TY - JOUR
T1 - Effects of Distance From Academic Cancer Center on Overall Survival of Acute Myeloid Leukemia
T2 - Retrospective Analysis of Treated Patients
AU - Dhakal, Prajwal
AU - Lyden, Elizabeth
AU - Muir, Kate Lynn E.
AU - Al-Kadhimi, Zaid S.
AU - Maness, Lori J.
AU - Gundabolu, Krishna
AU - Bhatt, Vijaya Raj
N1 - Funding Information:
This work was supported by the National Institute of General Medical Sciences ( 1 U54 GM115458 ), which funds the Great Plains Institutional Development Award (IDeA) Clinical Translational Research (CTR) Network; and a Fred and Pamela Buffett Cancer Center support grant from the National Cancer Institute (NCI) ( P30 CA036727 ). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Funding Information:
V.R.B. reports receiving consulting fees from Agios, Incyte, Partner Therapeutics, Omeros, Takeda, and AbbVie; research funding from Incyte, Jazz, Tolero Pharmaceuticals, and National Marrow Donor Program; and drug support for a trial from Oncoceutics. K.G. reports receiving consulting fees from Pfizer, Novartis, and Shionogi, and has stock in Portola Pharmaceuticals. The other authors have stated that they have no conflict of interest.This work was supported by the National Institute of General Medical Sciences (1 U54 GM115458), which funds the Great Plains Institutional Development Award (IDeA) Clinical Translational Research (CTR) Network; and a Fred and Pamela Buffett Cancer Center support grant from the National Cancer Institute (NCI) (P30 CA036727). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Funding Information:
V.R.B. reports receiving consulting fees from Agios, Incyte, Partner Therapeutics, Omeros, Takeda, and AbbVie; research funding from Incyte , Jazz , Tolero Pharmaceuticals , and National Marrow Donor Program ; and drug support for a trial from Oncoceutics. K.G. reports receiving consulting fees from Pfizer, Novartis, and Shionogi, and has stock in Portola Pharmaceuticals. The other authors have stated that they have no conflict of interest.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/10
Y1 - 2020/10
N2 - Introduction: Patients living farther away from academic centers may not have easy access to resources for management of acute myeloid leukemia (AML). We aimed to analyze the effect of distance traveled on overall survival (OS) of AML patients treated at an academic center. Patients and Methods: AML patients diagnosed at the University of Nebraska Medical Center were divided into 4 groups according to the shortest distance between the cancer center and patients’ residence (<25, 25-50, 50-100, and > 100 miles). Chi-square test and ANOVA were used to examine the association of distance with patient characteristics. OS, defined as the time from diagnosis of AML to death from any cause, was determined by the Kaplan-Meier method. Comparison of survival curves was done by the log-rank test. Multivariable analysis using Cox regression was performed to detect the survival effect of distance from the cancer center. Results: The total number of patients was 449. Median distance was 85 miles (interquartile range, 20-180). OS at 1 year for < 25, 25-50, 50-100, and > 100 miles was 45%, 55%, 38%, and 40% respectively (P = .6). In a Cox regression analysis, distance from treatment center, as a continuous variable, was not a significant factor for death (hazard ratio, 1.001; 95% confidence interval, 1.000-1.001). Multivariable analysis showed nonsignificant trend of increased mortality for patients traveling > 100 miles to a cancer center. Conclusion: This study did not demonstrate an association between distance from an academic cancer center and OS in AML. This finding should provide some assurance to patients who live farther away from academic centers.
AB - Introduction: Patients living farther away from academic centers may not have easy access to resources for management of acute myeloid leukemia (AML). We aimed to analyze the effect of distance traveled on overall survival (OS) of AML patients treated at an academic center. Patients and Methods: AML patients diagnosed at the University of Nebraska Medical Center were divided into 4 groups according to the shortest distance between the cancer center and patients’ residence (<25, 25-50, 50-100, and > 100 miles). Chi-square test and ANOVA were used to examine the association of distance with patient characteristics. OS, defined as the time from diagnosis of AML to death from any cause, was determined by the Kaplan-Meier method. Comparison of survival curves was done by the log-rank test. Multivariable analysis using Cox regression was performed to detect the survival effect of distance from the cancer center. Results: The total number of patients was 449. Median distance was 85 miles (interquartile range, 20-180). OS at 1 year for < 25, 25-50, 50-100, and > 100 miles was 45%, 55%, 38%, and 40% respectively (P = .6). In a Cox regression analysis, distance from treatment center, as a continuous variable, was not a significant factor for death (hazard ratio, 1.001; 95% confidence interval, 1.000-1.001). Multivariable analysis showed nonsignificant trend of increased mortality for patients traveling > 100 miles to a cancer center. Conclusion: This study did not demonstrate an association between distance from an academic cancer center and OS in AML. This finding should provide some assurance to patients who live farther away from academic centers.
KW - Academic center
KW - Hematopoietic cell transplantation
KW - Outcome
KW - Prognosis
KW - Transplant
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U2 - 10.1016/j.clml.2020.05.016
DO - 10.1016/j.clml.2020.05.016
M3 - Article
C2 - 32660903
AN - SCOPUS:85087745588
SN - 2152-2650
VL - 20
SP - e685-e690
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 10
ER -