title: Cancer-specific geriatric assessment and quality of life: important factors in caring for older patients with aggressive B-cell lymphoma.
abstract: To evaluate the efficacy and tolerability of chemotherapy, a geriatric assessment is recommended in elderly patients with cancer. We aimed to characterize and compare patients with aggressive lymphoma by objective response and survival status based on pre-treatment cancer-specific geriatric (C-SGA) and quality of life (QoL) assessments.
  
  
  
  Patients not eligible for anthracycline-based first-line therapy or intensive salvage regimens completed C-SGA and QoL assessment before and after a rituximab-bendamustine-lenalidomide (R-BL) treatment in a phase II clinical trial. Clinical outcomes were compared based on pre-treatment individual and summary C-SGA measures, their cutoff-based subcategories and QoL indicators, using Wilcoxon rank sum or chi-square tests.
  
  
  
  A total of 57 patients (41 included in the clinical trial) completed a C-SGA. Participants with pre-treatment impaired functional status (Vulnerable Elders Survey-13 score ≥3) were more likely to experience worse outcomes: a higher proportion were non-responders, died before the median follow-up of 31.6 months (interquartile range (IQR) 27.9-37.9) or died during treatment. Non-responders were patients categorized as having possible depression (Geriatric Depression Scale-5 score ≥2) and with worse QoL scores for functional performance. Patients with worse C-SGA summary scores and with greater tiredness were more likely to die during treatment.
  
  
  
  A pre-treatment impaired functional status is an important factor with respect to clinical outcomes in patients receiving an R-BL regimen. Individual geriatric and related QoL domains showed similar associations with clinical outcomes. Whether interventions targeting specific geriatric dimensions also translate in better symptom- or domain-specific QoL warrants further research.
authors.affiliation: International Breast Cancer Study Group, Coordinating Center, Effingerstr. 40, 3008, Bern, Switzerland. karin.ribi@ibcsg.org.
authors.forename: Karin
authors.initials: K
authors.lastname: Ribi
authors.affiliation: Swiss Group for Clinical Cancer Research, Coordinating Center, Effingerstr. 33, 3008, Bern, Switzerland.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Rondeau
authors.affiliation: Kantonsspital St. Gallen, Rorschacher Str. 95, 9007, St. Gallen, Switzerland.
authors.forename: Felicitas
authors.initials: F
authors.lastname: Hitz
authors.affiliation: Kantonsspital Graubünden, Loëstrasse 170, 7000, Chur, Switzerland.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mey
authors.affiliation: Swiss Group for Clinical Cancer Research, Coordinating Center, Effingerstr. 33, 3008, Bern, Switzerland.
authors.forename: Milica
authors.initials: M
authors.lastname: Enoiu
authors.affiliation: Inselspital Bern, Freiburgstrasse 8, 3010, Bern, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Pabst
authors.affiliation: IOSI (Istituto Oncologico della Svizzera Italiana), 6500, Bellinzona, Switzerland.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Stathis
authors.affiliation: Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
authors.forename: Natalie
authors.initials: N
authors.lastname: Fischer
authors.affiliation: Institute of Social and Preventive Medicine (ISPM), University of Bern, Finkenhubelweg, 11 3012, Bern, Switzerland.|Section of Geriatrics, Boston University Medical Center, Harrison Ave, Boston, MA, 02111, USA.
authors.forename: Kerri M
authors.initials: KM
authors.lastname: Clough-Gorr
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*
keywords: Aggressive B-cell lymphoma; Geriatric assessment; Quality of life; Rituximab-bendamustine-lenalidomide treatment