Impact of a comprehensive geriatric assessment on decision making in older patients with hematologic malignancies.

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.

journal_name

Eur J Haematol

authors

Garric M,Sourdet S,Cabarrou B,Steinmeyer Z,Gauthier M,Ysebaert L,Beyne-Rauzy O,Gerard S,Lozano S,Brechemier D,Filleron T,Mourey L,Balardy L

doi

10.1111/ejh.13570

subject

Has Abstract

pub_date

2020-12-19 00:00:00

eissn

0902-4441

issn

1600-0609

pub_type

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