Role of Geriatric Assessment in Hematopoietic Stem Cell Transplant and Cellular Therapies

Hematological malignancies are common among older adults, a group that faces unique challenges in treatment. While hematopoietic stem cell transplantation and CAR-T therapy offer promising, potentially curative and durable treatment options for older adults with high-risk diseases, their effectiveness can be limited by the individual's overall health and ability to tolerate intensive treatments. Conventional fitness assessments in this population often fall short in addressing the complexities of aging. Conversely, geriatric assessment provides a more comprehensive evaluation of an older adult's health across multiple domains, including physical health, cognitive function, mental health, nutrition, comorbidities, polypharmacy, and social support. This holistic approach helps to better understand the patient's resilience and facilitate timely adjustments to interventions, potentially improving both survival outcomes and quality of life. This review aims to explore the current evidence on integrating geriatric assessments into the optimization of older patients for hematopoietic stem cell transplantation and CAR-T therapy, along with various care models, their potential, and future directions.