Patient Characteristics, Clinical Management and Costs of Patients With Newly Diagnosed Acute Myeloid Leukemia From Finland

OBJECTIVES: This study described patient characteristics, treatment patterns and healthcare resource utilisation (HCRU) of newly diagnosed patients with acute myeloid leukaemia (AML).

METHODS: This non-interventional, retrospective registry-based study included data from 866 patients with AML (diagnosed 2007–2023) in the Helsinki University Hospital district. The primary objective was to describe patient demographic and clinical characteristics. Secondary objectives included: FMS-like tyrosine kinase 3 (FLT3) mutation testing rate, treatment patterns, overall survival (OS), and HCRU.

RESULTS: In the overall cohort, 591/866 (68.2%) patients underwent FLT3 testing and 128/591 (21.7%) had an FLT3 aberration (FLT3+; FLT3 cohort). FLT3 cohort patients were younger at diagnosis compared to the overall cohort. Baseline FLT3 inhibitor use was greater in the FLT3 (20.3%) vs overall cohort (4.3%).

At any time during the study period, 57.0% and 77.0% of patients in overall and FLT3 cohorts, respectively, were treated with high-intensity chemotherapy (HIC). FLT3 inhibitor use were more frequent in FLT3 vs overall cohorts (midostaurin [16.0% vs 3.0%], sorafenib [12.0% vs 2.0%] and gilteritinib [8.0% vs 2.0%]). Compared with the overall cohort, FLT3 cohort patients received more allogeneic haematopoietic stem cell transplants (HSCT) (25.4% vs 38.3%). In patients treated with HIC, median OS (95% CI) was 5.1 (3.7–9.8) and 1.5 (1.3–8.5) years in FLT3-wildtype and FLT3+ patients, respectively.

The FLT3 vs overall cohort had greater total healthcare cost accumulation excluding treatments per patient (€157,669 vs €119,703). Particularly, costs associated with inpatient care and procedures were elevated.

In both cohorts, the initial stages (first 12 months) of treatment incurred the highest costs and subsequently stabilised.

CONCLUSIONS: Patients with FLT3+ AML were generally younger and treated more frequently with HIC and HSCT, contributing to higher HCRU yet poorer OS. Further work is required to compare the cost profiles of patients with similar prognoses with or without FLT3 inhibitor treatment.