title: Quality of life in elderly patients with acute myeloid leukemia: patients may be more accurate than physicians.
abstract: BACKGROUND
  The aim of this study was to evaluate changes in quality of life scores and their association with therapy and survival in unselected elderly patients with acute myeloid leukemia.
  
  
  METHODS
  From February 2003 to February 2007, 113 patients aged more than 60 years with de novo acute myeloid leukemia were enrolled in a prospective observational study. Two different quality of life instruments were employed: the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - C30 (EORTC QLQ-C30) and a health-related quality of life questionnaire for patients with hematologic diseases (QOL-E).
  
  
  RESULTS
  Forty-eight patients (42.4%) received intensive chemotherapy and 65 (57.6%) were given palliative treatments. Age greater than 70 years (P=0.007) and concomitant diseases (P=0.019) had a significant impact on treatment allocation. At diagnosis, general quality of life was affected [median QOL-E standardized score 54, interquartile range 46-70; median EORTC global score 50, interquartile range 41-66]. Most patients were given a good ECOG Performance Status (< 2), which did not correlate with the patients' perception of quality of life. At multivariate analysis, palliative approaches (P=0.016), age more than 70 years (P=0.013) and concomitant diseases (P=0.035) each had an independent negative impact on survival. In a multivariate model corrected for age, concomitant diseases and treatment option, survival was independently predicted by QOL-E functional (P=0.002) and EORTC QLQ-C30 physical function (P=0.030) scores.
  
  
  CONCLUSIONS
  Quality of life could have an important role in elderly acute myeloid leukemia patients at diagnosis as a prognostic factor for survival and a potential factor for treatment decisions.
authors.affiliation: Hematology Division, Azienda Ospedaliera "Bianchi-Melacrino-Morelli", Via Melacrino, 89100 Reggio Calabria, Italy. estheroliva@hotmail.com
authors.forename: Esther N
authors.initials: EN
authors.lastname: Oliva
authors.forename: Francesco
authors.initials: F
authors.lastname: Nobile
authors.forename: Giuliana
authors.initials: G
authors.lastname: Alimena
authors.forename: Francesca
authors.initials: F
authors.lastname: Ronco
authors.forename: Giorgina
authors.initials: G
authors.lastname: Specchia
authors.forename: Stefana
authors.initials: S
authors.lastname: Impera
authors.forename: Massimo
authors.initials: M
authors.lastname: Breccia
authors.forename: Iolanda
authors.initials: I
authors.lastname: Vincelli
authors.forename: Ida
authors.initials: I
authors.lastname: Carmosino
authors.forename: Patrizia
authors.initials: P
authors.lastname: Guglielmo
authors.forename: Domenico
authors.initials: D
authors.lastname: Pastore
authors.forename: Caterina
authors.initials: C
authors.lastname: Alati
authors.forename: Roberto
authors.initials: R
authors.lastname: Latagliata
mesh_terms: D000208:Acute Disease; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D006801:Humans; D053208:Kaplan-Meier Estimate; D007951:Leukemia, Myeloid / Q000523:psychology* / Q000628:therapy*; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010166:Palliative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires