A new tool for comprehensive geriatric assessment in elderly patients with acute myeloid leukemia: a pilot study from China
10.1097/CM9.0000000000000645
- Author:
Zhang CHUN-LI
1
;
Feng RU
;
Li JIANG-TAO
;
Wang TING
;
Bai JIE-FEI
;
Liu HUI
Author Information
1. Department of Hematology
- Keywords:
Acute myeloid leukemia;
Albumin;
Comorbidity;
Instrumental activities of daily living;
Comprehensive geriatric assessment
- From:
Chinese Medical Journal
2020;133(4):381-387
- CountryChina
- Language:Chinese
-
Abstract:
Background:Acute myeloid leukemia (AML) is a common type of hematological malignancy in elderly people.Geriatricians have developed comprehensive geriatric assessment (CGA) methods for elderly patients;however,the tools used for CGA in AML are not uniform.Thus,we aimed to validate the instrumental activities of daily living (IADL) scales,age,comorbidities (Charlson Comorbidity Index),and albumin (IACA) index,which is a new tool for CGA,in elderly patients with AML.Methods:Patients aged ≥60 years who had been diagnosed with AML were screened for eligibility.Among the IACA low-,intermediate-,and high-risk groups,continuous variables were compared using the Mann-Whitney U test,and categorical variables were compared using x2 and Fisher exact tests.In addition,probabilities of overall survival (OS) were estimated using the Kaplan-Meier method.Results:A total of 21,34,and 6 patients were categorized into IACA low-risk (0 point),intermediate-risk (1-2 points),and high-risk (≥3 points) groups,respectively.The rates of relapse/progression-related mortality were 23.8％,58.8％,and 100.0％ in the IACA low-,intermediate-,and high-risk groups,respectively (x =12.81,P ＜ 0.001).The 2-year probabilities of OS were 47.7％ (95％ confidence interval [CI] 22.8％-72.6％) and 20.2％ (95％ CI 5.9％-34.5％) in the IACA low-and intermediate-risk groups,respectively (x2=5.99,P =0.014),which were significantly higher than those in the high-risk group (low-risk [47.7％ (95％ CI 22.8％-72.6％)] vs.high-risk [0],x2=20.80,P ＜ 0.001;intermediate-risk [20.2％ (95％ CI 5.9％-34.5％)] vs.high-risk [0],x2=7.56,P =0.006;respectively).In the IACA low-risk group,the 2-year probability of OS in patients receiving induction chemotherapy (50.8％ [95％ CI 24.1％-77.5％]) was significantly higher than that in those receiving best supportive care (0,x2=25.74,P＜ 0.001).Conclusion:We suggest that the IACA index might be a simple and effective tool for comprehensive geriatric assessment in elderly AML patients.
