How should quality of life assessment be integrated in the evaluation of patients with acute myeloid leukemia?

Abstract

ABSTRACT Introduction: Recent studies in acute myeloid leukemia (AML) suggest that self-reported health status (including quality of life) should be a part of the pretherapy evaluation especially of elderly and unfit patients. However, there is also a need for additional studies to clarify the long-term effects of various antileukemic therapies. Areas covered: We searched for original articles in the PubMed database by the following combinations of terms: (i) acute myeloid leukemia combined with quality of life, geriatric assessment, or quality of life + allogeneic stem cell transplantation; or (ii) acute myeloid leukemia combined with either elderly, unfit, low-dose cytarabine or azacitidine. Expert commentary: We review and discuss the results from studies of quality of life for AML patients treated with conventional chemotherapy, autologous and allogeneic stem cell transplantation, and patients with acute promyelocytic leukemia. Self-reported health status (including quality of life) should be a part of the pretherapy evaluation especially of elderly and unfit AML patients together with performance status, comorbidity scoring and geriatric assessment. The risk of chemoresistance to intensive treatment should also be included. All these aspects should be considered when evaluation the risk for treatment-related mortality and deciding the intensity of the antileukemic therapy.