A geriatric assessment (GA) has independent prognostic utility for hematopoietic cell transplant (HCT) outcomes in patients aged 50 years and older, according to a study of 203 older adults (median age 59 years; range 50-73) undergoing GA within one month prior to transplant. At a median follow up of 36 months, poor performance on three GA scales were each significantly associated with inferior survival, independent of scores on the standard HCT-Comorbidity Index (HCT-CI). The researchers then created a simple risk score with 1 point for the most prognostic functional GA measure (Instrumental Activities of Daily Living — IADL) and 1 point for an HCT-CI score >3. This significantly stratified HCT outcomes, particularly in those ≥60 years, with two-year survival of 63%, 29%, and 0% for 0, 1, and 2 points, respectively (p<0.05). The researchers concluded that implementation of GA prior to HCT may aid in appropriate selection of older adults for HCT.
Muffly L, et al. Biol Blood Marrow Transplant (Full abstract only available to BBMT subscribers)