Page 32 - Haematologica - Vol. 105 n. 6 - June 2020

Publication Author
Corsetti20
Deschler21
Year Number of patients
2011 31
Type of malignancy
Results of univariate and multivariate analysis
Age PS Comorbidity ADL IADL Cognition Mood Physical Nutritional Social Polypharmacy Frailty Summarized
E.R.M. Scheepers et al.
Discussion
This systematic review of 44 studies shows that impair- ment in geriatric domains is common among older patients with a hematologic malignancy, even in those with a good performance status. The most relevant impairment is frailty (assessed with a frailty screening tool or by summarizing the geriatric assessment), which showed an association with mortality, treatment-related
toxicity and treatment non-completion. Other relevant geriatric impairments were IADL functioning, nutritional status and polypharmacy. Impaired physical capacity was mainly associated with healthcare utilization.
These data should, however, be interpreted with care. The included studies are heterogeneous in study popula- tion, design, treatment regimens, content of geriatric assessment and reported outcomes. Various hematologic malignancies can have very different disease courses and
Table 3. The association of geriatric assessment, age, performance status, and comorbidity with mortality.
2013 195 AML;MDS -- ++ ++ ++ -- -- - -- ----------++--++
------- -- --++++++--------
+++
Klepin23 2013 74 AML Klepin24 2020 40 AML (FLT3)
Molga25 2020 98 AML; MDS
Umit27 Goede28 Molica29
2018 372 AML 2016 75 CLL 2019 108 CLL
Ribi30 2017 41 B-cell lymphoma
Ong32 2019 205 DLBCL
Spina33 2012 100 DLBCL Tucci34 2009 84 DLBCL
Tucci35 2015 173 DLBCL
Aaldriks36 2015 44 NHL Naito37 2016 93 NHL
Park38 Soubeyran40 Winkelmann41
2015 70 NHL 2011 32 NHL 2011 143 NHL
Engelhardt43 2016 125 MM
Gavriatopoulou44 2019 110 MM Palumbo45 2015 869 MM
Zhong48 2017 628 MM Buckstein49 2016 445 Various
Deschler50 Dubruille52 Dumontier53
2018 106 2015 90 2019 452
Various Various Various
Hamaker54 2016 157 Various
Huang55 2020 148 Various Lin56 2020 457 Various
Liu57 2019 448 Various Muffly58 2014 203 Various
Nawas59 2019 184 Various
Rollot-Trad61 2008 54 Various
Proportion of studies with a significant association in univariate analysis
Proportion of studies with a significant
+:association in univariate analysis;-:no association in univariate analysis;++:association in multivariate analysis;- -:no association in multivariate analysis;NA:not applicable.PS:World Health Organization performance status; ADL: activities of daily living; IADL: instrumental activities of daily living; GA: geriatric assessment; AML: acute myeloid leukemia; RAEB: refractory anemia with excess of blasts; MDS: myelodysplastic syndrome; FLT3: FMS-like tyrosine kinase-3; CLL: chronic lymphocytic leukemia; DLBCL: diffuse large B-cell lymphoma; NHL: non-Hodgkin lymphoma; MM: multiple myeloma.
capacity status support
screening GA score tool
AML; RAEB -
-
association in multivariate analysis
--------
++++++++ ++
---+-+
++ ---- ++
+ ++++ ++
-++ --++-+++- -
----++- ++++
---- -- --++
+++ ++
--
++--++++
-------- - ++++++++
++++--+- ++---++-----
------++
------ ++
-++- +++--++
++++++ ++-++-++ ++
--+++
---- ------
79% 63% 64% 67% 74% 55% 14% 63% 33% 33% 0% 71% 67%
43% 27% 47% 40% 62% 50% 0% 50% 50% NA NA 75% 100%
1490
haematologica | 2020; 105(6)