[Haematological malignancies in older adults: experience in a geriatric acute care department]

Ageing of population due to improvement in life expectancy has increased blood diseases (BD) incidence in the elderly population. In addition, treatments get more and more complex with increasingly late diagnosis as well as concomitant comorbidities.

We describe a series of 54 patients with BD, followed-up in an acute care geriatric department. Autonomy, way of life, nutritional status, comorbidities, treatment, mortality and evolution were analyzed.

Mean age at BD was 86+/-6 years (range 75-99) for 29 women and 25 men. Median follow up was 20 months (0-60). Lymphoma was the most frequent BD (44%). Thirty-one patients (57%) received chemotherapy. Mortality rate was 41% (22 patients). Forty patients (74%) were discharged and 25 patients (46%) required enhanced professional assistance. Survival was significantly decreased in patients with albuminemia less than or equal to 30 g/l. IADL score less than or equal to 3, ADL score less than or equal to 5, performance status more than or equal to 2, MMS less than 25 and weight loss more than or equal to 3 kg. After multivariate analysis, only albuminemia less than or equal to 30 g/l tended to predict death (hazard ratio 3.57, 95% confidence interval 0.96-13.3, p=0.06).

Our study confirms the importance of nutritional status on survival. A global geriatric evaluation is required for appropriate treatment, as currently available therapeutic protocols are not really adapted for old population. Additional studies should be conducted in this direction.