Park Seha, Hong Junshik, Hwang Incheol, Ahn Jeong-Yeal, Cho Eun Yeong, Park Jinny, Cho Eun Kyung, Shin Dong Bok, Lee Jae Hoon
Department of Medicine, Gachon University School of Medicine, Incheon 405-760, Republic of Korea.
Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon 405-760, Republic of Korea.
J Geriatr Oncol. 2015 Nov;6(6):470-8. doi: 10.1016/j.jgo.2015.10.183. Epub 2015 Oct 27.
The purpose of this prospective observational study is to evaluate the relation of the comprehensive geriatric assessment (CGA) to tolerability and survival of multi-agent chemotherapy for curative intent in elderly patients with aggressive non-Hodgkin lymphoma (NHL).
Patients who were 1) age ≥65 years, 2) newly diagnosed aggressive NHL, and 3) treated with multi-agent chemotherapy within 2 weeks from the time of diagnosis were enrolled from January 2011 to June 2014. Baseline clinical, laboratory, and CGA data being composed of Mini Nutritional Assessment-Short Form (MNA-SF), Korean version of Mini Mental Status Exam, Korean-Geriatric Depression Scale, and Groningen Frailty Index (GFI), were collected and analyzed for the relation to the outcome factors.
Seventy patients were included; the median age was 73.5 years, 27 (38.6%) patients were Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 2 or more, and half of the patients were high or high-intermediate risk by age-adjusted international prognostic index (aaIPI). Most patients received CHOP or CHOP-like chemotherapy. Factors affecting discontinuation of chemotherapy within 12 weeks were poor MNA-SF, poor GFI, poor PS, and presence of B symptom. Among those, poor MNA-SF was independent of other variables in multivariate analysis. Poor MNA-SF, bone marrow involvement, and baseline anemia of hemoglobin<10g /dL were found to be independent factors associated with inferior overall survival whereas aaIPI factors were not.
MNA-SF predicted tolerability to multi-agents chemotherapy and overall survival in elderly patients with aggressive NHL who were treated with multi-agent chemotherapy.
本前瞻性观察性研究旨在评估综合老年评估（CGA）与老年侵袭性非霍奇金淋巴瘤（NHL）患者根治性多药化疗耐受性及生存情况之间的关系。
纳入2011年1月至2014年6月期间符合以下条件的患者：1）年龄≥65岁；2）新诊断为侵袭性NHL；3）在诊断后2周内接受多药化疗。收集基线临床、实验室及CGA数据，包括简易营养评估简表（MNA-SF）、韩国版简易精神状态检查表、韩国老年抑郁量表和格罗宁根衰弱指数（GFI），并分析其与结局因素的关系。
共纳入70例患者；中位年龄为73.5岁，27例（38.6%）患者东部肿瘤协作组（ECOG）体能状态（PS）为2或更高，且根据年龄调整的国际预后指数（aaIPI），半数患者为高危或高中危。大多数患者接受CHOP或类似CHOP方案的化疗。影响化疗在12周内中断的因素包括MNA-SF差、GFI差、PS差及存在B症状。其中，在多因素分析中，MNA-SF差独立于其他变量。发现MNA-SF差、骨髓受累及基线血红蛋白<10g/dL的贫血是与总生存较差相关的独立因素，而aaIPI因素并非如此。
MNA-SF可预测接受多药化疗的老年侵袭性NHL患者对多药化疗的耐受性及总生存情况。
