e18555 Background: Among adults ages 20 and older with Acute Myeloid Leukemia (AML), 5-year relative survival is 30% and less for older patients. 1 With the average age at diagnosis of 68 years, less intense therapies are increasingly being used. 2 The decision for more-or less-intensive initial induction is largely based on chronological age and performance status. However, comorbidity indices have been shown to more accurately predict outcome. Patient reported outcomes (PRO) are needed to provide additional insight into treatment (TX) outcomes. This retrospective study sought to characterize patients using an electronic PRO (ePRO) system receiving intense and less intense treatment. Methods: Patients starting AML TX were enrolled in an ePRO system from 9/2020 to 9/2025. Baseline surveys included demographic data, symptoms (PRO-CTCAE), physical activity (PROMIS 4a), frailty (Cancer and Aging Resilience Evaluation Survey, CARES), and smoking status. TX data was sourced from the electronic medical record or entered directly into the platform. Symptom (SX) surveys were completed weekly throughout TX. Treatment bother (TXB) was measured by FACT-GP5 (“I am bothered by side effects of TX”). Biomarkers were characterized as high or favorable risk. SX reports at baseline, 6 and 12 weeks were analyzed using Fishers Exact Test. Results were stratified by intensive treatment (IT) defined as receiving idarubicin or daunorubicin plus cytarabine or less Intensive treatment (LIT) defined as azacitidine or decitabine plus venetoclax. Results: Eligible participants (n=164) were median age 68 (range=24-88), 52% (n=85) male, 79% (n=130) white, and 45% (n=28) current/former smokers. Of those completing CARE, 29% (n=36) were Frail/preFail and of 56 completing PROMIS 4a, 31% (n=17) reported altered mobility. 48% (n=74) received IT and 52% (n=85) received LIT. The IT group were median 61 years (range=24-74), 51% (n=40) male, 80% (n=63) white, and 33% (10 of 27) current/former smokers. Physically, 23% (13 of 57) were Frail/preFail and 25% (8 of 32) reported altered mobility. The LIT group were median 75 years (range=37-88), 53% (n=45) male, 52% (n=67) white and 52% (18 of 35) were current/former smokers. Physically, 33% (23 of 67) were Frail/preFail and 33% (9 of 24) reported altered mobility. The LIT group had more vomiting (p=.001) at baseline and more general pain and fatigue at 12 w (p=.04 for both.) The high-risk biomarker group was associated with receipt of LIT (p=0.004). The favorable risk group showed a non-significant trend towards receiving IT (p=0.069). Conclusions: Although the LIT group was older, more minority, more current/former smokers and were frailer and with more reported altered mobility, symptom prevalence and TB was similar to the IT group at three timepoints. Further examination of symptom severity and TB over the entire treatment period is warranted.
Jamy et al. (Thu,) studied this question.