The relevance of a geriatric assessment for elderly patients with a haematological malignancy – A systematic review

Hamaker, Marije E.; Prins, Meike C.; Stauder, Reinhard

doi:10.1016/j.leukres.2013.12.018

Cited by 178 publications

(119 citation statements)

References 29 publications

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“…We should routinely use objective tools to assess the health and frailty of our patients over 65 years old, such as the Charlson Comorbidity Index, ADL, and IADL [103,104]. Too often we see the use of age as a surrogate for fitness leading to the choice of less effective (and supposedly better tolerated) regimens.…”

Section: Don't Administer Prolonged Courses Of High-dose Corticosteroidsmentioning

confidence: 99%

Limiting early mortality: Do's and don'ts in the management of patients with newly diagnosed multiple myeloma

et al. 2015

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In the era of novel biological agents, multiple myeloma (MM) is often approached as a chronic condition. While survival continues to improve, population‐level data indicate that early mortality remains a substantial barrier to advances in MM outcomes. Here we provide “do's and don'ts” management recommendations that may minimize the risk of early mortality and ensure that patients have the opportunity to benefit from the long term impact of new effective MM agents. Such recommendations encompass the early introduction of novel agents even in the presence of comorbidities and advanced age and aggressive management of MM‐related complications. Am. J. Hematol. 91:101–108, 2016. © 2015 Wiley Periodicals, Inc.

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Section: Don't Administer Prolonged Courses Of High-dose Corticosteroidsmentioning

confidence: 99%

Limiting early mortality: Do's and don'ts in the management of patients with newly diagnosed multiple myeloma

et al. 2015

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“…Growing evidence suggests that a Comprehensive Geriatric Assessment (CGA) in older patients with malignant haemopathies helps haematologists to detect "frailty" in cancer patients leading to useful interventions but less useful to identify patients for whom chemotherapy should be avoided or reduced as it could negatively impact functionality, quality of life, treatment-related toxicity or survival (1,2). However, the CGA is time consuming, expensive, complex, not reproducible and not helpful for an individual patient with a specific treatment (3).…”

Section: Introductionmentioning

confidence: 99%

Identification of clinical parameters predictive of one-year survival using two geriatric tools in clinically fit older patients with hematological malignancies: Major impact of cognition

Dubruille

Libert

Roos

et al. 2015

Journal of Geriatric Oncology

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Little is known about the reliability of G8 screening tool and the prognostic value of clinical parameters within the Comprehensive Geriatric Assessment (CGA) in clinically fit older patients with haematological malignancies. This study was performed to assess the reliability of G8 as a screening tool and to determine the predictive value of CGA items in terms of one-year overall survival (OS). G8 and CGA were proposed to 107 consecutive patients (65-89yrs) with haematological malignancies that were judged clinically fit to receive chemotherapy. Ninety patients were evaluable with both scales; 72% and 80% were defined as "vulnerable" when evaluated with G8 (≤14.5) or CGA (≥2 impairments) respectively. The area under ROC-curve of G8 compared to CGA was 0.749 ± 0.051. Neither G8 nor CGA total score were predictive of one-year OS. However, age (HR=1.09, 95%CI: 1.009-1.185; p=0.029), diagnosis (HR=5.99, 95%CI: 2.322-15.428; p<0.001) and cognitive status (HR=3.50, 95%CI: 1.132-10.849; p=0.030) were predictive of OS. We conclude that in our selected haematological patients 1) the G8 score does not help selecting patients for CGA 2) the G8 and CGA total score do not predict OS 3) in addition to the age and disease itself, cognitive impairment appears to be a powerful prognostic factor.

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“…Moderate to severe comorbidity was a risk factor for non-hematologic toxicity in one study, whereas in the other study patients deemed to be unfit showed a 20% chemotherapy-related death rate compared with only 2% in fit patients. 26 Secondly, the CGA is time consuming. Therefore, several studies investigated the possibility of shorter screening versions in order to identify fit patients who are able to receive standard of care with acceptable toxicity and vulnerable patients in whom extensive GA is needed to individualize therapy.…”

Section: Meta Analysismentioning

confidence: 99%

Age and aging in blood disorders: multiple myeloma

et al. 2014

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The relevance of a geriatric assessment for elderly patients with a haematological malignancy – A systematic review

Cited by 178 publications

References 29 publications

Limiting early mortality: Do's and don'ts in the management of patients with newly diagnosed multiple myeloma

Limiting early mortality: Do's and don'ts in the management of patients with newly diagnosed multiple myeloma

Identification of clinical parameters predictive of one-year survival using two geriatric tools in clinically fit older patients with hematological malignancies: Major impact of cognition

Age and aging in blood disorders: multiple myeloma

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