Treatment and outcomes for chronic myelomonocytic leukemia compared to myelodysplastic syndromes in older adults
Dan P. Zandberg,
Ting-Ying Huang,
Xuehua Ke,
Maria R. Baer,
Steven D. Gore,
Sheila Weiss Smith,
Amy J. Davidoff
Affiliations
Dan P. Zandberg
Division of Hematology/Oncology, Department of Medicine, University of Maryland School of Medicine and Marlene and Stewart Greenebaum Cancer Center, University of Maryland, Baltimore MD
Ting-Ying Huang
Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
Xuehua Ke
Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
Maria R. Baer
Division of Hematology/Oncology, Department of Medicine, University of Maryland School of Medicine and Marlene and Stewart Greenebaum Cancer Center, University of Maryland, Baltimore MD
Steven D. Gore
Department of Oncology, The Johns Hopkins University, Baltimore, MD and Division of Hematologic Malignancies, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
Sheila Weiss Smith
Division of Hematology/Oncology, Department of Medicine, University of Maryland School of Medicine and Marlene and Stewart Greenebaum Cancer Center, University of Maryland, Baltimore MD;Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
Amy J. Davidoff
Agency for Healthcare Research and Quality, Center for Financing, Access, and Cost Trends, U.S. Department of Health and Human Services, Rockville, MD, USA
Prior studies have investigated patients' characteristics, treatments, and outcomes for older adults with myelodysplastic syndromes, but most failed to distinguish chronic myelomonocytic leukemia. Recognizing potentially important differences between the diseases, we undertook a population-based comparison of baseline characteristics, treatments, and outcomes between older adults with chronic myelomonocytic leukemia and myelodysplastic syndromes. The patients' data were obtained from Surveillance Epidemiology and End Results registry data from 2001-2005, linked to Medicare claims. Baseline characteristics, treatment (red blood cell transfusions, hematopoietic growth factors, hypomethylating agents, chemotherapy or transplantation), progression to acute myeloid leukemia, and overall survival were compared using bivariate techniques. Multivariate logistic regression estimated differences in treatments received. Cox proportional hazard models estimated the effects of chronic myelomonocytic leukemia relative to myelodysplastic syndromes on progression-free survival. A larger proportion of patients with chronic myelomonocytic leukemia (n=792), compared to patients with myelodysplastic syndromes (n=7,385), failed to receive any treatment (25% versus 15%; P
