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April 3, 2013BloodOpen Access

Geriatric assessment predicts survival for older adults receiving induction chemotherapy for acute myelogenous leukemia

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Authors

HKHeidi D. KlepinWake Forest UniversityAGAnn M. GeigerUMass Memorial Health CareJTJanet A. ToozeWake Forest University

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Implication

Cohort study reveals that baseline cognitive and physical impairments predict poorer overall survival in older adults with acute myelogenous leukemia, highlighting the prognostic value of...

Key Points

  • To determine whether pretreatment geriatric assessment domains independently predict overall survival in older adults receiving intensive chemotherapy for acute myelogenous leukemia.
  • Enrolled 74 consecutive patients aged ≥ 60 years (mean age 70 years) with newly diagnosed acute myelogenous leukemia undergoing intensive chemotherapy at a single institution.
  • Conducted pretreatment geriatric assessments evaluating cognition (Modified Mini-Mental State Exam), depression, distress, comorbidities, and objective physical function using grip strength and the Short Physical Performance Battery.
  • Fitted multivariable Cox proportional hazards models adjusting for age, gender, Eastern Cooperative Oncology Group score, cytogenetic risk category, myelodysplastic syndrome, and hemoglobin.
  • Impaired cognition (Modified Mini-Mental State Exam score < 77) was independently associated with significantly worse overall survival on multivariable analysis.
  • Impaired objective physical performance (Short Physical Performance Battery score < 9) independently predicted significantly reduced overall survival.
  • Most participants (78.4%) presented with favorable performance status (Eastern Cooperative Oncology Group score ≤ 1), demonstrating that geriatric assessments capture prognostic vulnerabilities missed by routine functional status evaluations.

Cite This Study

Klepin et al. (2013) studied this question.

synapsesocial.com/papers/69ffa754ef8139f8ff776b0dhttps://doi.org/10.1182/blood-2012-12-471680
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