TO THE EDITOR:

Geriatric assessment is feasible and can predict survival in older adults starting therapy for acute myeloid leukemia (AML).1-4  Among older adults receiving intensive therapy, impaired objectively measured physical function (Short Physical Performance Battery; SPPB) and cognition are associated with worse survival. In the nonintensive setting, a frailty score inclusive of impairment in activities of daily living (ADL) is associated with worse survival. Studies investigating patient characteristics, such as comorbidity and polypharmacy, further support evaluation of patient-specific vulnerabilities to inform mortality risk.5-11 

Most studies, however, have focused on the use of geriatric assessment at the time of diagnosis. Geriatric assessment–detected vulnerabilities are dynamic and may improve or worsen during therapy. Short-term declines in self-reported and objective physical function occur after intensive induction therapy.4,12  However, the use of repeated geriatric assessment at the time of postremission therapy to predict clinically important outcomes is...

REFERENCES

REFERENCES
1.
Deschler
B
,
Ihorst
G
,
Platzbecker
U
, et al
.
Parameters detected by geriatric and quality of life assessment in 195 older patients with myelodysplastic syndromes and acute myeloid leukemia are highly predictive for outcome
.
Haematologica
.
2013
;
98
(
2
):
208
-
216
.
2.
Klepin
HD
,
Geiger
AM
,
Tooze
JA
, 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
-
1846
.
3.
Klepin
HD
,
Geiger
AM
,
Tooze
JA
, et al
.
Geriatric assessment predicts survival for older adults receiving induction chemotherapy for acute myelogenous leukemia
.
Blood
.
2013
;
121
(
21
):
4287
-
4294
.
4.
Klepin
HD
,
Ritchie
E
,
Major-Elechi
B
, et al
.
Geriatric assessment among older adults receiving intensive therapy for acute myeloid leukemia: Report of CALGB 361006 (Alliance)
.
J Geriatr Oncol
.
2020
;
11
(
1
):
107
-
113
.
5.
Elliot
K
,
Tooze
JA
,
Geller
R
, et al
.
The prognostic importance of polypharmacy in older adults treated for acute myelogenous leukemia (AML)
.
Leuk Res
.
2014
;
38
(
10
):
1184
-
1190
.
6.
Etienne
A
,
Esterni
B
,
Charbonnier
A
, et al
.
Comorbidity is an independent predictor of complete remission in elderly patients receiving induction chemotherapy for acute myeloid leukemia
.
Cancer
.
2007
;
109
(
7
):
1376
-
1383
.
7.
Giles
FJ
,
Borthakur
G
,
Ravandi
F
, et al
.
The haematopoietic cell transplantation comorbidity index score is predictive of early death and survival in patients over 60 years of age receiving induction therapy for acute myeloid leukaemia
.
Br J Haematol
.
2007
;
136
(
4
):
624
-
627
.
8.
Kuhlman
P
,
Isom
S
,
Pardee
TS
, et al
.
Association between glycemic control, age, and outcomes among intensively treated patients with acute myeloid leukemia
.
Support Care Cancer
.
2019
;
27
(
8
):
2877
-
2884
.
9.
Sherman
AE
,
Motyckova
G
,
Fega
KR
, et al
.
Geriatric assessment in older patients with acute myeloid leukemia: a retrospective study of associated treatment and outcomes
.
Leuk Res
.
2013
;
37
(
9
):
998
-
1003
.
10.
Sorror
ML
,
Storer
BE
,
Fathi
AT
, et al
.
Development and validation of a novel acute myeloid leukemia-composite model to estimate risks of mortality
.
JAMA Oncol
.
2017
;
3
(
12
):
1675
-
1682
.
11.
Tawfik
B
,
Pardee
TS
,
Isom
S
, et al
.
Comorbidity, age, and mortality among adults treated intensively for acute myeloid leukemia (AML)
.
J Geriatr Oncol
.
2016
;
7
(
1
):
24
-
31
.
12.
Klepin
HD
,
Tooze
JA
,
Pardee
TS
, et al
.
Effect of intensive chemotherapy on physical, cognitive, and emotional health of older adults with acute myeloid leukemia
.
J Am Geriatr Soc
.
2016
;
64
(
10
):
1988
-
1995
.
13.
El-Jawahri
A
,
Traeger
L
,
Greer
JA
, et al
.
Effect of inpatient palliative care during hematopoietic stem-cell transplant on psychological distress 6 months after transplant: results of a randomized clinical trial
.
J Clin Oncol
.
2017
;
35
(
32
):
3714
-
3721
.
14.
El-Jawahri
A
,
LeBlanc
T
,
VanDusen
H
, et al
.
Effect of inpatient palliative care on quality of life 2 weeks after hematopoietic stem cell transplantation: a randomized clinical trial
.
JAMA
.
2016
;
316
(
20
):
2094
-
2103
.
15.
Liu
MA
,
DuMontier
C
,
Murillo
A
, et al
.
Gait speed, grip strength, and clinical outcomes in older patients with hematologic malignancies
.
Blood
.
2019
;
134
(
4
):
374
-
382
.
16.
Alibhai
SM
,
Durbano
S
,
Breunis
H
, et al
.
A phase II exercise randomized controlled trial for patients with acute myeloid leukemia undergoing induction chemotherapy
.
Leuk Res
.
2015
;
S0145-2126(15)30365-9
.
17.
Alibhai
SM
,
O’Neill
S
,
Fisher-Schlombs
K
, et al
.
A clinical trial of supervised exercise for adult inpatients with acute myeloid leukemia (AML) undergoing induction chemotherapy
.
Leuk Res
.
2012
;
36
(
10
):
1255
-
1261
.
18.
Kilari
D
,
Soto-Perez-de-Celis
E
,
Mohile
SG
, et al
.
Designing exercise clinical trials for older adults with cancer:recommendations from 2015 Cancer and Aging Research Group NCI U13 Meeting
.
J Geriatr Oncol
.
2016
;
7
(
4
):
293
-
304
.
19.
Klepin
HD
,
Danhauer
SC
,
Tooze
JA
, et al
.
Exercise for older adult inpatients with acute myelogenous leukemia: a pilot study
.
J Geriatr Oncol
.
2011
;
2
(
1
):
11
-
17
.
20.
Pinquart
M
,
Duberstein
PR
.
Depression and cancer mortality: a meta-analysis
.
Psychol Med
.
2010
;
40
(
11
):
1797
-
1810
.
21.
Kanesvaran
R
,
Li
H
,
Koo
KN
,
Poon
D
.
Analysis of prognostic factors of comprehensive geriatric assessment and development of a clinical scoring system in elderly Asian patients with cancer
.
J Clin Oncol
.
2011
;
29
(
27
):
3620
-
3627
.
22.
Kirkhus
L
,
Harneshaug
M
,
Šaltytė Benth
J
, et al
.
Modifiable factors affecting older patients’ quality of life and physical function during cancer treatment
.
J Geriatr Oncol
.
2019
;
10
(
6
):
904
-
912
.
You do not currently have access to this content.

Sign in via your Institution

Sign In