A prospective study of comprehensive geriatric assessment in elderly patients with acute myeloid leukemia

Abstract

Objective To evaluate the performance on comprehensive geriatric assessment(CGA)in elderly patients with acute myeloid leukemia(AML)and to investigate the differences between Eastern Cooperative Oncology Group(ECOG)performance status(PS)and CGA scoring. Methods Patients aged 60 years or over diagnosed with AML at Beijing Hospital from September 2008 to April 2018 were enrolled in this study.CGA was performed during staging procedures through application of age, activities of daily living(ADL)/instrumental activities of daily living(IADL)and the comorbidity score based on the cumulative illness rating scale for geriatrics(CIRS-G). According to CGA scores, patients were classified into a not-applicable group, an applicable group and a frail group.The difference between ECOG-PS and CGA scoring was compared. Results A total of 73 patients were enrolled in this study.There were 37(50.7%), 14(19.2%)and 22(30.1%)patients in the applicable, not-applicable and frail groups, respectively.Comorbidities were observed in the majority of patients, with cardiovascular disease, diabetes mellitus and hypertension among the most common disorders.In patients aged 60 to 64 years, 16.7%(1/6)were considered as frail, and the percentage of frail patients increased to 36.4%(8/22)in patients aged 80 years and over.Moreover, functional impairment evaluated by CGA was observed in 36.5%(19/52)of patients with ECOG-PS ≤1. Conclusions According to CGA scoring, approximately half of AML patients aged 60 years or over have functional impairment.Functional impairment is observed in some patients with ECOG-PS ≤1, indicating that ECOG-PS may underestimate functional impairment in elderly AML patients. Key words: Leukemia, myeloid; Comprehensive geriatric assessment