Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on modern management of frailty

LIVE: Thursday 17th October 2024, 18:00-19:30 (CEST)

Frailty has a significant impact on health and wellbeing, especially in older adults. Join our experts to understand the factors that contribute to the development of frailty and find out how to manage the condition and reduce the risk of disability, dependency, and mortality.
ADVANCED SEARCH
Log in
Top
Current Oncology Reports

11-09-2024 | Geriatric Assessment | REVIEW

Developing a National Study That Integrates the Geriatric Assessment into the Care of Older Patients with Myeloid Malignancies

Author: Vijaya Raj Bhatt

Published in: Current Oncology Reports

Login to get access

Abstract

Purpose of Review

To highlight the priorities in geriatric assessment research in myeloid malignancies and discuss design considerations necessary to ensure research is patient-centric, generalizeable, and high quality.

Recent Findings

Older adults with myeloid malignancies including those who are perceived to have excellent performance status have multiple functional impairments. These impairments are associated with early mortality. Older adults have different functional trajectories through the course of treatment; this will be further investigated in our ongoing multicenter study. In a single-center study, we have demonstrated the use of geriatric assessment to guide treatment is feasible.

Summary

Key priorities include designing a multicenter validation study to confirm the role of geriatric assessment in determining treatment tolerance and survival. Such a study should include core geriatric assessment measures and should enroll diverse patient population across various practices. Conducting such a study is necessary to advance patient care and trial design, and to open venues to conduct studies to confirm the role of geriatric assessment in treatment selection.
Literature
1.
Bhatt VR, Wichman C, Al-Kadhimi ZS, Koll TT, Fisher AL, Mahato RI, et al. Integrating geriatric assessment and genetic profiling to personalize therapy selection in older adults with acute myeloid leukemia. J Geriatr Oncol. 2022;13(6):871–4.CrossRefPubMedPubMedCentral
2.
Min G-J, Cho B-S, Park S-S, Park S, Jeon Y-W, Shin S-H, et al. Geriatric assessment predicts nonfatal toxicities and survival for intensively treated older adults with AML. Blood. 2022;139(11):1646–58.CrossRefPubMed
3.
Ritchie EK, Klepin HD, Storrick E, Major B, Le-Rademacher J, Wadleigh M, et al. Geriatric assessment for older adults receiving less-intensive therapy for acute myeloid leukemia: report of CALGB 361101. Blood Adv. 2022;6(12):3812–20.CrossRefPubMedPubMedCentral
4.
Klepin HD, Geiger AM, Tooze JA, Kritchevsky SB, Williamson JD, Pardee TS, et al. Geriatric assessment predicts survival for older adults receiving induction chemotherapy for acute myelogenous leukemia. Blood. 2013;121(21):4287–94.CrossRefPubMedPubMedCentral
5.
Hupfer V, Grishina O, Schmoor C, Schlenk RF, Salih HR, Crysandt M, et al. Validation of a frailty score predicting survival of elderly, non-Fit AML patients receiving hypomethylating therapy: results of the decider trial. Blood. 2018;132(Suppl 1):720.CrossRef
6.
Saad M, Loh KP, Tooze JA, Pardee TS, Ellis LR, Powell BL, et al. Geriatric assessment and survival among older adults receiving postremission therapy for acute myeloid leukemia. Blood. 2020;136(23):2715–9.CrossRefPubMedPubMedCentral
7.
Klepin HD, Geiger AM, Tooze JA, Kritchevsky SB, Williamson JD, Ellis LR, et al. The feasibility of inpatient geriatric assessment for older adults receiving induction chemotherapy for acute myelogenous leukemia. J Am Geriatr Soc. 2011;59(10):1837–46.CrossRefPubMedPubMedCentral
8.
Bhatt VR. Advances and unanswered questions in management of acute myeloid leukemia in older adults: a glimpse into the future. J Geriatr Oncol. 2021;12(6):980–4.CrossRefPubMedPubMedCentral
9.
Bhatt VR. Understanding patients’ values and priorities in selecting cancer treatments: developing a therapy preference scale. J Geriatr Oncol. 2019;10(5):677–9.CrossRefPubMed
10.
Richardson DR, Crossnohere NL, Seo J, Estey E, O’Donoghue B, Smith BD, et al. Age at diagnosis and patient preferences for treatment outcomes in AML: a discrete choice experiment to explore meaningful benefits. Cancer Epidemiol Biomarkers Prev. 2020;29(5):942–8.CrossRefPubMedPubMedCentral
