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Assessing frailty using comprehensive geriatric assessment in older patients with hematologic malignancy
Jung-Yeon Choi1, Kwang-Il Kim1,2
1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Blood Research
|April 28, 2022
Summary
Comprehensive Geriatric Assessment (CGA) is crucial for older adults with hematologic malignancies. It predicts chemotherapy complications and guides treatment for better outcomes in elderly cancer patients.
Area of Science:
- Geriatric Oncology
- Hematologic Malignancies
- Clinical Geriatrics
Background:
- Hematologic malignancy incidence rises with age, increasing the number of older patients needing intensive chemotherapy.
- In 2018, over 46% of new cases of multiple myeloma, myelodysplastic syndrome, myeloproliferative disorder, and non-Hodgkin lymphoma in Korea were in patients over 65.
- Patient health status, particularly frailty, significantly impacts outcomes, showing high heterogeneity among older adults.
Purpose of the Study:
- To emphasize the importance of Comprehensive Geriatric Assessment (CGA) in older patients with hematologic malignancies.
- To highlight CGA's role in identifying frailty and guiding treatment decisions for intensive chemotherapy.
- To advocate for routine CGA implementation in treatment planning for elderly cancer patients.
Main Methods:
- Comprehensive Geriatric Assessment (CGA) is a multidimensional, multidisciplinary process evaluating functional status, cognition, comorbidities, medications, socioeconomic status, and nutrition.
- CGA identifies frailty, considered the 'gold standard of care' for frail older patients.
- CGA objectively assesses problems, predicts treatment complications, and identifies suitable candidates for intensive chemotherapy.
Main Results:
- CGA findings can be used to assess frailty and guide treatment planning.
- It allows for pre-emptive and non-oncologic interventions.
- CGA is a reliable tool for predicting chemotherapy-related complications and patient suitability for intensive treatment.
Conclusions:
- Comprehensive Geriatric Assessment (CGA) should be standard practice before initiating intensive chemotherapy in older patients with hematologic malignancies.
- CGA improves the prediction of treatment complications and helps determine appropriate candidates for curative-intent chemotherapy.
- Further research is needed to personalize treatment plans and geriatric interventions based on CGA results.
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