title: Comprehensive geriatric assessment in elderly patients with newly diagnosed aggressive non-Hodgkin lymphoma treated with multi-agent chemotherapy.
abstract: OBJECTIVE
  The purpose of this prospective observational study is to evaluate the relation of the comprehensive geriatric assessment (CGA) to tolerability and survival of multi-agent chemotherapy for curative intent in elderly patients with aggressive non-Hodgkin lymphoma (NHL).
  
  
  METHODS
  Patients who were 1) age ≥65 years, 2) newly diagnosed aggressive NHL, and 3) treated with multi-agent chemotherapy within 2 weeks from the time of diagnosis were enrolled from January 2011 to June 2014. Baseline clinical, laboratory, and CGA data being composed of Mini Nutritional Assessment-Short Form (MNA-SF), Korean version of Mini Mental Status Exam, Korean-Geriatric Depression Scale, and Groningen Frailty Index (GFI), were collected and analyzed for the relation to the outcome factors.
  
  
  RESULTS
  Seventy patients were included; the median age was 73.5 years, 27 (38.6%) patients were Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 2 or more, and half of the patients were high or high-intermediate risk by age-adjusted international prognostic index (aaIPI). Most patients received CHOP or CHOP-like chemotherapy. Factors affecting discontinuation of chemotherapy within 12 weeks were poor MNA-SF, poor GFI, poor PS, and presence of B symptom. Among those, poor MNA-SF was independent of other variables in multivariate analysis. Poor MNA-SF, bone marrow involvement, and baseline anemia of hemoglobin<10g /dL were found to be independent factors associated with inferior overall survival whereas aaIPI factors were not.
  
  
  CONCLUSIONS
  MNA-SF predicted tolerability to multi-agents chemotherapy and overall survival in elderly patients with aggressive NHL who were treated with multi-agent chemotherapy.
authors.affiliation: Department of Medicine, Gachon University School of Medicine, Incheon 405-760, Republic of Korea.
authors.forename: Seha
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon 405-760, Republic of Korea. Electronic address: alertjun@hanmail.net.
authors.forename: Junshik
authors.initials: J
authors.lastname: Hong
authors.affiliation: Department of Family Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon 405-760, Republic of Korea.
authors.forename: Incheol
authors.initials: I
authors.lastname: Hwang
authors.affiliation: Department of Laboratory Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon 405-760, Republic of Korea.
authors.forename: Jeong-Yeal
authors.initials: JY
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon 405-760, Republic of Korea.
authors.forename: Eun Yeong
authors.initials: EY
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon 405-760, Republic of Korea.
authors.forename: Jinny
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon 405-760, Republic of Korea.
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon 405-760, Republic of Korea.
authors.forename: Dong Bok
authors.initials: DB
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon 405-760, Republic of Korea.
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006037:Glyoxal / Q000627:therapeutic use; D006801:Humans; D007069:Ifosfamide / Q000627:therapeutic use; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D011238:Prednimustine / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D006037:Glyoxal; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011238:Prednimustine; D007069:Ifosfamide; D011241:Prednisone
keywords: Chemotherapy; Elderly; Geriatric assessment; Non-Hodgkin lymphoma