11.
Bhatt VR, Dhakal P, Wichman CS, Pozehl B. Development and validation of the therapy preference scale to understand patients systemic cancer treatment preferences. Future Oncol. 2021;17(1):37–44.CrossRefPubMed
12.
Dhakal P, Wichman CS, Pozehl B, Weaver M, Fisher AL, Vose J, et al. Preferences of adults with cancer for systemic cancer treatment: do preferences differ based on age? Future Oncol. 2022;18(3):311–21.CrossRefPubMed
13.
Dhakal P, Wichman C, Pozehl B, Mahato K, Bhatt VR. Preferences of patients with acute myeloid leukemia and other myeloid malignancies on cancer treatment: effect of patient- and treatment-characteristics? Blood. 2023;142(Supplement 1):3731.CrossRef
14.
Bhatt VR, Shostrom V, Gundabolu K, Armitage JO. Utilization of initial chemotherapy for newly diagnosed acute myeloid leukemia in the United States. Blood Adv. 2018;2(11):1277–82.CrossRefPubMedPubMedCentral
15.
Bhatt VR, Wichman C, Koll TT, Fisher A, Wildes TM, Haddadin M, et al. Use of geriatric assessment and genetic profiling to personalize selection of intensive versus low intensity chemotherapy in older adults with acute myeloid leukemia (AML): final results of a phase II trial. Blood. 2023;142(1):4265.CrossRef
16.
Bhatt VR. Personalizing therapy for older adults with acute myeloid leukemia: role of geriatric assessment and genetic profiling. Cancer Treat Rev. 2019;75:52–61.CrossRefPubMed
17.
Artz A, Logan BR, Saber W, Geller N, Bellach A, Kou J, et al. The composite health risk assessment model (CHARM) to predict 1-year non-relapse mortality (NRM) among older recipients of allogeneic transplantation: a prospective BMT-CTN study 1704. Blood. 2023;142(Supplement 1):109.CrossRef
18.
Bhatt VR, Gundabolu K, Koll T, Maness LJ. Initial therapy for acute myeloid leukemia in older patients: principles of care. Leuk Lymphoma. 2018;59(1):29–41.CrossRefPubMed
19.
Bhatt VR, Uy GL, Klepin HD. Determining treatment tolerance and fitness for intensive chemotherapy in older adults with AML: a call to action. Blood. 2024;143(6):483–7.CrossRefPubMed
20.
Bhatt VR, Wichman C, Koll TT, Fisher AL, Wildes TM, Berger A, et al. Longitudinal changes in cognitive and physical function and health-related quality of life in older adults with acute myeloid leukemia. J Geriatr Oncol. 2024;15(1):101676.CrossRefPubMed
21.
Dhakal P, Shostrom V, Al-Kadhimi ZS, Maness LJ, Gundabolu K, Bhatt VR. Usefulness of charlson comorbidity index to predict early mortality and overall survival in older patients with acute myeloid leukemia. Clin Lymphoma Myeloma Leuk. 2020;20(12):804–12.CrossRefPubMedPubMedCentral
22.
Bhatt VR, Shostrom V, Holstein SA, Al-Kadhimi ZS, Maness LJ, Berger A, et al. Survival of older adults with newly diagnosed acute myeloid leukemia: effect of using multiagent versus single-agent chemotherapy. Clin Lymphoma Myeloma Leuk. 2020;20(5):e239–58.CrossRefPubMedPubMedCentral
23.
Klepin HD, Ritchie EK, Sanford BL, Marcucci G, Zhao W, Geyer SM, et al. Feasibility of geriatric assessment for older adults with acute myeloid leukemia (AML) receiving intensive chemotherapy on a cooperative group trial: CALGB 361006 (Alliance). J Clin Oncol. 2014;32(15_Suppl):7102.CrossRef
24.
25.
Bhatt VR, Ulrich AM, Uy GL, Stone RM, Stock W, Ojelabi MO, et al. Outcomes of older adults with AML treated in community versus academic centers: an analysis of alliance trials. JCO Oncol Pract. 2023;19(6):e877–91.CrossRefPubMedPubMedCentral
26.
Bhatt VR, Shostrom V, Giri S, Gundabolu K, Monirul Islam KM, Appelbaum FR, et al. Early mortality and overall survival of acute myeloid leukemia based on facility type. Am J Hematol. 2017;92(8):764–71.CrossRefPubMed
27.
Hurria A, Mohile S, Gajra A, Klepin H, Muss H, Chapman A, et al. Validation of a prediction tool for chemotherapy toxicity in older adults with cancer. J Clin Oncol. 2016;34(20):2366–71.CrossRefPubMedPubMedCentral
28.
Mohile SG, Dale W, Somerfield MR, Schonberg MA, Boyd CM, Burhenn PS, et al. Practical assessment and management of vulnerabilities in older patients receiving chemotherapy: ASCO guideline for geriatric oncology. J Clin Oncol. 2018;36(22):2326–47.CrossRefPubMedPubMedCentral
