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. 2023 Dec;14(6):1393-1402.
doi: 10.1007/s41999-023-00870-2. Epub 2023 Oct 12.

Frailty assessment to individualize treatment in older patients with lymphoma

Ana I Hormigo-Sanchez  1   2   3 , Alberto Lopez-Garcia  4   5   6 , Ignacio Mahillo-Fernandez  7 , Elham Askari  4 , Daniel Morillo  4 , María A Perez-Saez  4 , Miriam Riesco  5 , Celia Urrutia  5 , Francisco J Martinez-Peromingo  8 , Raúl Cordoba #  4   5   6 , Juan I Gonzalez-Montalvo #  9   10   11
Affiliations

Frailty assessment to individualize treatment in older patients with lymphoma

Ana I Hormigo-Sanchez et al. Eur Geriatr Med. 2023 Dec.

Abstract

Purpose: A study analyzing the application of a protocol of comprehensive geriatric assessment (CGA) in older patients with lymphoma was carried out to allow frailty-based patient classification and individualized treatment.

Methods: Lymphoma patients older than 70 years referred to the Geriatric Clinic at a tertiary hospital between May 2016 and March 2021 were included. The assessment protocol included comorbidity, polypharmacy, nutritional, functional, and mental status, geriatric syndromes, and life expectancy. CGA enabled patient classification into four groups (Type I to Type IV) based on frailty assessment instrument scoring and clinical, functional, and mental status. Variables were compared using parametric and non-parametric statistical tests and Kaplan-Meier survival curves.

Results: Ninety-three patients (55.9% women) were included. Median age was 81.1 years (± 5.7). 23 patients (24.7%) were classified as robust (type I), 30 (32.3%) as pre-frail (type II) with potentially reversable deficits, 38 (40.9%) as frail (type III), and 2 (2.2%) as requiring palliative care (type IV). Patients received oncospecific treatment with modifications carried out in 64.5% of cases based on CGA results. Differences in overall survival (p = 0.002), response to treatment (p < 0.001) and likelihood of increased frailty (p = 0.024) were observed, with type III-IV patients showing significantly worse outcomes.

Conclusion: Performance of standardized, systematic CGA by geriatricians permits older lymphoma patients to be classified according to frailty, with significant differences in terms of clinical outcomes across groups. We propose incorporating CGA performed by geriatricians as part of the multidisciplinary care team to optimize therapeutic strategy for these patients.

Keywords: Comprehensive geriatric assessment; Frailty; Geriatric care; Hematologic neoplasm; Lymphoma; Oncogeriatric.

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Conflict of interest statement

The authors declare that they have no competing interests related to this work.

Figures

Fig. 1
Fig. 1
Kaplan–Meier-estimated overall survival curves for patients type I, II and III–IV according to comprehensive geriatric assessment
See this image and copyright information in PMC

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