Baseline correlates of frailty and its association with survival in United States veterans with acute myeloid leukemia

• Published in: Leukemia & lymphoma Vol. 64; no. 13; pp. 2081 - 2090
• Main Authors: La, Jennifer, Lee, Michelle H, Brophy, Mary T, Do, Nhan V, Driver, Jane A, Tuck, David P, Fillmore, Nathanael R, Dumontier, Clark
• Format: Journal Article
• Language: English
• Published: United States 01.12.2023
• Subjects: overall survival; frailty; geriatric oncology; veterans; Acute myeloid leukemia; electronic frailty index
• ISSN: 1042-8194; 1029-2403; 1029-2403
• DOI: 10.1080/10428194.2023.2254434

Frailty is an important construct to measure in acute myeloid leukemia (AML). We used the Veterans Affairs Frailty Index (VA-FI) - calculated using readily available data within the VA's electronic health records - to measure frailty in U.S. veterans with AML. Of the 1166 newly diagnosed and treated veterans with AML between 2012 and 2022, 722 (62%) veterans with AML were classified as frail (VA-FI > 0.2). At a median follow-up of 252.5 days, moderate-severely frail veterans had significantly worse survival than mildly frail, and non-frail veterans (median survival 179 vs. 306 vs. 417 days,  < .001). Increasing VA-FI severity was associated with higher mortality. A model with VA-FI in addition to the European LeukemiaNet (ELN) risk classification and other covariates statistically outperformed a model containing the ELN risk and other covariates alone (  < .001). These findings support the VA-FI as a tool to expand frailty measurement in research and clinical practice for informing prognosis in veterans with AML.