Contemporary Clinical Outcomes and Healthcare Utilization in Older Adults with Acute Myeloid Leukemia: Insights from a Single-Center Retrospective Cohort

Abstract

Simple Summary Many older adults with acute myeloid leukemia (AML) cannot receive intensive treatment because of comorbidities or frailty. Newer, lower-intensity treatments have expanded options for these patients. In this retrospective analysis, we examined treatment patterns, survival, and healthcare utilization in patients ≥75 years treated at our institution. We found that adding venetoclax to hypomethylating agents was not associated with longer survival compared with hypomethylating agents alone, potentially reflecting treatment selection bias or a smaller sample size. Receipt of any AML-directed treatment was associated with longer survival compared with supportive care alone, except in patients with adverse risk or TP53-mutated disease who were not eligible for intensive chemotherapy. Nearly half of patients died in the hospital, and hospice and comfort-focused care were often initiated only in the final days of life. These findings highlight the need for more effective treatments for adverse-risk patients and earlier integration of palliative and hospice care.