The performance of abbreviated comprehensive geriatric assessment in elderly patients with diffuse large B cell lymphoma.

IF 2.8 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Supportive Care in Cancer Pub Date : 2025-01-08 DOI:10.1007/s00520-024-09142-6

Yu-Shin Hung, Hung Chang, Ming-Chung Kuo, Wen-Chi Chou

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Abstract

Purpose: Diffuse large B-cell lymphoma (DLBCL) is one of the most common and aggressive forms of non-Hodgkin's lymphoma. This study aimed to evaluate the performance of the abbreviated Comprehensive Geriatric Assessment (aCGA) in assessing frailty and predicting clinical outcomes in elderly patients with DLBCL.

Methods: A total of 91 patients aged ≥ 65 years with newly diagnosed DLBCL and who received immunochemotherapy at a single medical center in Taiwan between August 2019 and December 2022 were prospectively enrolled. Frailty was assessed in all participating patients within seven days of the first cycle of immunochemotherapy. The primary objective was to compare aCGA's accuracy in assessing frailty with that of the full CGA. Secondary objectives included assessing correlations between frailty and severe adverse events (sAEs), early mortality, and overall survival (OS).

Results: In the cohort, 50 (55%) and 38 (42%) patients were categorized as frail based on CGA and aCGA, respectively. A high number of aCGA domains impairment were positively associated with a high number of CGA domains impairment. The receiver operating characteristic for aCGA for detecting frailty was 0.846 (95% confidence interval [CI], 0.756-0.926). A cut-off point of ≥ 2 aCGA domain impairments indicated frailty, with a sensitivity of 70.0% and specificity of 92.7%. Based on aCGA, the early mortality rate was 7.5% and 26.3% (p = 0.019) for fit and frail patients, respectively. The 1-year and 2-year OS rates were 77.7% and 67.4% for fit patients, and 57.1% and 45.4% for frail patients, respectively. The adjusted hazard ratio for OS was 2.42 (95% CI, 1.06-5.49, p = 0.035) for frail patients compared to fit patients.

Conclusions: This finding suggested that aCGA could be used as an efficient alternative to the full CGA, potentially improving the clinical management and treatment decision-making for elderly patients with DLBCL.

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老年弥漫性大B细胞淋巴瘤患者的简略综合老年病学评价。

目的：弥漫性大b细胞淋巴瘤（DLBCL）是最常见和侵袭性的非霍奇金淋巴瘤之一。本研究旨在评估简化的综合老年评估（aCGA）在评估老年DLBCL患者衰弱和预测临床结局方面的表现。方法：前瞻性纳入2019年8月至2022年12月在台湾单一医疗中心接受免疫化疗的91例≥65岁新诊断的DLBCL患者。在第一个免疫化疗周期的7天内评估所有参与的患者的虚弱程度。主要目的是比较aCGA与完整CGA在评估虚弱方面的准确性。次要目标包括评估虚弱和严重不良事件（sAEs）、早期死亡率和总生存率（OS）之间的相关性。结果：在队列中，分别有50例（55%）和38例（42%）患者根据CGA和aCGA被分类为虚弱。高数量的aCGA结构域损伤与高数量的CGA结构域损伤呈正相关。aCGA检测脆弱的受试者工作特征为0.846（95%可信区间[CI]， 0.756-0.926）。≥2个aCGA结构域损伤的分界点为脆弱，敏感性为70.0%，特异性为92.7%。基于aCGA，健康和虚弱患者的早期死亡率分别为7.5%和26.3% （p = 0.019）。健康患者1年和2年OS分别为77.7%和67.4%，体弱患者为57.1%和45.4%。与健康患者相比，虚弱患者的OS校正风险比为2.42 （95% CI, 1.06-5.49, p = 0.035）。结论：该发现提示aCGA可作为全CGA的有效替代方案，有可能改善老年DLBCL患者的临床管理和治疗决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Supportive Care in Cancer 医学-康复医学

CiteScore

5.70

自引率

9.70%

发文量

751

审稿时长

3 months

期刊介绍： Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.