Department of Internal Medicine, Division of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE, USA.
Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA.
Leuk Lymphoma. 2020 Jul;61(7):1702-1708. doi: 10.1080/10428194.2020.1737687. Epub 2020 Mar 11.
Polypharmacy, usually defined as taking ≥5 prescribed medications, increases chances of drug-drug interactions and toxicities, and may harm cancer patients who need multiple chemotherapeutic agents and supportive medications. We analyzed the effects of polypharmacy in overall survival (OS) in acute myeloid leukemia (AML). A total of 399 patients were divided into two groups: patients with polypharmacy (≥5 medications) versus without polypharmacy (<5 medications). Polypharmacy was associated with age ≥60 years, Karnofsky Performance Status of ≤80, hematopoietic cell transplant (HCT) comorbidity index of ≥5, and adverse cytogenetics. Patients with polypharmacy were less likely to receive intensity chemotherapy or HCT. One-year OS of patients with polypharmacy versus those without polypharmacy was 29 vs. 49% (<.001). Polypharmacy conferred worse OS in patients <60 years (37 vs. 65% at 1 year, HR 1.95, 95% CI 1.21-3.15) but not in patients ≥60 years (26 vs. 27% at 1 year, HR 1.12, 95% CI 0.81-1.57). Thus, polypharmacy has negative impact on OS in AML, particularly among patients aged <60 years.
多药治疗，通常定义为服用≥5 种规定药物，增加药物-药物相互作用和毒性的可能性，并可能损害需要多种化疗药物和支持性药物的癌症患者。我们分析了多药治疗对急性髓系白血病（AML）总生存率（OS）的影响。共有 399 名患者分为两组：多药治疗（≥5 种药物）与非多药治疗（<5 种药物）。多药治疗与年龄≥60 岁、卡氏功能状态评分≤80、造血细胞移植（HCT）合并症指数≥5 和不良细胞遗传学相关。多药治疗的患者接受强化化疗或 HCT 的可能性较低。多药治疗患者与非多药治疗患者的 1 年 OS 分别为 29%和 49%（<.001）。多药治疗在<60 岁的患者中对 OS 的影响更差（1 年时为 37%比 65%，HR 1.95，95%CI 1.21-3.15），但在≥60 岁的患者中没有影响（1 年时为 26%比 27%，HR 1.12，95%CI 0.81-1.57）。因此，多药治疗对 AML 的 OS 有负面影响，特别是在<60 岁的患者中。
