The geriatric assessment in hematology (GAH) scale predicts treatment tolerability in older patients diagnosed with hematological malignancies, according to a report published in the Journal of Geriatric Oncology.

The GAH instrument is a validated 30-item tool for identifying older patients with hematological malignancies at higher risk of treatment-related toxicity. It takes approximately 10 to 12 minutes to administer and assesses 8 geriatric dimensions related to functional, mental and nutritional status, comorbidity, and mobility.

Researchers conducted a multicenter retrospective cohort study to determine the weights for each dimension of the GAH scale and cut-off point to reliably predict treatment tolerability in older patients (≥ 65 years) with newly diagnosed myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML), multiple myeloma (MM), or chronic lymphoid leukemia (CLL). Patients were treated with standard front-line therapy within 3 months of having completed the GAH scale. They estimated the cut-off point using a weighted receiver-operating characteristic analysis and quantified the area under the curve (AUC).


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A total of 97 patients (54.6% women and 45.4% men) were included in the analysis. Patients had a median age of 78.0 years (range, 73.0–83.0). Most patients were diagnosed with MDS/AML (48.5%), followed by MM (46.4%) and CLL (5.2%).

The researchers found 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. At this value, they found 66.1% of patients developed treatment-related toxicity and the AUC was 0.63 (95% CI, 0.51-0.74; P =.035).

Limitations of the study included the retrospective design, relatively small sample size, and inclusion of patients with different diagnoses, treatments, and potential complications.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

de la Rubia J, González B, Cruz-Jentoft AJ, et al. Geriatric assessment in hematology scale predicts treatment tolerability in older patients diagnosed with hematological malignancies: The RETROGAH study. J Geriatr Oncol. Published online November 17, 2022. doi:10.1016/j.jgo.2022.10.016