Geriatric assessment in hematology scale predicts treatment tolerability in older patients diagnosed with hematological malignancies: The RETROGAH study
التفاصيل البيبلوغرافية
العنوان:
Geriatric assessment in hematology scale predicts treatment tolerability in older patients diagnosed with hematological malignancies: The RETROGAH study
Institut Català de la Salut, [de la Rubia J, Jarque I] Hematology Department, H.U. i Politècnic La Fe. Valencia, Spain. School of Medicine and Dentistry, Catholic University of Valencia, Valencia, Spain. Centro de Investigación Biomédica en Red de Cáncer, CIBERONC CB16/12/00284, Instituto de Salud Carlos III. Madrid, Spain. [González B] Hematology Department, H.U. de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain. [Cruz-Jentoft AJ] Geriatric Unit, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain. [Iglesias L] Hematology Department, C.H.U. A Coruña. A Coruña, Spain. [Persona EP] Hematology Department H. U, Vitoria-Gasteiz, Álava, Spain. [Gironella M] Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus
Chemotherapy; Geriatric assessment; Toxicity Quimioterapia; Evaluación geriátrica; Toxicidad Quimioteràpia; Avaluació geriàtrica; Toxicitat Introduction The GAH (Geriatric Assessment in Hematology) scale is a psychometrically valid tool aimed at identifying older patients with hematological malignancies at higher risk of treatment-related toxicity. Our objective in this study was to determine the weights for each dimension of the GAH scale and the cut-off point to reliably predict treatment tolerability in this population, estimated by a weighted receiver operating characteristic (ROC) analysis and quantified by the area under the curve (AUC). Material and Methods The RETROGAH was a retrospective cohort study including 126 patients who had previously participated in the GAH study. Patients were ≥ 65 years old with newly diagnosed myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML), multiple myeloma (MM), or chronic lymphoid leukemia (CLL) and treated with standard front-line therapy within three months after having completed the GAH scale. Results The optimal cut-off value of the GAH total score to discriminate patients at higher risk of treatment toxicity was 42, with 68.5% sensitivity and 55.8% specificity. Using this value, 66.1% of patients evaluated were found to develop some type of toxicity. The AUC was 0.6259 (95% CI: 0.512–0.739; p = 0.035). Discussion The GAH scale not only would enable clinicians to individualize therapy based on individual risk of toxicity but also discriminate patients that will benefit most from intensive treatments from those requiring an adapted approach. While futures studies in clinical practice may improve the model and overcome its limitations, the GAH scale should not be used alone when making treatment decisions. This study was supported by Celgene España S.L.