Photo by Bo Jungmayer
The Clinical Research Division's Dr. Mohamed Sorror is the recipient of a four-year, $951,000 Research Scholar Grant from the American Cancer Society. The grant will fund Sorror's study titled "Improving Outcomes of Older and Medically Infirm Patients with AML (acute myeloid leukemia)."
"Currently, there are no data on measures of organ dysfunctions to predict the tolerability of older patients with newly diagnosed leukemia to treatment with chemotherapy or their chances to proceed to a potentially curative procedure such as allogeneic transplants," Sorror said. "This grant will enable us to develop tools and generate decision-making information to guide therapeutic choices for these patients."
In 2011 Sorror and colleagues reported in the Journal of the American Medical Association that allogeneic HCT after a conditioning regimen with minimal intensity is well-tolerated by older patients. However, to date there are no studies describing which factors play major roles in the decision to refer older patients to allogeneic transplants. "Moreover, there are no available comparison data between allogeneic HCT and additional chemotherapy for older patients who survive the initial therapy," Sorror said.
Sorror will perform multi-institutional studies to generate a new index to measure the burden of organ dysfunctions and a risk-factor model to assess risks of mortality and to determine appropriate choices for therapy. He also plans a longitudinal observation study to investigate which factors influence the path of older patients to allogeneic transplants versus additional chemotherapy.
Information gained will be used to:
- Provide an evidence-based system to determine patient eligibility for additional therapy
- Propose novel interventions to prophylactically prevent chemotherapy-induced organ dysfunctions that might limit future chances of treatment or to develop educational materials if a lack of knowledge on the suitability of a treatment approach by the patient/physician is a barrier to therapy.
"We will also analyze whether the potential morbidity and mortality after allogeneic transplants is justifiable for older AML patients by comparing survival, quality of life and quality-adjusted survival between patients treated with transplants versus conventional chemotherapy," Sorror said.
These comparisons will help physicians identify patients who will benefit best by transplantation or chemotherapy, as well as those who will not benefit from either treatment. Using the risk-factor model, Sorror and colleagues will attempt to identify a group of patients to possibly target in the future in a national prospective study randomizing patients between transplants and chemotherapy.
The Clinical Research Division's Drs. Elihu Estey, Stephanie Lee, Barry Storer, Fred Appelbaum and Rainer Storb all are consultants on the project, which includes collaborators from Stanford University, Oregon Health & Science University and the University of Utah.