An Evaluation of Major Comorbidities and Treatment Patterns of Newly Diagnosed Acute Myeloid Leukemia Patients: A Retrospective Analysis of Electronic Medical Records from US

Background: There is limited data available on patient characteristics and treatment patterns for patients diagnosed with acute myeloid leukemia (AML) particularly from electronic medical record (EMR) database in US.

Objective: Our goal was to examine comorbidities and treatment patterns among newly diagnosed AML patients in US.

Methods: We conducted a retrospective cohort study using fully adjudicated data provided by IQVIA from the EMR database including patient data from January 2012-July 2018 across the US. ICD-9/10-CM codes were used to identify newly diagnosed AML (excluding APL) patients. Initial AML diagnosis codes which indicated relapse or remission were excluded from the newly diagnosed population. Demographics and comorbidities at baseline as well as AML

treatments received after initial diagnosis were examined.

Results: A total of 3387 patients who had an AML diagnosis were retrieved. 2879 were newly diagnosed with mean age of 65.9 and median age at 70 (ranged from 17 to 85) and 54.8 % were male. Prior to the first AML diagnosis record (i.e. index date), 18.7% had other prior malignant solid tumors and 13.5% had antecedent Myelodysplastic Syndrome (MDS), while 71.2% were AML de novo.

Cardiovascular diseases (18.7%) and diabetes (4.6%) were the most common comorbidities occurred before or after initial AML diagnosis. After index date, 38.2% of the newly diagnosed patients received FDA approved drugs for AML and 18% received supportive care only. 2.3 % received hematopoietic cell transplant. Among the FDA approved drugs for AML, hypomethylating agents (37.4% Decitabine and 35.3% Azacitidine), cytarabine based treatments (21.8%) were the most commonly used first line treatment. 25% switched to other AML drugs later in the treatment. Filgrastim (49.6%) and Azoles (37.4%) were the most frequently used supportive care.

Conclusions: Among newly diagnosed AML patients, most had AML de novo. Cardiovascular disease and diabetes are the most common comorbidities and monotherapy was predominantly used as first line therapy. Low percentage of hematopoietic cell transplant observed in this population needs further investigation.