Morgani Rodrigues1, Polianna Mara Rodrigues de Souza2, Ludmila de Oliveira Muniz Koch3, Nelson Hamerschlak4. 1. Department of Hematology, Hospital Israelita Albert Einstein, São Paulo (SP), Brazil. Electronic address: morgani.rodrigues@einstein.br. 2. Geriatrician of department of Oncology and Hematology, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: polianna.souza@einstein.br. 3. Department of Oncology, Hospital Israelita Albert Einstein, São Paulo (SP), Brazil. Electronic address: ludmila.koch@einstein.br. 4. Department of Hematology, Hospital Israelita Albert Einstein, São Paulo (SP), Brazil. Electronic address: hamer@einstein.br.
Abstract
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.
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.
Authors: Patrick J Smith; Meagan Lew; Yen Lowder; Kristi Romero; Jillian C Thompson; Lauren Bohannon; Alyssa Pittman; Alexandra Artica; Sendhilnathan Ramalingam; Taewoong Choi; Cristina Gasparetto; Mitchell Horwitz; Gwynn Long; Richard Lopez; David Rizzieri; Stefanie Sarantopoulos; Keith Sullivan; Nelson Chao; Anthony D Sung Journal: Bone Marrow Transplant Date: 2021-10-19 Impact factor: 5.483
Authors: Ellen R M Scheepers; Ariel M Vondeling; Noortje Thielen; René van der Griend; Reinhard Stauder; Marije E Hamaker Journal: Haematologica Date: 2020-05-07 Impact factor: 9.941