Summary of evidence
| Study . | Disease, N . | Age, y . | Timeframe . | GA domains . | Main findings . |
|---|---|---|---|---|---|
| Klepin et al9 2016; Saad et al10 2017; Loh et al11 2019 | AML, N = 49 | ≥60 | At baseline and within 8 wk of completing induction | Physical function: ADL, IADL, mobility, SPPB, grip strength; cognition: 3MS; mood: CES-D, distress thermometer; comorbidity: HCT-CI | Physical function: decrease in all measures; cognition: no change; mood: stable CES-D, decrease in distress |
| •Depression symptom correlated with greater decline in SPPB scores | |||||
| •Lower postinduction SPPB scores correlated with worse survival in patients who achieved remission | |||||
| •TNFα sR1 was a correlative biomarker for physical functioning | |||||
| •Baseline TNFα and CRP were associated with overall survival | |||||
| Alibhai et al12 2015 | AML, N = 97 | ≥60 | At baseline and 7 time points the following year | Physical function: IADL, grip strength, 2MWT, chair stands; mood: Beck Depression Scale; QOL: EORTC QLQ-C30; fatigue: FACT-F scale | Physical function: IADL and grip strength worse in the first 3 mo and then improves steadily; other tests improve steadily; mood: improves steadily; QOL: improves steadily; fatigue: improves steadily |
| •GA and QOL improvements were seen in patients in clinical remission | |||||
| •Similar trajectories were seen in younger patients (<60 y old) | |||||
| Bonanad et al13 2015; Cruz-Jentoft et al14 2017 | Various hematologic malignancy, N = 164 | ≥65 | At baseline and on average, 1.4 y later | Physical function: ADL, gait speed; cognition: SPMSQ; mood: CES-D; nutrition: MNA; subjective health: VES-13; medications and comorbidities | GAH total score: no changes for the complete cohort from the baseline to the follow-up assessment |
| •GAH score changes correlated with ECOG, KPS, and VAS score changes | |||||
| •Score changes were significantly different for patients in remission vs progressive/stable disease | |||||
| Deschler et al15 2018 | Allo-HCT, N = 108 | ≥60 | At baseline and days +30, +100, and +180 | Physical function: ADL, IADL, timed up and go; cognition: MMSE; nutrition: MNA; QOL: EORTC QLQ-C30; German short-form resilience; comorbidities | Physical function: nadir by day +30 to +100 → recover close to baseline by day +180; cognition: nadir by day +30 → improve; nutrition: nadir by day +30 → improve; QOL: nadir by day +30 → improve |
| •Baseline timed up and go was predictive of overall survival | |||||
| •Changes in physical function or nutrition were associated with survival outcomes |
| Study . | Disease, N . | Age, y . | Timeframe . | GA domains . | Main findings . |
|---|---|---|---|---|---|
| Klepin et al9 2016; Saad et al10 2017; Loh et al11 2019 | AML, N = 49 | ≥60 | At baseline and within 8 wk of completing induction | Physical function: ADL, IADL, mobility, SPPB, grip strength; cognition: 3MS; mood: CES-D, distress thermometer; comorbidity: HCT-CI | Physical function: decrease in all measures; cognition: no change; mood: stable CES-D, decrease in distress |
| •Depression symptom correlated with greater decline in SPPB scores | |||||
| •Lower postinduction SPPB scores correlated with worse survival in patients who achieved remission | |||||
| •TNFα sR1 was a correlative biomarker for physical functioning | |||||
| •Baseline TNFα and CRP were associated with overall survival | |||||
| Alibhai et al12 2015 | AML, N = 97 | ≥60 | At baseline and 7 time points the following year | Physical function: IADL, grip strength, 2MWT, chair stands; mood: Beck Depression Scale; QOL: EORTC QLQ-C30; fatigue: FACT-F scale | Physical function: IADL and grip strength worse in the first 3 mo and then improves steadily; other tests improve steadily; mood: improves steadily; QOL: improves steadily; fatigue: improves steadily |
| •GA and QOL improvements were seen in patients in clinical remission | |||||
| •Similar trajectories were seen in younger patients (<60 y old) | |||||
| Bonanad et al13 2015; Cruz-Jentoft et al14 2017 | Various hematologic malignancy, N = 164 | ≥65 | At baseline and on average, 1.4 y later | Physical function: ADL, gait speed; cognition: SPMSQ; mood: CES-D; nutrition: MNA; subjective health: VES-13; medications and comorbidities | GAH total score: no changes for the complete cohort from the baseline to the follow-up assessment |
| •GAH score changes correlated with ECOG, KPS, and VAS score changes | |||||
| •Score changes were significantly different for patients in remission vs progressive/stable disease | |||||
| Deschler et al15 2018 | Allo-HCT, N = 108 | ≥60 | At baseline and days +30, +100, and +180 | Physical function: ADL, IADL, timed up and go; cognition: MMSE; nutrition: MNA; QOL: EORTC QLQ-C30; German short-form resilience; comorbidities | Physical function: nadir by day +30 to +100 → recover close to baseline by day +180; cognition: nadir by day +30 → improve; nutrition: nadir by day +30 → improve; QOL: nadir by day +30 → improve |
| •Baseline timed up and go was predictive of overall survival | |||||
| •Changes in physical function or nutrition were associated with survival outcomes |
Allo-HCT, allogeneic hematopoietic cell transplantation; CES-D, Center for Epidemiologic Studies—Depression Scale; CRP, C-reactive protein; ECOG, Eastern Cooperative Oncology Group; EORTC QLQ-C30, European organization for research and treatment of cancer quality of life questionnaire core; FACT-F, functional assessment of cancer therapy: fatigue scale; GAH: Geriatric Assessment in Hematology; HCT-CI: hematopoietic cell transplantation-specific comorbidity index; KPS, Karnofsky performance scale; MMSE: Mini-Mental State Examination; MNA, mini-nutrition assessment; 3MS, Modified Mini-Mental State examination; 2MWT, 2-minute walk test; N, number; SPMSQ, short portable mental status questionnaire; TNFα sR1, tumor necrosis factor-α; TNFα sR1, soluble tumor necrosis factor-α receptor 1; VAS, visual analog scale; VES-13, vulnerable elders survey.