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

We investigated the predictive value of geriatric assessment (GA) on overall survival (OS) for older adults with acute myelogenous leukemia (AML). Consecutive patients ≥ 60 years with newly diagnosed AML and planned intensive chemotherapy were enrolled at a single institution. Pretreatment GA includ...

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Bibliographic Details
Published in:Blood Vol. 121; no. 21; p. 4287
Main Authors: Klepin, Heidi D, Geiger, Ann M, Tooze, Janet A, Kritchevsky, Stephen B, Williamson, Jeff D, Pardee, Timothy S, Ellis, Leslie R, Powell, Bayard L
Format: Journal Article
Language:English
Published: United States 23.05.2013
Subjects:
Affective Symptoms - diagnosis
Aged
Cognition
Comorbidity
Depression - diagnosis
Female
Geriatric Assessment - methods
Humans
Induction Chemotherapy - methods
Kaplan-Meier Estimate
Leukemia, Myeloid, Acute - drug therapy
Leukemia, Myeloid, Acute - mortality
Male
Middle Aged
Motor Activity
Multivariate Analysis
Predictive Value of Tests
Prognosis
Prospective Studies
Risk Factors
Secondary Prevention
Treatment Outcome
ISSN:1528-0020, 1528-0020
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Summary:We investigated the predictive value of geriatric assessment (GA) on overall survival (OS) for older adults with acute myelogenous leukemia (AML). Consecutive patients ≥ 60 years with newly diagnosed AML and planned intensive chemotherapy were enrolled at a single institution. Pretreatment GA included evaluation of cognition, depression, distress, physical function (PF) (self-reported and objectively measured), and comorbidity. Objective PF was assessed using the Short Physical Performance Battery (SPPB, timed 4-m walk, chair stands, standing balance) and grip strength. Cox proportional hazards models were fit for each GA measure as a predictor of OS. Among 74 patients, the mean age was 70 years, and 78.4% had an Eastern Cooperative Oncology Group (ECOG) score ≤ 1. OS was significantly shorter for participants who screened positive for impairment in cognition and objectively measured PF. Adjusting for age, gender, ECOG score, cytogenetic risk group, myelodysplastic syndrome, and hemoglobin, impaired cognition (Modified Mini-Mental State Exam < 77) and impaired objective PF (SPPB < 9) were associated with worse OS. GA methods, with a focus on cognitive and PF, improve risk stratification and may inform interventions to improve outcomes for older AML patients.
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ISSN:1528-0020
1528-0020
DOI:10.1182/blood-2012-12-471680