Clinical geriatric assessment in older patients with lymphoma: a narrative review

Abstract

Background and Objective: Aging is a highly individualized global process involved in cancer pathogenesis, response to therapy and susceptibility to adverse events (AEs), resulting in physiological, medical, and psycho-cognitive changes. The attempt to stratify patients according to their fitness in order to define the best tailored treatment, thus avoiding under- or over-treatment, is an important issue of geriatric hematology. Chronological age and performance status (PS) evaluation do not account for the complexity of older patients; for this reason, comprehensive geriatric assessment (CGA) was recognized as a multidimensional, interdisciplinary diagnostic process focusing on determining an older person’s medical, psychosocial, and functional capabilities to develop a coordinated plan to guide treatment decisions and long-term follow-up. Various tools and scores exploring different geriatric domains have been developed and validated. Aim of this review is to define the aging process in its aspects that influence lymphoma management and to summarize the available tools to define patient fitness, remarking the importance of performing a geriatric assessment (GA) in older patients affected by lymphoma.