|The following article features coverage from the American Society of Clinical Oncology 2019 meeting. Click here to read more of Hematology Advisor’s conference coverage.|
A recent study uncovered factors that may have prognostic value regarding outcomes for geriatric patients after allogeneic hematopoietic cell transplantation (HCT), according to findings presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois.
The study was a retrospective analysis of clinical data from 457 patients aged 60 years or older who had hematological malignancies that were treated with allogeneic HCT. The researchers examined several patient factors that may have been associated with treatment outcomes in this population, including routine laboratory tests, medications, nutrition, cognition, mobility, and functional activity.
The authors reported that overall survival (OS) showed a 3-year probability of 50% (95% CI, 45%-55%) and nonrelapse mortality (NRM) showed a 2-year risk of 25% (95% CI, 22%-28%).
Poorer results for both OS and progression-free survival were associated with deficits in conducting instrumental activities of daily living (IADL). There was also an association between higher NRM and IADL impairment. These patterns remained evident in multivariate analyses.
Multivariate analysis additionally showed relationships between OS and both disease risk index (DRI) and cytomegalovirus infection status. NRM was also associated with donor mismatch and age-adjusted HCT-Comorbidity Index (aaHCTCI).
IADL impairment in combination with DRI was associated with an effect on OS, and the combination of IADL impairment with aaHCTCI showed a relationship with NRM.
The study researchers proposed that pretransplant testing of IADL functionality, aaHCTCI, and DRI may form the basis of a strategy to determine risks with allogeneic HCT in geriatric patients. They also suggested these factors could inform future trials to safely serve the needs of this patient population.
- Lin RJ, Elko TA, Devlin SM, et al. Impact of geriatric vulnerability on outcomes of older patients in allogeneic hematopoietic cell transplantation. Poster presentation at: 2019 ASCO Annual Meeting; June 3, 2019; Chicago, IL. Abstract 7017.