For a study, researchers explored the predictive efficacy of multiparameter geriatric assessment (GA) domains on tolerance and outcomes following rigorous chemotherapy in older persons with acute myeloid leukemia (AML) because there were only a few prospective studies with inconsistent results. In all, 105 newly diagnosed patients with AML over the age of 60 who were receiving aggressive treatment with cytarabine and idarubicin were recruited in the study. Evaluations for social and nutritional support, cognition, depression, distress, and physical function were all performed prior to therapy. The median age was 64 (range: 60-75 years), and 93% had an Eastern Cooperative Oncology Group performance score of 2 or above. Each domain of GA was represented by 32.4% to 69.5% of patients who matched the criteria for impairment.
Physical impairment as measured by the Short Physical Performance Battery (SPPB) and cognitive dysfunction as measured by the Mini-Mental State Examination in the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Assessment Packet (MMSE-KC) were both linked to nonfatal toxicities, such as grade 3 to 4 infections (SPPB, P=.024; MMSE-KC, P=.044), acute renal failure (SPPB, P=.013), and/ Reduced physical function measured by the SPPB and depressive symptoms measured by the Korean version of the short form of geriatric depression measures (SGDS-K) were both linked to a lower risk of death (SPPB, P=.027; SGDS-K, P=.048). The most accurate metrics for predicting survival outcomes were gait speed and sit-and-stand speed.
Notably, the combination of SPPB and SGDS-K, gait speed and SGDS-K, or sit-and-stand speed and SGDS-K considerably increased the power of existing survival prediction models. Finally, GA enhanced risk categorization for treatment decisions and might influence strategies to improve outcomes for older persons with AML.
