Alfonso José Cruz-Jentoft1, Bernardo González2, Javier de la Rubia3, José Ángel Hernández Rivas4, Juan Alfonso Soler5, Carlos Fernández Lago6, Mario Arnao7, Mercedes Gironella8, Ernesto Pérez Persona9, María Teresa Zudaire10, Carmen Olivier11, Alberto Altés12, Antonio García Guiñón13, Benet Nomdedeu14, Montserrat Arnan15, Ángel Ramírez Payer16, Pedro Sánchez-Godoy17, Nuria Pajuelo18, David Vilanova19, Diego Fernánez Monjil19, Santiago Bonanad3. 1. Geriatric Department, H.U. Ramón y Cajal, Ctra. de Colmenar Viejo, km. 9, 100, 28034 Madrid, Spain. Electronic address: alfonsojose.cruz@salud.madrid.org. 2. Hematology Department, H.U. de Canarias, Ctra. Ofra, s/n, 38320 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain. 3. Hematology Department, H. U. La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain. 4. Hematology Department, H.U. Infanta Leonor, Avenida Gran Vía del Este, 80, 28031 Madrid, Spain. 5. Hematology Department, C.S. Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Barcelona, Spain. 6. Hematology Department, C.H.U. A Coruña, As Xubias, 84, 15006, A Coruña, Spain. 7. Hematology Department, H.U. de La Ribera, Carretera Corbera, km 1, 46600 Alzira, Valencia, Spain. 8. Hematology Department, H. U. Vall d'Hebrón, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain. 9. Hematology Department, H.U. Txagorritxu, c/Jose Atxotegi, s/n, 01009 Vitoria-Gasteiz, Álava, Spain. 10. Hematology Department, C.H. de Navarra, Av. Pío XII, 36, 31008, Pamplona, Navarra, Spain. 11. Hematology Department, C.H. de Segovia, c/de Miguel Servet, s/n, Segovia, Spain. 12. Hematology Department, H. Sant Joan de Déu, C/Joan Soler 1-3, 08243 Manresa, Barcelona, Spain. 13. Hematology Department, H.U. Arnau de Vilanova, Avenida Alcalde Rovira Roure, 80, 25198 Lleida, Spain. 14. Hematology Department, Hospital Clínic de Barcelona, Carrer Villarroel, 170, 08036 Barcelona, Spain. 15. Hematology Department, Catalan Institute of Oncology, IDIBELL, Hospital Duran i Reynals, Avinguda Granvia de l'Hospitalet, 199-203, 08908 l'Hospitalet de Llobregat, Barcelona, Spain. 16. Hematology Department, H.U. Central de Asturias, Calle Carretera de Rubín, s/n, 33011 Oviedo, Spain. 17. Hematology Department, Hospital Universitario Severo Ochoa, Avenida de Orellana, s/n, 28911 Leganés, Madrid, Spain. 18. Dynamic Science S.L., c/Azcona, 31, 28028 Madrid, Spain. 19. Celgene S.L.U., Paseo de Recoletos, 37, 28004 Madrid, Spain.
Abstract
OBJECTIVES: The purpose of this study was to assess the responsiveness of the newly developed Geriatric Assessment in Hematology (GAH) scale to clinical change in older patients diagnosed with hematologic malignancies. METHODS: A prospective observational study conducted in 164 patients aged ≥65years and diagnosed with myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML), multiple myeloma (MM), or chronic lymphocytic leukemia (CLL). Responsiveness of the GAH scales was studied by means of the Eastern Cooperative Oncology Group (ECOG) score, the Karnofsky performance status (KPS) score, the visual analog scale (VAS), and the physician's subjective assessment, used as clinical anchors to identify whether patients had changed clinically (either improved or worsened) or not since the baseline visit. Responsiveness was evaluated on the basis of effect size (ES). RESULTS: 164 patients (men, 63.7%; median age, 77.0 (72.8-81.4) participated. Statistically significant correlations were obtained between the investigator's qualitative assessment and changes in ECOG, KPS, and VAS scores. Likewise, a statistically significant correlation was obtained between the investigator's qualitative assessment and changes in the GAH scale score. Responsiveness of the GAH scale to detect clinical change was satisfactory (ES 0.34). CONCLUSION: Findings confirm that the GAH scale is responsive to clinical changes in patients' health status. Additionally, the GAH scale is a promising tool to improve clinical decision-making in older patients with hematological malignancies.
OBJECTIVES: The purpose of this study was to assess the responsiveness of the newly developed Geriatric Assessment in Hematology (GAH) scale to clinical change in older patients diagnosed with hematologic malignancies. METHODS: A prospective observational study conducted in 164 patients aged ≥65years and diagnosed with myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML), multiple myeloma (MM), or chronic lymphocytic leukemia (CLL). Responsiveness of the GAH scales was studied by means of the Eastern Cooperative Oncology Group (ECOG) score, the Karnofsky performance status (KPS) score, the visual analog scale (VAS), and the physician's subjective assessment, used as clinical anchors to identify whether patients had changed clinically (either improved or worsened) or not since the baseline visit. Responsiveness was evaluated on the basis of effect size (ES). RESULTS: 164 patients (men, 63.7%; median age, 77.0 (72.8-81.4) participated. Statistically significant correlations were obtained between the investigator's qualitative assessment and changes in ECOG, KPS, and VAS scores. Likewise, a statistically significant correlation was obtained between the investigator's qualitative assessment and changes in the GAH scale score. Responsiveness of the GAH scale to detect clinical change was satisfactory (ES 0.34). CONCLUSION: Findings confirm that the GAH scale is responsive to clinical changes in patients' health status. Additionally, the GAH scale is a promising tool to improve clinical decision-making in older patients with hematological malignancies.