BSH25-PO146 A role for frailty assessments in frail and older adults diagnosed with Acute Myeloid Leukaemia

Published Date: 01st April 2025

Publication Authors: Garth. L

Abstract
Acute Myeloid Leukaemia (AML) has a median age at diagnosis of 70 years old. It is therefore vital that assessments of frailty, particularly as an aid to prognostication, become priority for centres treating AML. The need for a holistic approach to treatment in frail and older patients has been gaining increasing recognition in recent years, both the British and American Societies for Haematology publishing guidance specific to this in 2022 and 2020 respectively. This is a retrospective audit collating data on all patients with newly diagnosed AML aged 60 years and older in a busy district general hospital. This data forms the basis of a wider quality improvement project to streamline frailty assessments for our patients as an aid to the multidisciplinary team(MDT) in formulating appropriate treatment strategies. Data was collected in patients aged 60 years and above with a new diagnosis of AML from01/01/2022-11/06/2024 at Wirral University Teaching Hospital NHS Foundation Trust. Data was collected from electronic patient records and analysed using Microsoft Excel. Data of twenty (n=20) patients were collected. The average age at diagnosis was 76 years. At the time of data collection 50% (n=10) of patients were deceased. The average time from diagnosis to death was 6.5 months. 90% (n=18) patients had documentation of performance status and 95%(n=19) had documentation of comorbidities. MDT discussion occurred in 85% of (n=17) patients. Social history was documented for 70% (n=14) of patients. However, no patients (n=0) had formal documentation of a frailty assessment. Most patients (90%, n=18) received systemic anti-cancer therapy with 10% (n=10) receiving best supportive care. The most common regime used was Azacitidine and Venetoclax (40%, n=8). We were able to retrospectively calculate a Charlson Comorbidity Index (CCI) for 95% (n=19) of patients. The CCI predicts 10-year survival in patients with multiple comorbidities. The CCI estimated 10-year survival for this cohort of patients ranged from 0-53% with an average of 15%.This data shows the complex nature of decision making in this cohort of patients. Data required to fulfil many comprehensive geriatric assessments was already collected, allowing for retrospective calculation of the CCI for example. Use of evidenced assessments such as CCI and the Edmonton Frailty index will allow frailty assessments to be standardised and used more effectively in MDT treatment decision making. This audit will provide the foundation for a further project improving our assessments of frail and older adults.

Jeffers, L; Garth, L; Jones, E. (2026). BSH25-PO146 A role for frailty assessments in frail and older adults diagnosed with Acute Myeloid Leukaemia. British Journal of Haematology. 206(Suppl 1), p.246. [Online]. Available at: https://doi.org/10.1111/bjh.20117 [Accessed 20 February 2026]