Development of a Quality of Life Decision-Making Model for Older Patients with Acute Myeloid Leukemia

项目摘要/摘要 患有急性髓系白血病的老年患者(60岁)没有足够的信息， 根据研究，确定符合他们目标的最佳化疗方法，无论是 为了生存或改善生活质量(QOL)。这项建议旨在确定重要的患者因素和 以疾病特征为基础构建以生活质量为中心的患者决策模型，同时进行监测 生死存亡。这将为患者在选择最合适的治疗方案时提供帮助 带着他们的护理目标。 这一职业发展奖构建了一个患者生活质量决策模型，该模型结合了重要的临床 莫菲特癌症中心诊断为急性髓细胞白血病的老年患者的疾病和患者因素预测因素。这个 这项研究的具体目的是：1)描述新诊断的老年AML患者的生活质量差异 接受强化化疗与非强化化疗的患者(基线和30、60、90和180天) 治疗后)；2)确定个别临床疾病特征(原始细胞百分比、输血 依赖性和细胞遗传学风险组)和患者因素(年龄、合并症、功能状态和 新诊断的老年AML患者的躯体症状)预测接受两次治疗的患者的生活质量 治疗，强化化疗与非强化化疗；3)设计患者决策模型 整合新诊断的老年AML患者的重要临床疾病和患者因素对生活质量的预测作用 接受强化治疗与非强化治疗的患者。概率将在PIE中提供给患者 生存时间和总生活质量评分随治疗强度变化的图表。 拟议的职业和学习目标是：1)发展姑息治疗方面的专业知识，重点是 急性髓系白血病确诊患者的独特需求；2)获得以下技能和知识 决策模型研究在临床研究中的应用；3)掌握研究设计、数据等方面的先进技能 管理、测量和统计方法以确定因素；4)通过以下方式传播研究结果 出版物和演示文稿；5)培养专业技能。 长期职业目标：随机对照试验比较治疗与偏好的一致性 老年急性髓系白血病患者将该模式融入到他们的日常护理中。

Project Summary/Abstract Older patients (≥ 60 years of age) with acute myeloid leukemia (AML) do not have enough information, based on research, to determine the best chemotherapy treatment that aligns with their goals, whether for survival or improved quality of life (QOL). This proposal seeks to identify significant patient factors and disease characteristics in order to build a patient decision-making model focused on QOL, while monitoring survival. This will provide an aid to patients when choosing the most appropriate treatment that optimally aligns with their goals for care. This career development award constructs a patient QOL decision-making model integrating significant clinical disease and patient factor predictors in older patients diagnosed with AML at Moffitt Cancer Center. The Specific Aims of the research are to: 1) Describe differences in QOL among newly diagnosed older AML patients receiving intensive versus non-intensive chemotherapy (at baseline and 30, 60, 90 and 180 days post treatment); 2) Identify the individual clinical disease characteristics (blast percentage, transfusion dependence, and cytogenetic risk group), and patient factors (age, comorbidities, functional status, and physical symptoms) of newly diagnosed older AML patients that predict their QOL among those receiving two treatments, intensive versus non-intensive chemotherapy; 3) Design a patient decision making model integrating significant clinical disease and patient factor predictors of QOL for newly diagnosed older AML patients receiving intensive versus non-intensive treatment. Probability will be provided to patients in pie charts for survival and total QOL score with treatment intensity. Proposed Career and Learning Objectives are to: 1) Develop expertise in palliative care, focused on the unique needs of individuals diagnosed with acute myeloid leukemia; 2) Attain skills and knowledge for the clinical research application of decision-making model research; 3) Attain advanced skills in study design, data management, measurement, and statistical methods to identify factors; 4) Disseminate findings through publications and presentations; 5) Develop grantsmanship skills. Long-term career goal: Randomized controlled trial comparing the alignment of treatment with preferences in older patients with AML with integration of the model into their care to usual care.