title: Pilot study of comprehensive geriatric assessment (CGA) in allogeneic transplant: CGA captures a high prevalence of vulnerabilities in older transplant recipients.
abstract: Comprehensive geriatric assessment (CGA) is frequently used in oncology to measure the health status of older adults with cancer, but it has not been studied in allogeneic hematopoietic cell transplantation (HCT). We conducted a prospective pilot study of CGA in allogeneic HCT recipients aged ≥50 years to examine the prevalence of vulnerabilities in this population. Patients aged ≥50 years eligible for HCT were enrolled. CGA consisted mainly of self-reported, performance-based, and chart-extracted measures evaluating domains of comorbidity, physical and mental function, frailty, disability, and nutrition. Of 238 eligible patients, 166 completed CGA and underwent HCT. Only 1% had a Zubrod Performance Status score >1; 44% had high comorbidity defined by the Hematopoietic Cell Transplantation Comorbidity Index, and 66% had high comorbidity defined by the Cumulative Illness Rating Scale-Geriatrics. The presence of additional vulnerability was frequent. Disability was present in 40% by Instrumental Activities of Daily Living. Self-reported physical and mental function were significantly lower than population age group norms, 58% were pre-frail, and 25% were frail. Among those with Zubrod Performance Status score of 0, 28% demonstrated disability, 58% were pre-frail, 15% were frail, 35% reported low physical function, and 55% reported low mental function. CGA uncovers a substantial prevalence of undocumented impairments in functional status, frailty, disability, and mental health in older allogeneic HCT recipients.
authors.affiliation: Hematology-Oncology Section, Department of Medicine, University of Chicago, 5841 S Maryland Ave,Chicago, IL 60637, USA.
authors.forename: Lori S
authors.initials: LS
authors.lastname: Muffly
authors.forename: Melissa
authors.initials: M
authors.lastname: Boulukos
authors.forename: Kate
authors.initials: K
authors.lastname: Swanson
authors.forename: Masha
authors.initials: M
authors.lastname: Kocherginsky
authors.forename: Paula Del
authors.initials: PD
authors.lastname: Cerro
authors.forename: Linda
authors.initials: L
authors.lastname: Schroeder
authors.forename: Lisa
authors.initials: L
authors.lastname: Pape
authors.forename: Martine
authors.initials: M
authors.lastname: Extermann
authors.forename: Koen
authors.initials: K
authors.lastname: Van Besien
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Artz
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009752:Nutritional Status; D010865:Pilot Projects; D011446:Prospective Studies; D012107:Research Design; D057566:Self Report; D014184:Transplantation, Homologous