A nationwide analysis of inpatient mortality for patients with leukemia with iron deficiency anemia.

person Benjamin Olufemi Adegbite Mount Sinai Morningside/West, New York, NY info_outline Benjamin Olufemi Adegbite, Lawrence Cytryn

Authors person Benjamin Olufemi Adegbite Mount Sinai Morningside/West, New York, NY info_outline Benjamin Olufemi Adegbite, Lawrence Cytryn Organizations Mount Sinai Morningside/West, New York, NY, Icahn School of Medicine at Mount Sinai, New York, NY Abstract Disclosures Research Funding No funding sources reported Background: Leukemia consists of multiple diverse disorders which confer varying morbidities and an increased risk of mortality. Iron deficiency anemia (IDA) is much more common, and while non-malignant, has also been shown to have an association with increased mortality. Despite the probability of these two hematological conditions coexisting, the interaction between them has yet to be closely studied. This retrospective cohort study aims to help elucidate how IDA affects mortality in patients with leukemia. Methods: Data was obtained from the 2017 – 2019 versions of the National Inpatient Sample (NIS) database from the Healthcare Cost and Utilization Project (HCUP) using ICD-10 codes. Patients with all forms of leukemia were identified and then placed into 4 categories: acute myeloid leukemia (AML), acute lymphocytic anemia (ALL), chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL). Lastly, a multivariate regression model was used (adjusted for age, sex, race, median household income based on patient ZIP code, Charleston Comorbidity Index score, hospital region, hospital teaching status based on rural/urban setting) to calculate the adjusted odds ratio (aOR) for the association between the presence of IDA and inpatient mortality. A significance level of p < 0.05 was used throughout. Results: The sample population consisted of leukemia patients with or without IDA. In total, there were 162,873 patients with all ICD-10 coded forms of leukemia, with 5,710 (3.51%) having IDA. Furthermore, this cohort was found to be older than non-IDA leukemia patients (71.1 ± 0.45 years and 59.2 ± 0.71 years with p < 0.05, respectively). With inpatient mortality as the outcome, the multivariate regression analysis performed for the entire sample showed that the odds of mortality while having IDA was 0.65 times that of not having IDA (95% CI 0.56 – 0.76, p < 0.001). When the analysis was then applied to each of the 4 leukemia categories, the IDA cohort still had lower odds of mortality with CLL (aOR 0.73, 95% CI 0.56 – 0.96; p = 0.024). Conclusions: The analyses show that iron deficiency anemia was generally not associated with increased mortality among leukemia patients, particularly those with CLL. This seemingly counterintuitive result warrants further research to confirm these findings and explore possible underlying mechanisms.