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. 2021 May;106(5):616-626.
doi: 10.1111/ejh.13570. Epub 2021 Feb 14.

Impact of a comprehensive geriatric assessment on decision-making in older patients with hematological malignancies

Marie Garric  1 , Sandrine Sourdet  1 , Bastien Cabarrou  2 , Zara Steinmeyer  1 , Martin Gauthier  3 , Loïc Ysebaert  3   4 , Odile Beyne-Rauzy  5 , Stephane Gerard  1 , Stephanie Lozano  1 , Delphine Brechemier  1 , Thomas Filleron  2 , Loïc Mourey  6 , Laurent Balardy  1
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Impact of a comprehensive geriatric assessment on decision-making in older patients with hematological malignancies

Marie Garric et al. Eur J Haematol. 2021 May.

Abstract

Objective: Hematological treatment decisions in older adults with hematological malignancies are complex. Our objective is to study the impact of a comprehensive geriatric assessment on hematological treatment decision in older patients and the factors associated with change in treatment plan.

Methods: We conducted a cross-sectional analysis of patients aged 65 years and above with hematological malignancies, hospitalized between 2008 and 2019 at the University Cancer Institute of Toulouse. They were assessed by a geriatrician/nurse team using a comprehensive geriatric assessment (CGA). A penalized logistic regression model with elastic net regularization was used to identify factors associated with change in hematological treatment plan.

Results: A total of 424 patients were included. Main hematological malignancies were lymphoma (36.1 %), acute myeloid leukemia (26.9 %) and myelodysplastic syndrome (19.8%). Change in hematological treatment plan was suggested after CGA for 92 patients (21.7%). Factors associated with change in treatment plan were functional impairment according to ADL and IADL scale, mobility impairment, the presence of comorbidity defined by the Charlson score >1 and increasing age.

Conclusion: A CGA has a significant impact on hematological treatment decision in older patients. Functional and mobility impairment, comorbidities and age are predictive factors of change in treatment plan.

Keywords: geriatric assessment; hematological malignancies; older patients; oncogeriatric.

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References

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