Development and psychometric validation of a brief comprehensive health status assessment scale in older patients with hematological malignancies: The GAH Scale

Bonanad, Santiago; Rubia, Javier de la; Gironella, Mercedes; Persona, Ernesto Pérez; González, Bernardo; Lago, C. Fernández; Arnán, Montserrat; Zudaire, Maite; Rivas, José; Soler, A.; Marrero, Carmen; Olivier, C; Altés, A.; Valcárcel, David; Hernandez, Marisol; Oiartzabal, Itziar; Ordoño, R. Fernández; Arnao, Mario; Esquerra, A.; Sarrà, Josep; González‐Barca, Eva; Gonzalez, Jesús Vicente García; Calvo, Xavier; Nomdedéu, Meritxell; Guiñon, Antonio Garcia; Payer, Ángel Ramírez; Casado, Alfonso; López, Santiago Rodríguez; Durán, Marta; Marcos, M.; Cruz-Jentoft, Alfonso J.

doi:10.1016/j.jgo.2015.03.003

Cited by 58 publications

(35 citation statements)

References 42 publications

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“…Given the aspects of hematologic oncology that are unique (eg, continued potential curability despite the presence of advanced disease), Spanish researchers developed the Geriatric Assessment in Hematology (GAH) scale, a 30-item measure that covers 8 geriatric domains. 19 Taking about 12 minutes to complete, the scale was piloted with 363 patients aged 65 years or older with MDS, AML, multiple myeloma, and CLL. Almost 90% of patients completed all items.…”

Section: What Can the Individual Hematologist Do?mentioning

confidence: 99%

“…The Rockwood model 18 alternatively assesses frailty as the cumulative effect of 30 or more "deficits" and considers additional factors such as comorbidity and cognition. There are also hybrid models 19 and simple questionnaires, [20][21][22] but screening is best captured through in-person functional examination, known as geriatric assessment. This approach has been repeatedly shown to detect unrecognized vulnerabilities in large cohorts of patients with cancer and predict treatment tolerance, survival, and quality of survivorship.…”

Section: Introduction To Frailtymentioning

confidence: 99%

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Frailty and the management of hematologic malignancies

Abel

Klepin

2018

Blood

161

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The majority of blood cancers occur in the elderly. This fact conspires with an aging population in many countries to make rigorous assessment for frailty increasingly important for hematologic oncologists. In this review, we first define frailty and its relevance for patients with hematologic malignancy. Next, we review current data regarding the effect of domains of frailty on outcomes for blood cancers including myelodysplastic syndromes, acute leukemia, non-Hodgkin lymphomas such as chronic lymphocytic leukemia, and multiple myeloma. Finally, after presenting assessment and treatment options for the practicing hematologist, we propose elements of a new research agenda for geriatric hematology: the exchange of age limits for rigorous frailty screening, development of disease-specific measures, and inclusion of functional and patient-reported outcomes alongside survival.

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Section: What Can the Individual Hematologist Do?mentioning

confidence: 99%

Section: Introduction To Frailtymentioning

confidence: 99%

Frailty and the management of hematologic malignancies

Abel

Klepin

2018

Blood

161

View full text Add to dashboard Cite

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“… 25 Other geriatric assessment tools have been developed and applied to hematological cancers in general, and it is likely that a geriatric assessment score will be incorporated into future international trials. 26 – 28 There is a clear need to gather further prospective evidence in this older age group, and to develop and validate new scoring systems that may guide practice in the future.…”

Section: Challenge 2 – How Should the Need For Treatment And The Fitnmentioning

confidence: 99%

Multiple myeloma in the very elderly patient: challenges and solutions

Willan

Eyre

Sharpley

et al. 2016

CIA

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Diagnosis and management of myeloma in the very elderly patient is challenging. Treatment options have vastly improved for elderly myeloma patients but still require the clinician to personalize therapy. In this paper, we offer evidence-based, pragmatic advice on how to overcome six of the main challenges likely to arise: 1) diagnosis of myeloma in this age group, 2) assessment of the need for treatment, and the fitness for combination chemotherapy, 3) provision of the best quality of supportive care, 4) choice of combination chemotherapy in those fit enough for it, 5) treatment of relapsed myeloma, and 6) provision of end of life care. With an increased burden of comorbidities and a reduced resilience to treatment and its associated toxicities, the management of myeloma in this age group requires a different approach to that in younger patients to maximize both quality and length of life.

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“…Older adults diagnosed with cancer must be assessed [ 5 , 6 , 7 , 8 , 9 ] by a geriatric team or a “geriatric trained physician”, upfront or after a screening procedure. Nevertheless, many hospitals lack optimal geriatric facilities and the Spanish Group for Geriatrics in Hematology has developed an abridged geriatric scale (Geriatric Assessment in Hematology, GAH) to simplify this process [ 10 , 11 ]. GAH is now on an advanced stage of development and validation, and it is owned by Celgene S.L.U.…”

Section: Introductionmentioning

confidence: 99%

Patient General Condition at Diagnosis: A Systematic Evaluation for Adults Diagnosed with Hematologic Malignancies

Ramos

González-Carmona

Porras-Guerra

et al. 2020

JPM

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Several societies have published recommendations for evaluating older adults with cancer in standard conditions. It is vital to assure a proper systematic patient condition evaluation, not only in the oldest (geriatric assessment) but in all adult patients. We have investigated the feasibility of a systematic evaluation of the general condition of all patients diagnosed with hematologic malignancies, and the degree of acceptance by the clinical team, in a prospective cohort of 182 consecutive adults, by using the ECOG performance status scale (ECOG, age 18 and over, 18+), Lee Index for Older Adults (LEE, 50+), Geriatric Assessment in Hematology (GAH, 65+), and the Comprehensive Geriatric Assessment (CGA, 75+). Clinical team acceptance was analyzed with a visual analogue scale, and the objective feasibility was calculated as the proportion of patients that could be finally evaluated with each tool. Acceptance was high, but the objective feasibility was progressively lower as the complexity of the different tools increased (ECOG 100%, LEE 99.4%, GAH 93.2%, and CGA 67.9%). LEE and GAH categories showed a weak concordance (Cohen’s Kappa 0.24) that was slight between LEE and CGA (Kappa 0.18). Unexpectedly, we found no significant association between the GAH and CGA categories (p = 0.16). We confirm that a systematic evaluation of all adult patients diagnosed with hematologic malignancies is feasible in daily practice by using an age-adapted approach. Direct comparisons among the different predictive tools in regard to patients’ tolerance to treatments of different intensities must be a priority research subject in the coming years.

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Development and psychometric validation of a brief comprehensive health status assessment scale in older patients with hematological malignancies: The GAH Scale

Cited by 58 publications

References 42 publications

Frailty and the management of hematologic malignancies

Frailty and the management of hematologic malignancies

Multiple myeloma in the very elderly patient: challenges and solutions

Patient General Condition at Diagnosis: A Systematic Evaluation for Adults Diagnosed with Hematologic Malignancies

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