Researchers have developed and validated a novel, risk-stratifying acute myeloid leukemia (AML) composite model (CM) incorporating comorbidities, age, and cytogenetic and molecular risk factors to predict mortality after initial therapy, which can guide clinicians in determining appropriate therapies for their patients with AML.
The new AML-CM score augments the current HCT-Comorbidity Index (HCT-CI), and was developed through a multicenter validation test of 1,100 patients with AML. The augmented HCT-CI was the best suited index for comorbidity evaluation in AML, and the AML-CM provided better discrimination of 1-year mortality rates compared with all other risk factors and Karnofsky performance status.
The researchers note that targeting comorbidities with interventions alongside specific AML therapy could improve patient survival, but the major role of the AML-CM is to inform clinical decisions as to whether patients with newly diagnosed AML should receive more intensive or less intensive therapies for their disease.
In addition, the researchers say that current decisions about initial therapy for patients with newly diagnosed AML are based largely on age and an often subjective assessment of a patient’s fitness. “The use of the AML-CM by community internists will allow objective identification of those older patients with AML, who have traditionally been offered palliative care but who might be better served by referral to receive either conventional or investigational AML therapy.”
The researchers have developed an online calculator to compute AML-CM scores.