Oncologists, Patients Have Different Views on AML Treatment Outcomes, Prognosis

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Patients reviewed, especially those receiving nonintensive chemotherapy, were likely to have a different assessment of their likely treatment outcomes.
Patients reviewed, especially those receiving nonintensive chemotherapy, were likely to have a different assessment of their likely treatment outcomes.

Patients with acute myeloid leukemia (AML) who are older than 60 years had optimistic outlooks for curation likelihood and an overestimation of treatment risks that were both at odds with the outlooks of their oncologists, according to study results to be presented at the 2017 Palliative and Supportive Care in Oncology Symposium. 

The treatment of AML can be a difficult one to navigate especially for the elderly; therapy options are often risky and involve multidrug intensive chemotherapy with only a slight chance of a cure, or are palliative and noncurative.

 

For this study, researchers enrolled 100 patients with AML to undergo intensive chemotherapy (50 patients) or nonintensive chemotherapy (50 patients). Three days after initiating treatment, patients and oncologists were given questionnaires to evaluate their views on the likelihood of dying from treatment, and 1 month later their views on prognosis were assessed.

Patients in both arms of the study reported feeling as though they were somewhat (58/92, 63.0%) or extremely (26/92, 28.3%) likely to die due to treatment. Their oncologists reported that it would be very unlikely (80.0%, 74/92) that patients would die (P < .001).

Most patients expressed positive feelings about their prognosis; nearly 90% (73/81) reported that they were somewhat or very likely to be cured. This stood in stark contrast to the opinions of their oncologists, who reported that the chances of cure were unlikely or very unlikely (74%, 60/81) (P <.001).

The authors concluded “[p]rognostic misperceptions are especially striking in patients receiving nonintensive chemotherapy. Interventions to facilitate communication are needed to ensure patients with AML have an accurate understanding of their treatment risks and prognosis and are therefore enabled to make informed decisions about treatment.”

Reference

Nicholson S, Abel GA, Fathi AT, et al. Perceptions of prognosis and treatment risk in older patients with acute myeloid leukemia (AML). Poster presented at: 2017 Palliative and Supportive Care in Oncology Symposium; October 27-28, 2017; San Diego, CA. Abstract 43. 

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