A retrospective study on 73 elderly patients (≥75years) with aggressive B-cell non Hodgkin lymphoma: Clinical significance of treatment intensity and comprehensive geriatric assessment

Marchesi, Francesco; Cenfra, Natalia; Altomare, Lidia; Dessanti, Maria Laura; Mecarocci, Sergio; Cerchiara, Elisabetta; Rago, Angela; D’Andrea, Marco Maria; Tomarchio, Valeria; Olimpieri, Odoardo Maria; Tirindelli, Maria Cristina; Mengarelli, Andrea; Petti, Maria Concetta; Avvisati, Giuseppe; Cimino, Giuseppe

doi:10.1016/j.jgo.2013.04.003

Cited by 34 publications

(26 citation statements)

References 29 publications

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“…The same results were obtained in a recent study by Marchesi et al who used a similar simplified CGA [24]. In our paper frail patients had more frequently worse IPI score and stage B than fit patients, although the difference was not significant; however significant better survival of fit compared to frail intensively treated patients was evident both in the subgroup of low and high IPI score, and in the subgroup of A and B stage, eliminating possible bias (data not shown).…”

Section: Discussionsupporting

confidence: 88%

Comprehensive geriatric assessment is an essential tool to support treatment decisions in elderly patients with diffuse large B-cell lymphoma: a prospective multicenter evaluation in 173 patients by the Lymphoma Italian Foundation (FIL)

Tucci

Martelli²,

Rigacci

et al. 2014

Leukemia & Lymphoma

144

120

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We performed a multicenter study in order to validate the concept that a simple CGA can identify elderly DLBCL non-fit patients in whom curative treatment is not better then palliation and to analyse potential benefits of treatment modulation after further subdividing the non-fit category by CGA criteria.One-hundred-seventy-three patients aged > 69 treated with curative or palliative intent by clinical judgment only were grouped according to CGA in fit (46%), unfit (16%) and frail (38%) categories. Two-yr OS was significantly better in fit than in non-fit patients (84% vs 47%; P <.0001). Survival in unfit and frail patients was not significantly different. Curative treatment slightly improved 2-yr OS in unfit (75% vs 44%), but not in frail patients (45% vs 39%).CGA was confirmed as very efficient in identifying elderly DLBCL patients who can benefit from a curative approach. Further efforts are needed to better tailor therapies in non-fit patients.3

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Section: Discussionsupporting

confidence: 88%

Comprehensive geriatric assessment is an essential tool to support treatment decisions in elderly patients with diffuse large B-cell lymphoma: a prospective multicenter evaluation in 173 patients by the Lymphoma Italian Foundation (FIL)

Tucci

Martelli²,

Rigacci

et al. 2014

Leukemia & Lymphoma

144

120

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“…38–41 The GFI predicted mortality from chemotherapy in advanced CRC patients. 42, 43 Weak grip strength predicted chemotherapy toxicity but not mortality among older (65+) patients with cancer while the ECOG PS score predicted mortality but not treatment toxicity.…”

Section: Importance Of the Frailty Syndrome Assessment To Cancer Carementioning

confidence: 99%

How should older adults with cancer be evaluated for frailty?

Huisingh-Scheetz

Walston

2017

Journal of Geriatric Oncology

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Traditionally used as a descriptive term, frailty is now a recognized medical syndrome identifying individuals with decreased physiologic reserve. Frailty is characterized by diminished strength, endurance, and reduced physiologic function. Several valid frailty screening tools exist in the literature, and these measures have been used to relate frailty to outcomes important to the older patient with cancer. Frail adults are at increased risk of adverse surgical outcomes and early findings suggest that frailty predicts poor chemotherapy tolerance. While much research is needed to explore the biologic relationships between frailty and cancer, there is an urgent need to implement frailty screening and management into the care of the older patient with cancer in order to improve outcomes in this vulnerable subset. The purpose of this paper is to provide an introduction of frailty to oncologists including a review of the definition, frailty screening tools, its clinical relevance to older patients with cancer, and a brief guide to frailty management.

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“…Although several researchers have reported the effectiveness of using CGA and the effects of treatment in patients with aggressive B‐cell non‐Hodgkin's lymphoma , these findings await further corroboration. Tucci et al .…”

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confidence: 95%

“… and Marchesi et al . reported that curative treatment failed to improve outcomes for patients classified as ‘unfit’ by CGA, compared with palliative treatment. On the other hand, other reports revealed better outcomes for curative treatment than for palliative treatment .…”

mentioning

confidence: 99%

Analysis of elderly patients with diffuse large B‐cell lymphoma: aggressive therapy is a reasonable approach for ‘unfit’ patients classified by comprehensive geriatric assessment

Yoshida

Nakao

Horiuchi

et al. 2015

European J of Haematology

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A retrospective study on 73 elderly patients (≥75years) with aggressive B-cell non Hodgkin lymphoma: Clinical significance of treatment intensity and comprehensive geriatric assessment

Cited by 34 publications

References 29 publications

Comprehensive geriatric assessment is an essential tool to support treatment decisions in elderly patients with diffuse large B-cell lymphoma: a prospective multicenter evaluation in 173 patients by the Lymphoma Italian Foundation (FIL)

Comprehensive geriatric assessment is an essential tool to support treatment decisions in elderly patients with diffuse large B-cell lymphoma: a prospective multicenter evaluation in 173 patients by the Lymphoma Italian Foundation (FIL)

How should older adults with cancer be evaluated for frailty?

Analysis of elderly patients with diffuse large B‐cell lymphoma: aggressive therapy is a reasonable approach for ‘unfit’ patients classified by comprehensive geriatric assessment

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