Hilberink, Jacobien RJacobien RHilberinkvan Zeventer, Isabelle AIsabelle Avan ZeventerChitu, Dana ADana AChituPabst, Thomas NiklausThomas NiklausPabstKlein, Saskia KSaskia KKleinStussi, GeorgGeorgStussiGriskevicius, LaimonasLaimonasGriskeviciusValk, Peter J MPeter J MValkCloos, JacquelineJacquelineCloosvan de Loosdrecht, Arjan AArjan Avan de LoosdrechtBreems, DimitriDimitriBreemsvan Lammeren-Venema, DanielleDaniellevan Lammeren-VenemaBoersma, RinskeRinskeBoersmaJongen-Lavrencic, MojcaMojcaJongen-LavrencicFehr, MartinMartinFehrHoogendoorn, MelsMelsHoogendoornManz, Markus GMarkus GManzSöhne, MaaikeMaaikeSöhnevan Marwijk Kooy, RienRienvan Marwijk KooyDeeren, DriesDriesDeerenvan der Poel, Marjolein W MMarjolein W Mvan der PoelLegdeur, Marie CecileMarie CecileLegdeurTick, LidwineLidwineTickChalandon, YvesYvesChalandonAmmatuna, EmanueleEmanueleAmmatunaBlum, SabineSabineBlumLöwenberg, BobBobLöwenbergOssenkoppele, Gert JGert JOssenkoppeleHuls, GerwinGerwinHuls2024-10-252024-10-252023-06-19https://boris-portal.unibe.ch/handle/20.500.12422/167950Treatment choice according to the individual conditions remains challenging, particularly in older patients with acute myeloid leukemia (AML) and high risk myelodysplastic syndrome (MDS). The impact of performance status, comorbidities, and physical functioning on survival is not well defined for patients treated with hypomethylating agents. Here we describe the impact of performance status (14% ECOG performance status 2), comorbidity (40% HCT-comorbidity index ≥ 2), and physical functioning (41% short physical performance battery < 9 and 17% ADL index < 6) on overall survival (OS) in 115 older patients (age ≥ 66 years) treated on a clinical trial with a 10-day decitabine schedule. None of the patient-related variables showed a significant association with OS. Multivariable analysis revealed that age > 76 years was significantly associated with reduced OS (HR 1.58; p = 0.043) and female sex was associated with superior OS (HR 0.62; p = 0.06). We further compared the genetic profiles of these subgroups. This revealed comparable mutational profiles in patients younger and older than 76 years, but, interestingly, revealed significantly more prevalent mutated ASXL1, STAG2, and U2AF1 in male compared to female patients. In this cohort of older patients treated with decitabine age and sex, but not comorbidities, physical functioning or cytogenetic risk were associated with overall survival.en600 - Technology::610 - Medicine & healtharticle10.48350/1835463733689010.1038/s41408-023-00850-6