Impact of a comprehensive geriatric assessment on decision‐making in older patients with hematological malignancies. (14th February 2021)

• Record Type: Journal Article
• Authors: Garric, Marie; Sourdet, Sandrine; Cabarrou, Bastien; Steinmeyer, Zara; Gauthier, Martin; Ysebaert, Loïc; Beyne‐Rauzy, Odile; Gerard, Stephane; Lozano, Stephanie; Brechemier, Delphine; Filleron, Thomas; Mourey, Loïc; Balardy, Laurent
• Is Part Of: European journal of haematology. Volume 106:Number 5(2021)
• Page Start: 616
• Page End: 626
• Publication Date: 2021-02-14
• Subjects: geriatric assessment -- hematological malignancies -- older patients -- oncogeriatric; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Blood -- Periodicals; 616.15005
• DOI: 10.1111/ejh.13570
• Languages: English
• ISSNs: 0902-4441

Abstract

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.