Simplified Geriatric Assessment in Older Patients With Diffuse Large B-Cell Lymphoma: The Prospective Elderly Project of the Fondazione Italiana Linfomi
| Autor: | Barbara Botto, Eliza A Hawkes, Allison Barraclough, Dario Marino, Maria Christina Cox, Simone Ferrero, Michele Merli, L. Flenghi, Angela Ferrari, Benedetta Puccini, Carlos S. Chiattone, Giuseppe Tarantini, Alice Di Rocco, Manuela Zanni, Michele Spina, Marcia Torresan Delamain, Luigi Rigacci, Monica Tani, Francesca Re, Luca Nassi, Emanuele Cencini, Isabel Alvarez, Chiara Bottelli, Giuseppina Cabras, Alessandro Re, Francesco Merli, Annalia Molinari, Alessandra Tucci, Sofia Kovalchuk, Monica Balzarotti, Elsa Pennese, Federica Cavallo, Arben Lleshi, Luigi Marcheselli, Stefan Hohaus, Sara Veronica Usai, Gerardo Musuraca, Emanuela Chimienti, Vittorio Ruggero Zilioli, Roberto Sartori, Caterina Mammi, Guido Gini, Alberto Fabbri, Stefano Luminari, Annalisa Arcari |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Aged
80 and over Cancer Research medicine.medical_specialty business.industry MEDLINE Geriatric assessment medicine.disease lymphoma geriatric assessment Lymphoma Prognostic score Oncology Older patients Internal medicine medicine Humans Lymphoma Large B-Cell Diffuse Prospective Studies business Geriatric Assessment Diffuse large B-cell lymphoma Aged |
| ISSN: | 0236-4050 |
| Popis: | PURPOSE To prospectively validate the use of a simplified geriatric assessment (sGA) at diagnosis and to integrate it into a prognostic score for older patients with diffuse large B-cell lymphoma (DLBCL). METHODS We conducted the prospective Elderly Project study on patients with DLBCL older than 64 years who underwent our Fondazione Italiana Linfomi original geriatric assessment (oGA) (age, Cumulative Illness Rating Scale for Geriatrics, activities of daily living, and instrumental activities of daily living) before treatment. Treatment choice was left to the physician's discretion. The primary end point was overall survival (OS) (ClinicalTrials.gov identifier: NCT02364050 ). RESULTS We analyzed 1,163 patients (median age 76 years), with a 3-year OS of 65% (95% CI, 62 to 68). Because at multivariate analysis on oGA, age > 80 years retained an independent correlation with OS, we also developed a new, simplified version of the GA (sGA) that classifies patients as fit (55%), unfit (28%), and frail (18%) with significantly different 3-year OS of 75%, 58%, and 43%, respectively. The sGA groups, International Prognostic Index, and hemoglobin levels were independent predictors of OS and were used to build the Elderly Prognostic Index (EPI). Three risk groups were identified: low (23%), intermediate (48%), and high (29%), with an estimated 3-year OS of 87% (95% CI, 81 to 91), 69% (95% CI, 63 to 73), and 42% (95% CI, 36 to 49), respectively. The EPI was validated using an independent external series of 328 cases. CONCLUSION The Elderly Project validates sGA as an objective tool to assess fitness status and defines the new EPI to predict OS of older patients with DLBCL. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|