pages8
JournalCancer
Volume121
Issue number21
DOIs
StatePublished - Nov 1 2015
Externally publishedYes

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Acute Myeloid Leukemia
Survival
Insurance Coverage
Marital Status
SEER Program
Divorce
Medicaid
Biological Factors
Registries
Multivariate Analysis
Education
Drug Therapy
Mortality
Population
Neoplasms

Keywords

  • acute myelogenous leukemia
  • health care disparity
  • income
  • marital status
  • socioeconomic factors
  • survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Nonbiological factors affecting survival in younger patients with acute myeloid leukemia. / Borate, Uma; Mineishi, Shin; Costa, Luciano Jose.

In: Cancer, Vol. 121, No. 21, 01.11.2015, p. 3877-3884.

Research output: Contribution to journalArticle

Borate, Uma ; Mineishi, Shin ; Costa, Luciano Jose. / Nonbiological factors affecting survival in younger patients with acute myeloid leukemia. In: Cancer. 2015 ; Vol. 121, No. 21. pp. 3877-3884.
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