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. 2020 Oct;105(4):399-407.
doi: 10.1111/ejh.13457. Epub 2020 Jul 2.

Application of comprehensive geriatric assessment in predicting early mortality among elder patients with B-cell lymphoma receiving immunochemotherapy

Wen-Chi Chou  1 , Hung Chang  1 , Po-Nan Wang  1 , Ming-Chung Kuo  1 , Jin-Hou Wu  1 , Tung-Liang Lin  1 , Yi-Jiun Su  1 , Hsiao-Wen Kao  1 , Che-Wei Ou  1 , Chia-Yen Hung  1   2 , Shun-Wen Hsueh  3 , Yu-Shin Hung  1
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Application of comprehensive geriatric assessment in predicting early mortality among elder patients with B-cell lymphoma receiving immunochemotherapy

Wen-Chi Chou et al. Eur J Haematol. 2020 Oct.

Abstract

Objectives: Early mortality, defined as death within 120 days after initiated antitumor therapy, is an important issue especially for elder patients with B-cell lymphoma. This study aimed to evaluate the clinical value of comprehensive geriatric assessment (CGA) in early mortality prediction in elderly patients with B-cell lymphoma receiving immunochemotherapy.

Methods: Seventy-six consecutive patients with newly diagnosed B-cell lymphoma receiving immunochemotherapy from a medical center in Taiwan were prospectively enrolled. Patients were divided into fit (n = 49) and frail (n = 27) groups per pretreatment CGA for early mortality comparison.

Results: The early mortality rate in our patient cohort was 16% (n = 12): from 6% in patients with no CGA domain impairment to 43% in patients with ≥4 CGA domain impairment. The early mortality rate was 6% and 33% in fit and frail patients (odds ratio, 7.67; 95% CI, 1.86-31.6; P = .005), respectively. Frailty was the significant predictor for early mortality in univariate and multivariate analysis.

Conclusion: In this study, the number of geriatric domain impairment is positively associated with the early mortality risk in elderly patients with B-cell lymphoma. Therefore, CGA can help clinicians to identify the risk of early mortality in elderly patients and provide alternative treatment.

Keywords: early mortality; frailty assessment; non-Hodgkin lymphoma; rituximab.

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References

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