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Prevalence and effects of polypharmacy on overall survival in acute myeloid leukemia
Journal article   Open access   Peer reviewed

Prevalence and effects of polypharmacy on overall survival in acute myeloid leukemia

Prajwal Dhakal, Elizabeth Lyden, Kate-Lynn E. Muir, Zaid S. Al-Kadhimi, Thuy Koll, Lori J. Maness, Krishna Gundabolu and Vijaya Raj Bhatt
Leukemia & lymphoma, Vol.61(7), pp.1702-1708
06/06/2020
DOI: 10.1080/10428194.2020.1737687
PMCID: PMC9393046
PMID: 32157936
url
https://www.ncbi.nlm.nih.gov/pmc/articles/9393046View
Open Access

Abstract

Polypharmacy, usually defined as taking ≥5 prescribed medications, increases chances of drug-drug interactions and toxicities, and may harm cancer patients who need multiple chemotherapeutic agents and supportive medications. We analyzed the effects of polypharmacy in overall survival (OS) in acute myeloid leukemia (AML). A total of 399 patients were divided into two groups: patients with polypharmacy (≥5 medications) versus without polypharmacy (<5 medications). Polypharmacy was associated with age ≥60 years, Karnofsky Performance Status of ≤80, hematopoietic cell transplant (HCT) comorbidity index of ≥5, and adverse cytogenetics. Patients with polypharmacy were less likely to receive intensity chemotherapy or HCT. One-year OS of patients with polypharmacy versus those without polypharmacy was 29 vs. 49% (p<.001). Polypharmacy conferred worse OS in patients <60 years (37 vs. 65% at 1 year, HR 1.95, 95% CI 1.21-3.15) but not in patients ≥60 years (26 vs. 27% at 1 year, HR 1.12, 95% CI 0.81-1.57). Thus, polypharmacy has negative impact on OS in AML, particularly among patients aged <60 years.
Acute myeloid leukemia medications overall survival polypharmacy prognosis

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