29.
Dale W, Klepin HD, Williams GR, Alibhai SMH, Bergerot C, Brintzenhofeszoc K, et al. Practical assessment and management of vulnerabilities in older patients receiving systemic cancer therapy: ASCO guideline update. J Clin Oncol. 2023;41(26):4293–312.CrossRefPubMed
30.
Diaz FC, Hamparsumian A, Loh KP, Verduzco-Aguirre H, Abdallah M, Williams GR, et al. Geriatric oncology: a 5-year strategic plan. Am Soc Clin Oncol Educ Book. 2024;44(3):e100044.CrossRefPubMed
31.
Ginsburg GS, Picard RW, Friend SH. Key issues as wearable digital health technologies enter clinical care. N Engl J Med. 2024;390(12):1118–27.CrossRefPubMed
32.
Ehlers DK, Aguiñaga S, Cosman J, Severson J, Kramer AF, McAuley E. The effects of physical activity and fatigue on cognitive performance in breast cancer survivors. Breast Cancer Res Treat. 2017;165(3):699–707.CrossRefPubMed
33.
Anderson DE, Bhatt VR, Schmid K, Lunning M, Holstein SA, Rizzo M. Electrophysiological measure of impaired information processing in drivers with hematological malignancy. Transp Res Rec. 2018;2672(37):64–73.CrossRefPubMedPubMedCentral
34.
Anderson DE, Bhatt VR, Schmid K, Holstein SA, Lunning M, Berger AM, et al. Neurophysiological evidence of impaired attention and working memory in untreated hematologic cancer patients. Clin Neurophysiol. 2019;130(8):1243–52.CrossRefPubMedPubMedCentral
35.
Anderson DE, Kedar S, Bhatt VR, Schmid K, Holstein SA, Rizzo M. Neurophysiologic and ophthalmic markers of chemotherapy-related cognitive impairment in patients diagnosed with hematologic cancer: a feasibility study. J Neurol Sci. 2020;410:116644.CrossRefPubMed
36.
Cheng JJ, Tooze JA, Callahan KE, Pajewski NM, Pardee TS, Reed DR, et al. Assessment of an embedded primary care-derived electronic health record (EHR) frailty index (eFI) in older adults with acute myeloid leukemia. J Geriatr Oncol. 2023;14(7):101509.CrossRefPubMedPubMedCentral
37.
Klepin HD, Isom S, Callahan KE, Pajewski N, Topaloglu U, Wagner LI, et al. Frailty status determined by an electronic health record embedded frailty index and hospitalization risk among older adults following the initiation of cancer chemotherapy. J Clin Oncol. 2023;41(16_suppl):12010.CrossRef
38.
Shiwani T, Relton S, Evans R, Kale A, Heaven A, Clegg A, et al. New Horizons in artificial intelligence in the healthcare of older people. Age Ageing. 2023;52(12).
39.
Rosko AE, Elsaid M, Wall SA, Mims A, Woyach JA, Presley C, et al. Molecular biomarkers of aging to predict clinical frailty in newly diagnosed hematologic malignancy. Blood. 2023;142(Supplement 1):5164.CrossRef
40.
Ipson BR, Fletcher MB, Espinoza SE, Fisher AL. Identifying exosome-derived MicroRNAs as candidate biomarkers of frailty. J Frailty Aging. 2018;7(2):100–3.PubMedPubMedCentral
Metadata
Title
Developing a National Study That Integrates the Geriatric Assessment into the Care of Older Patients with Myeloid Malignancies
Author
Vijaya Raj Bhatt
Publication date
11-09-2024
Publisher
Springer US
Published in
Current Oncology Reports
Print ISSN: 1523-3790
Electronic ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-024-01600-y

2024 ESMO Congress

Add-on Ra223 could be a new first-line option in mCRPC

Adding radium-223 to first-line enzalutamide significantly improves the survival of patients with bone metastatic castration-resistant prostate cancer.

Read more

AI model can predict tumor mutations

No OS benefit of adding preoperative CRT in gastric cancer

T-DXd supported for breast cancer with brain metastases

» View more highlights on the ESMO 2024 hub page

SPONSORED

Recent advances in the use of CAR T-cell therapies in relapsed/refractory diffuse large B-cell lymphoma and follicular lymphoma

  • Webinar | 01-10-2024 | 12:30 (CEST)

In this webinar, Professor Martin Dreyling and an esteemed international panel of CAR T-cell therapy experts discuss the latest data on the safety, efficacy, and clinical impact of CAR T-cell therapies in the treatment of r/r DLBCL and r/r FL.

Please note, this webinar is not intended for healthcare professionals based in the US and UK.

Sponsored by:
  • Novartis Pharma AG
Chaired by: Prof. Martin Dreyling
Developed by: Springer Healthcare
Get a reminder for the on-demand version
Image Credits