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

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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.