Time at home is a critically important outcome to adults with acute myeloid leukemia (AML) when selecting treatment; however, no study to date has adequately described the amount of time older adults spend at home following initiation of chemotherapy. We queried records from a multi-institution health system to identify adults age ≥60 newly diagnosed with AML treated with azacitidine (AZA) or venetoclax (VEN) and evaluated the proportion of days at home (PDH) following diagnosis. Days were considered “at home” if patients were not admitted or seen in the emergency department or oncology/infusion clinic. Assessed covariates included demographics and disease risk. Associations between PDH and baseline characteristics were evaluated via linear regression, adjusted for log length of follow-up. From 2015-2020, 113 older adults were identified. Most received AZA+VEN (51.3%) followed by AZA monotherapy (38.9%). Mean PDH for all patients was 0.58 (95% confidence interval 0.54-0.63, median 0.63). PDH increased among survivors over time. PDH did not differ between therapy groups (adjusted mean, AZA+VEN: 0.68; AZA monotherapy: 0.66; p=0.64) or between disease risk categories (p=0.34). Compared to AZA monotherapy, patients receiving AZA+VEN had longer clinic visits (median minutes: 127.9 vs. 112.9, p<0.001) and infusion visits (194.3 vs. 132.5, p<0.001). The burden of care for older adults with AML treated with “less-intense” chemotherapy is high. The addition of VEN to AZA did not translate into increased time at home. Future prospective studies should evaluate patient-centered outcomes including time at home to inform shared decision-making and drug development.
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