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

项目总结/摘要 老年急性髓性白血病（AML）患者（≥ 60岁）的信息不足， 根据研究，以确定与他们的目标相一致的最佳化疗治疗， 生存或改善生活质量（QOL）。该提案旨在确定重要的患者因素， 疾病特征，以建立一个病人的决策模型，重点是生活质量，同时监测 生存这将为患者选择最合适的治疗提供帮助， 他们的目标是护理。 该职业发展奖构建了一个患者QOL决策模型， 莫菲特癌症中心诊断为急性粒细胞白血病的老年患者的疾病和患者因素预测因素。的 研究的具体目的是：1）描述新诊断的老年AML之间的生活质量差异 接受强化与非强化化疗的患者（基线和30、60、90和180天 治疗后）; 2）识别个体临床疾病特征（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患者的身体症状），预测他们在接受两种治疗的患者中的QOL 治疗，强化与非强化化疗; 3）设计患者决策模型 整合新诊断的老年AML的显著临床疾病和患者因素QOL预测因子 接受强化与非强化治疗的患者。概率将以饼图形式提供给患者 生存率和总QOL评分与治疗强度的图表。 建议的职业和学习目标是：1）发展姑息治疗的专业知识，重点是 诊断为急性髓细胞白血病的个体的独特需求; 2）获得技能和知识， 决策模型研究的临床研究应用; 3）获得研究设计，数据的高级技能 管理、测量和统计方法，以确定因素; 4）通过 出版物和演示文稿; 5）培养专业技能。 长期职业目标：比较治疗与偏好一致性的随机对照试验 老年AML患者将模型整合到他们的护理中，以进行常规护理。

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.