Pre- and post-comprehensive geriatric assessment in older patients with hematological malignancy before allogeneic stem cell transplantation.

Abstract

212 Background: Comprehensive geriatric assessment (CGA) is a multi-dimensional evaluation which influences medical decisions and predicts toxicity in older cancer patients. CGA pre-allogeneic stem cell transplant patients (ASCT) and repeated post-transplant provides information about treatment and helps to determine which parameters may predict ASCT outcomes. Methods: This was a prospective observational study evaluating 17 older patients with hematologic malignancy with CGA between December 9, 2016 and April 3, 2018 within the Levine Cancer Institute Senior Oncology Clinic. Included were validated measures across domains of cognition, disability, frailty, function and psychologic status. Repeat CGA was performed on surviving patients at least 99 days after ASCT (avg 122 days). Results: Median age was 66 (range 60-75) and the most common diagnosis was AML. There was no notable difference in pre and post-CGA physical and neurocognitive parameters for ASCT survivors (n=8). Within the deceased group (n=9) there was a longer TUG, lower patient-reported KPS, poorer psychological status, grip strength, and social support. Conclusions: There was no notable difference in the physical and neurocognitive CGA parameters before and after ASCT. Although the sample is small, there were notable trends toward lower patient-rated KPS compared to physician-rated KPS, poorer ADL function, slower TUG, and weaker grip strength in those patients who did not survive. CGA may identify older patients with hematologic malignancy who are at risk for worse outcomes post-ASCT.[Table: see text]