The use of comprehensive geriatric assessment in older patients before allologeneic hematopoietic stem cell transplantation: A cross-sectional study.

Autor: Rodrigues M; Department of Hematology, Hospital Israelita Albert Einstein, São Paulo (SP), Brazil. Electronic address: morgani.rodrigues@einstein.br., de Souza PMR; Geriatrician of department of Oncology and Hematology, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: polianna.souza@einstein.br., de Oliveira Muniz Koch L; Department of Oncology, Hospital Israelita Albert Einstein, São Paulo (SP), Brazil. Electronic address: ludmila.koch@einstein.br., Hamerschlak N; Department of Hematology, Hospital Israelita Albert Einstein, São Paulo (SP), Brazil. Electronic address: hamer@einstein.br.
Jazyk: angličtina
Zdroj: Journal of geriatric oncology [J Geriatr Oncol] 2020 Jan; Vol. 11 (1), pp. 100-106. Date of Electronic Publication: 2019 Jun 20.
DOI: 10.1016/j.jgo.2019.05.022
Abstrakt: Objectives: To evaluate the results of the comprehensive geriatric assessment (CGA) before allogeneic hematopoietic stem cell (HSCT) transplantation in patients aged 60 years and over.
Methods: We evaluated all consecutive patients undergoing CGA before HSCT between September 2011 and July 2018 in a private hospital in Brazil. We also evaluated the Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-SCI) and the Disease Risk Index (DRI).
Results: During the study period, 61 patients were referred for transplant evaluation. After exclusions, we analyzed 40 patients, with a mean age of 67.6 years (60-76). The CGA detected vulnerability and frailty in 43% and 18.9% respectively according to the Fried Frailty Phenotype score; limitations across the domain of function and disability with handgrip test alterations in 65.8%. However, 36 (90%) were independent for instrumental activities of daily living (IADL). Cognitive and depression domain have shown abnormal with the clock test in 44.4%, and loss of memory complains in 37.5%. But the mini-mental test was normal in 89%. Geriatric Depression Scale (GDS) was normal in 82.5%. 30% were considered at risk for malnutrition. Half of the patients (50%) had a high Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) score. 32.5% needed ICU admission. The overall survival and non-relapse mortality at 2 years were 41.8% and 38.7% respectively.
Conclusion: The CGA was feasible in detecting the patients' vulnerabilities in our population. More studies, multicentric and with a larger number of patients, are needed to evaluate the role of CGA in this context of allo-HCT in our population.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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