Correlation of geriatric assessment and outcomes of acute myeloid leukemia in elderly patients

Abstract

Background Frailty is a vulnerable susceptibility to stressors during aging. Assessment of frailty could help make appropriate management plans and early interventions. Geriatric 8 (G8) is a screening tool designed to identify those at risk for frailty who need a more detailed assessment, while Geriatric Assessment in Hematology (GAH) is a multidimensional assessment similar to the comprehensive assessment designed specifically for patients with hematological malignancies. Methods Thirty-two newly diagnosed elderly acute myeloid leukemia (AML) patients, with a mean age of 64.9 years, were assessed by G8 and GAH scores to be reclassified into 16 frail patients and 16 non-frail patients. The disease progression, hospital stay, complications, overall survival, and mortality rates in both groups were followed for 6 months. Results Comorbidities with diabetes mellitus (DM) and hypertension (HTN) were significantly higher in frail patients compared to non-frail patients; also, the ECOG performance score was significantly higher in frail patients compared to the non-frail patients. At 6 months of evaluation, non-frail patients had better overall response compared to frail patients, on using both G8 and GAH scores. At 1, 3, and 6 months of evaluation, the frail patients group exhibited a significantly higher mortality rate than the non-frail group. In our study, median hospitalization of non-frail group was significantly higher than that of frail group and total incidence of complications did not reveal a significant correlation with patient's frailty status. Conclusion Based on G8 and GAH scores, frail AML patients were more likely to have a higher incidence of early mortality and lower overall survival compared to non-frail patients.