Frailty assessment to individualize treatment in older patients with lymphoma.
Comprehensive geriatric assessment
Frailty
Geriatric care
Hematologic neoplasm
Lymphoma
Oncogeriatric
Journal
European geriatric medicine
ISSN: 1878-7649
Titre abrégé: Eur Geriatr Med
Pays: Switzerland
ID NLM: 101533694
Informations de publication
Date de publication:
12 Oct 2023
12 Oct 2023
Historique:
received:
20
06
2023
accepted:
19
09
2023
medline:
12
10
2023
pubmed:
12
10
2023
entrez:
12
10
2023
Statut:
aheadofprint
Résumé
A study analyzing the application of a protocol of comprehensive geriatric assessment (CGA) in older patients with lymphoma was carried out to allow frailty-based patient classification and individualized treatment. Lymphoma patients older than 70 years referred to the Geriatric Clinic at a tertiary hospital between May 2016 and March 2021 were included. The assessment protocol included comorbidity, polypharmacy, nutritional, functional, and mental status, geriatric syndromes, and life expectancy. CGA enabled patient classification into four groups (Type I to Type IV) based on frailty assessment instrument scoring and clinical, functional, and mental status. Variables were compared using parametric and non-parametric statistical tests and Kaplan-Meier survival curves. Ninety-three patients (55.9% women) were included. Median age was 81.1 years (± 5.7). 23 patients (24.7%) were classified as robust (type I), 30 (32.3%) as pre-frail (type II) with potentially reversable deficits, 38 (40.9%) as frail (type III), and 2 (2.2%) as requiring palliative care (type IV). Patients received oncospecific treatment with modifications carried out in 64.5% of cases based on CGA results. Differences in overall survival (p = 0.002), response to treatment (p < 0.001) and likelihood of increased frailty (p = 0.024) were observed, with type III-IV patients showing significantly worse outcomes. Performance of standardized, systematic CGA by geriatricians permits older lymphoma patients to be classified according to frailty, with significant differences in terms of clinical outcomes across groups. We propose incorporating CGA performed by geriatricians as part of the multidisciplinary care team to optimize therapeutic strategy for these patients.
Identifiants
pubmed: 37823983
doi: 10.1007/s41999-023-00870-2
pii: 10.1007/s41999-023-00870-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Pfizer
ID : 56565519
Informations de copyright
© 2023. The Author(s).
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