Because frailty is prevalent in many patients pre- and post-transplant and is associated with age-independent adverse transplant outcomes, the authors of this review recommend incorporating a frailty assessment to optimize the predictive ability of existing pre-transplant assessment (PTA) tools across all age groups and particularly in elderly individuals.
They note that conventional PTA parameters such as chronologic age, comorbidity indices, and Karnofsky performance status may not adequately detect the presence of frailty.
The authors recommend incorporating a frailty assessment into the Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) algorithm.
Such algorithms could identify HCT candidates who are potentially at high risk of adverse HCT outcomes, according to the authors, who conclude that “selecting individuals most likely to benefit from frailty-specific interventions is likely the key to improving HCT outcomes.”
Hegde A, et al. Bone Marrow Transplant