Pivotal prospective geriatric assessment studies in patients with AML
| Study . | Multicenter . | Prospective . | Intensive chemotherapy . | Predictor of mortality . |
|---|---|---|---|---|
| Klepin et al3 | No | Yes | Yes | Objective physical function (SPPB < 9) and cognition (3MS < 77) |
| Klepin et al,4 CALGB 361006 | Yes | Yes | Yes | None (small feasibility study)∗ |
| Min et al7 | No | Yes | Yes | Objective physical function (SPPB < 9; 4-m gait speed < 4.82 s; and impaired sit to stand speed >11.2 s), emotional health (GDS ≥ 6) |
| Ritchie et al,5 CALGB | Yes | Yes | No | Comorbidity burden (HCT CI ≥ 3), cognition (BOMC ≥ 4), physical function (OARS IADL < 14) |
| Deschler et al24 | Yes | Yes | Various intensity treatments including BSC | Physical function (impaired ADL), high level of fatigue, and KPS < 80 |
| Study . | Multicenter . | Prospective . | Intensive chemotherapy . | Predictor of mortality . |
|---|---|---|---|---|
| Klepin et al3 | No | Yes | Yes | Objective physical function (SPPB < 9) and cognition (3MS < 77) |
| Klepin et al,4 CALGB 361006 | Yes | Yes | Yes | None (small feasibility study)∗ |
| Min et al7 | No | Yes | Yes | Objective physical function (SPPB < 9; 4-m gait speed < 4.82 s; and impaired sit to stand speed >11.2 s), emotional health (GDS ≥ 6) |
| Ritchie et al,5 CALGB | Yes | Yes | No | Comorbidity burden (HCT CI ≥ 3), cognition (BOMC ≥ 4), physical function (OARS IADL < 14) |
| Deschler et al24 | Yes | Yes | Various intensity treatments including BSC | Physical function (impaired ADL), high level of fatigue, and KPS < 80 |
ADL, activities of daily living; BOMC, Blessed orientation-memory-concentration test; GDS, geriatric depression scale; HCT CI, hematopoietic cell transplantation comorbidity index; IADL, instrumental activities of daily living; KPS, Karnofsky performance status; 3MS, modified mini-mental state examination; OARS, Older Americans Resources and Services; SPPB, short physical performance battery.
Min et al7 also demonstrated an association between impairment in function and outcomes such as nonrelapse mortality, grade 3 to 4 infections, and acute kidney injury as well as prolonged hospitalization.
A subsequent analysis of Klepin et al3 study demonstrated that objectively measured physical function (SPPB) and depressive symptoms are associated with worse survival in patients with AML undergoing postremission therapy.25
This feasibility study (n = 54) demonstrated that multidimensional geriatric study can be conducted across multicenter studies with high acceptance and requires ≤30 minutes in total for completion.