Health-Related Quality of Life and Treatment of Older Adults with Acute Myeloid Leukemia: a Young International Society of Geriatric Oncology Review Paper

Curr Hematol Malig Rep. 2019 Dec;14(6):523-535. doi: 10.1007/s11899-019-00552-6.

Abstract

Purpose of review: The treatment landscape for older patients with acute myeloid leukemia (AML) is evolving. Many treatments have comparable efficacy making their impact on quality of life (QoL) an important differentiating factor. In this review, we discuss QoL in older adults with AML, focusing on therapeutic and observational trials that have incorporated QoL assessments.

Recent findings: Health-related quality of life (HRQoL) is a multi-dimensional concept incorporating physical, mental, emotional, and social functioning domains. HRQoL components overlap with components of geriatric assessment, a multidisciplinary diagnostic process that identifies underlying vulnerabilities of older adults and guides subsequent management strategies. HRQoL questionnaires may be general, cancer-specific, leukemia-specific, or symptom-focused. Therapeutic and observational cohort studies suggest HRQoL improves, or at least remains stable, during intensive and lower-intensity therapies. Nonetheless, HRQoL is not routinely incorporated in AML therapeutic trials. HRQoL assessments can inform both decision-making and management for older adults with AML.

Keywords: Acute myeloid leukemia; Geriatric assessment; Intensive therapies; Lower intensity therapies; Quality of life; Therapeutic trials.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Clinical Decision-Making
  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Disease Management
  • Geriatric Assessment*
  • Health Care Surveys
  • Humans
  • Leukemia, Myeloid, Acute / diagnosis
  • Leukemia, Myeloid, Acute / epidemiology*
  • Leukemia, Myeloid, Acute / therapy*
  • Quality of Life*
  • Surveys and Questionnaires
  • Treatment Outcome