PMID- 35650009
OWN - NLM
STAT- MEDLINE
DCOM- 20220719
LR  - 20230410
IS  - 2152-2669 (Electronic)
IS  - 2152-2669 (Linking)
VI  - 22
IP  - 8
DP  - 2022 Aug
TI  - Predicting the Risks of Aggressive-Intent Chemotherapy Toxicity in Older Patients 
      With Lymphoma: A Prospective Observational Pilot Study.
PG  - e792-e803
LID - S2152-2650(22)00122-7 [pii]
LID - 10.1016/j.clml.2022.04.011 [doi]
AB  - INTRODUCTION: Lymphoma is a disease of older patients and while treatment is 
      subtype specific, curative or aggressive intent combination chemotherapy is often 
      recommended. However, there has been limited evidence on which to base treatment 
      decisions for older adults. Our objectives were to assess the utility of risk 
      stratification measures and serial functional tests in predicting chemotherapy 
      toxicity and as well the feasibility of conducting these in older adults 
      undergoing chemotherapy for lymphoproliferative disorders. MATERIALS AND METHODS: 
      This prospective cohort study recruited lymphoma patients 70 years or older 
      planned for systemic chemotherapy. The Cancer and Aging Research Group (CARG) 
      risk stratification tool and Chemotherapy Risk Assessment Scale for High-Age 
      Patients (CRASH) were calculated at baseline. The Clinical Frailty Scale (CFS), 
      Charlson Comorbidity Index score, grip strength and gait speed test, and toxicity 
      events, were assessed at baseline and serially throughout treatment. Sarcopenia 
      was calculated on CT scans at baseline, midway through treatment, and 1-month 
      after completion of therapy. The primary endpoint was to assess the feasibility 
      of applying these measures in busy ambulatory clinics. These measures were also 
      correlated with clinical outcomes including >/=grade 3 adverse events (AEs), 
      hospitalizations and emergency department visits, dose changes or delays, and 
      overall survival. RESULTS: In total, 30 patients were enrolled (mean age 78.1 +/- 
      6.4 years), of whom 20 were treated with curative intent. A total of 16 patients 
      (53%) experienced grade >/=3 AEs, 9 (56%) of which led to a chemotherapy delay. On 
      univariable analyses, CFS score, a high CARG score, medium to high CRASH score, 
      and the gait speed were associated with grade >/=3 AEs, while only CFS remained 
      significant on multivariable analysis. On univariable analysis, patients with a 
      medium to high risk CRASH score were more likely than low risk patients to have 
      an unplanned emergency department visit or hospitalization. CONCLUSIONS: The CFS 
      seems to predict toxicity in this cohort study, with gait speed, CARG and CRASH 
      scores being potentially additional predictive methods of evaluation.
CI  - Copyright (c) 2022 Elsevier Ltd. All rights reserved.
FAU - Dhir, Vinita
AU  - Dhir V
AD  - Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 
      Toronto, ON, Canada.
FAU - Maganti, Manjula
AU  - Maganti M
AD  - Department of Biostatistics, University Health Network, Toronto, ON, Canada.
FAU - Rozenberg, Dmitry
AU  - Rozenberg D
AD  - Department of Medicine, Division of Respirology, University Health Network, 
      Toronto, ON, Canada.
FAU - Kukreti, Vishal
AU  - Kukreti V
AD  - Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 
      Toronto, ON, Canada.
FAU - Kuruvilla, John
AU  - Kuruvilla J
AD  - Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 
      Toronto, ON, Canada.
FAU - Crump, Michael
AU  - Crump M
AD  - Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 
      Toronto, ON, Canada.
FAU - Prica, Anca
AU  - Prica A
AD  - Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 
      Toronto, ON, Canada. Electronic address: Anca.Prica@uhn.ca.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20220429
PL  - United States
TA  - Clin Lymphoma Myeloma Leuk
JT  - Clinical lymphoma, myeloma & leukemia
JID - 101525386
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - *Frailty
MH  - Geriatric Assessment/methods
MH  - Humans
MH  - *Lymphoma/diagnosis/drug therapy
MH  - Pilot Projects
MH  - Prospective Studies
OTO - NOTNLM
OT  - Aging
OT  - Frailty
OT  - Geriatric oncology
OT  - Lymphoma
OT  - Physical performance testing
EDAT- 2022/06/02 06:00
MHDA- 2022/07/20 06:00
CRDT- 2022/06/01 22:05
PHST- 2022/01/11 00:00 [received]
PHST- 2022/04/03 00:00 [revised]
PHST- 2022/04/08 00:00 [accepted]
PHST- 2022/06/02 06:00 [pubmed]
PHST- 2022/07/20 06:00 [medline]
PHST- 2022/06/01 22:05 [entrez]
AID - S2152-2650(22)00122-7 [pii]
AID - 10.1016/j.clml.2022.04.011 [doi]
PST - ppublish
SO  - Clin Lymphoma Myeloma Leuk. 2022 Aug;22(8):e792-e803. doi: 
      10.1016/j.clml.2022.04.011. Epub 2022 Apr 29.