title: The prognostic importance of polypharmacy in older adults treated for acute myelogenous leukemia (AML).
abstract: We retrospectively evaluated the prognostic significance of polypharmacy and inappropriate medication use among 150 patients >60 years of age receiving induction chemotherapy for acute myelogenous leukemia (AML). After adjustment for age and comorbidity, increased number of medications at diagnosis (≥ 4 versus ≤ 1) was associated with increased 30-day mortality (OR=9.98, 95% CI=1.18-84.13), lower odds of complete remission status (OR=0.20, 95% CI=0.06-0.65), and higher overall mortality (HR=2.13, 95% CI=1.15-3.92). Inappropriate medication use (classified according to Beers criteria) was not significantly associated with clinical outcomes. Polypharmacy warrants further study as a modifiable marker of vulnerability among older adults with AML.
authors.affiliation: Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: kelliot@wakehealth.edu.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Elliot
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA; Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC, USA. Electronic address: jtooze@wakehealth.edu.
authors.forename: Janet A
authors.initials: JA
authors.lastname: Tooze
authors.affiliation: Wake Forest Translational Science Institute, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: rgeller@wakehealth.edu.
authors.forename: Rachel
authors.initials: R
authors.lastname: Geller
authors.affiliation: Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA; Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC, USA. Electronic address: bpowell@wakehealth.edu.
authors.forename: Bayard L
authors.initials: BL
authors.lastname: Powell
authors.affiliation: Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA; Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC, USA. Electronic address: tspardee@wakehealth.edu.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Pardee
authors.affiliation: Weill Cornell Medical College, New York, NY, USA. Electronic address: ritchie@med.cornell.edu.
authors.forename: Ellen
authors.initials: E
authors.lastname: Ritchie
authors.affiliation: Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: lakenned@wakehealth.edu.
authors.forename: LeAnne
authors.initials: L
authors.lastname: Kennedy
authors.affiliation: Department of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: kecallah@wakehealth.edu.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Callahan
authors.affiliation: Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA; Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC, USA. Electronic address: hklepin@wakehealth.edu.
authors.forename: Heidi D
authors.initials: HD
authors.lastname: Klepin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents
keywords: Elderly; Leukemia; Medications; Mortality; Older; Polypharmacy