Rehabilitation Needs of Adults With Acute Myeloid Leukemia Undergoing Oral Venetoclax and Infusional Hypomethylating Agent.

Research Objectives: To better understand the rehabilitation (occupational and physical therapy (OT/PT)) needs of adults with Acute Myeloid Leukemia at cycle 1 for treatment of oral Venetoclax (VEN) and Infusional Hypomethylating Agent (HMA).

Design: Prospective inception cohort trial (Clinicaltrial.gov #NCT04570709).

Setting: National Cancer Institute- funded, public comprehensive cancer center in Southern US, in both outpatient and inpatient settings.

Participants: Older adults (≥60 years) with newly diagnosed AML, who received HMA + VEN chemotherapy, had caregiver willing to participate, and were not referred to hospice.

Interventions: Patients were evaluated by oncology nurse, OT and PT within first week of starting treatment.

Main Outcome Measures: Possibilities for Activity Scale (PActS), Activity Measure in Post-Acute Care (AM-PAC) mobility and activities of daily living (ADL) scales, Performance Rate Assessment of Self-Care Skills (PASS, medication management and hand hygiene task), clock-drawing, Timed Up and Go (TUG), and Berg Balance Scale.

Results: Patients (N= 20) were 74.7±7.5 years, (range: 64-89), predominantly male (n=15, 75 %), White (n=18, 90%) and with some college education (n= 11, 55%). Average PActS score 43, (range 29-60), AM-PAC ADL raw scores (23.4 mean, 1.3SD, 19-24) and mobility (19.7 mean, 0.7 SD, 17-20), PASS hand hygiene and medication management, both average of 3 (range 1-3), clock drawing (n= 18) average of 12.5 (0.07 SD, 11-13), TUG average 13.1 (4.2SD, 6.6-21.0), Berg average 49.7 (5.9SD, range 39.0-56.0).

Conclusions: Older adults with AML undergoing HMA + VEN have varying needs for cancer rehabilitation services. On average, appear to only need optimization, the range of scores for all measures suggest potential needs for both rehabilitation and optimization with the goal of maintaining functional independence throughout multiple cycles. Future research should investigate patterns of functional decline and potential impact of OT/PT.

Author(s) Disclosures: This grant is funded by the National Institute of Nursing Research (NINR) R34NR019131-01A1 and UNC, Lineberger Comprehensive Cancer Center (Bryant). Pergolotti receives a salary from Select Medical.