Identification of clinical parameters predictive of one-year survival using two geriatric tools in clinically fit older patients with hematological malignancies: Major impact of cognition.
BACKGROUND
Little is known about the reliability of G8 screening tool and the prognostic value of clinical parameters within the Comprehensive Geriatric Assessment (CGA) in clinically fit older patients with hematological malignancies.


METHODS
This study was performed to assess the reliability of G8 as a screening tool and to determine the predictive value of CGA items in terms of 1-year overall survival (OS). G8 and CGA were proposed to 107 consecutive patients (65-89 years) with hematological malignancies assessed by their physicians as clinically fit, meaning not exhibiting geriatric syndromes and/or irreversible comorbidities significantly impairing their daily function, and thus able to receive chemotherapy.


RESULTS
Out of 107 patients, 90 patients were evaluable and completed both scales; 72% and 80% were defined as "vulnerable" when evaluated with G8 (≤ 14.5) or CGA (≥ 2 impairments) respectively. The area under ROC-curve of G8 compared to CGA was 0.749±0.051. Neither G8 nor CGA total scores were predictive of 1-year OS. However, age (HR=1.105, 95% CI: 1.016-1.202; p=0.019), diagnosis (HR=5.208, 95% CI: 1.895-14.310; p=0.001) and cognitive status (HR=3.260, 95% CI: 1.043-10.194; p=0.042) were predictive of OS.


CONCLUSIONS
We conclude that in our selected hematological patients: 1) the G8 score does not help selecting patients for CGA, 2) the G8 and CGA total scores do not predict OS, and 3) in addition to the age and disease itself, cognitive impairment appears to be a powerful prognostic factor.
Clinic of Psycho-Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Université Catholique de Louvain, Service de Médecine Psychosomatique, Cliniques Universitaires de Mont-Godinne, Yvoir, Belgium.
Stéphanie
S
Dubruille
Clinic of Psycho-Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Yves
Y
Libert
Onco-geriatry Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Myriam
M
Roos
Clinic of Psycho-Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Sandrine
S
Vandenbossche
Onco-geriatry Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Aurélie
A
Collard
Department of Hematology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Nathalie
N
Meuleman
Department of Hematology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Marie
M
Maerevoet
Université de Liège, Faculté des Sciences Psychologiques et de l'Education, Liège, Belgium.
Anne-Marie
AM
Etienne
Université Catholique de Louvain, Service de Médecine Psychosomatique, Cliniques Universitaires de Mont-Godinne, Yvoir, Belgium.
Christine
C
Reynaert
Clinic of Psycho-Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Darius
D
Razavi
Department of Hematology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Dominique
D
Bron
D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D019337:Hematologic Neoplasms / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D008297:Male; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
Cognitive impairment; Elderly; Geriatric assessment; Hematological malignancy