Are social inequalities in acute myeloid leukemia survival explained by differences in treatment utilization? Results from a French longitudinal observational study among older patients.
Age Factors
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Cancer Survivors
Female
Follow-Up Studies
France
Healthcare Disparities
Humans
Leukemia, Myeloid, Acute
/ drug therapy
Longitudinal Studies
Male
Middle Aged
Patient Acceptance of Health Care
Prognosis
Prospective Studies
Socioeconomic Factors
Survival Rate
Treatment Outcome
Acute myeloid leukemia
Cancer management and survival
Elderly patients
French European deprivation index
Observational study
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
05 Sep 2019
05 Sep 2019
Historique:
received:
28
05
2019
accepted:
26
08
2019
entrez:
7
9
2019
pubmed:
7
9
2019
medline:
27
2
2020
Statut:
epublish
Résumé
Evidences support social inequalities in cancer survival. Studies on hematological malignancies, and more specifically Acute Myeloid Leukemia (AML), are sparser. Our study assessed: 1/ the influence of patients' socioeconomic position on survival, 2/ the role of treatment in this relationship, and 3/ the influence of patients' socioeconomic position on treatment utilization. This prospective multicenter study includes all patients aged 60 and older, newly diagnosed with AML, excluding promyelocytic subtypes, between 1st January 2009 to 31st December 2014 in the South-West of France. Data came from medical files. Patients' socioeconomic position was measured by an ecological deprivation index, the European Deprivation Index. We studied first, patients' socioeconomic position influence on overall survival (n = 592), second, on the use of intensive chemotherapy (n = 592), and third, on the use of low intensive treatment versus best supportive care among patients judged unfit for intensive chemotherapy (n = 405). We found an influence of patients' socioeconomic position on survival (highest versus lowest position HR Finally, these results suggest an indirect influence of patients' socioeconomic position on survival through AML initial presentation.
Sections du résumé
BACKGROUND
BACKGROUND
Evidences support social inequalities in cancer survival. Studies on hematological malignancies, and more specifically Acute Myeloid Leukemia (AML), are sparser. Our study assessed: 1/ the influence of patients' socioeconomic position on survival, 2/ the role of treatment in this relationship, and 3/ the influence of patients' socioeconomic position on treatment utilization.
METHODS
METHODS
This prospective multicenter study includes all patients aged 60 and older, newly diagnosed with AML, excluding promyelocytic subtypes, between 1st January 2009 to 31st December 2014 in the South-West of France. Data came from medical files. Patients' socioeconomic position was measured by an ecological deprivation index, the European Deprivation Index. We studied first, patients' socioeconomic position influence on overall survival (n = 592), second, on the use of intensive chemotherapy (n = 592), and third, on the use of low intensive treatment versus best supportive care among patients judged unfit for intensive chemotherapy (n = 405).
RESULTS
RESULTS
We found an influence of patients' socioeconomic position on survival (highest versus lowest position HR
CONCLUSIONS
CONCLUSIONS
Finally, these results suggest an indirect influence of patients' socioeconomic position on survival through AML initial presentation.
Identifiants
pubmed: 31488077
doi: 10.1186/s12885-019-6093-3
pii: 10.1186/s12885-019-6093-3
pmc: PMC6729078
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
883Subventions
Organisme : Institut de Recherche en Santé Publique
ID : SSC201504
Organisme : Agence Nationale de la Recherche
ID : ANR-11-PHUC-001
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