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5146 Comprehensive Geriatric Assessment and Geriatric Intervention in Older Patients with Newly Diagnosed Lymphoma: A Prospective Study

Program: Oral and Poster Abstracts
Session: 905. Outcomes Research—Lymphoid Malignancies: Poster III
Hematology Disease Topics & Pathways:
Research, Clinical Practice (Health Services and Quality), Lymphomas, elderly, Clinical Research, health outcomes research, Diseases, real-world evidence, Lymphoid Malignancies, Study Population, Human
Monday, December 11, 2023, 6:00 PM-8:00 PM

Alberto Lopez Garcia, MD1, Ana Isabel Hormigo, MD2*, Ignacio Mahillo, PhD3*, Elham Askari, MD4*, Daniel Morillo, MD5*, Maria Angeles Perez Saez, MD4*, Elena Prieto, MD, PhD5*, Miriam Riesco6*, Celia Urrutia6*, Francisco Javier Martinez Peromingo, MD7*, Juan Ignacio Gonzalez Montalvo, PhD8* and Raul Cordoba, MD, PhD9

1Fundacion Jimenez Diaz University Hospital, Madrid, Spain
2Geriatric Department, Fundacion Jimenez Diaz, Madrid, Spain
3Biostatics Department, Fundacion Jimenez Diaz, Madrid, Spain
4Hematology Department, Fundacion Jimenez Diaz, Madrid, Spain
5Hematology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
6Oncohealth Institute, Fundacion Jimenez Diaz, Madrid, Spain
7General Director of Sociosanitary Coordination. Community of Madrid., Madrid, Spain
8Geriatrics Department, La Paz University Hosital, Madrid, Spain
9Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-JDF, Madrid, Spain

Introduction: Aggressive and indolent non-Hodgkin lymphomas have a median age at diagnosis of 70 years. Above this age, this population is very heterogeneous and clinical outcomes may be worsened due to patient’s frailty phenotype. Very few studies of comprehensive geriatric assessment (CGA) guided approach to care have been published.

Methods: A prospective follow-up with baseline CGA were performed in a cohort of consecutive patients older than 70 years with newly diagnosed Hodgkin and non-Hodgkin lymphoma as standard of care. CGA tools are described in Table 1. Clinical outcome has been analyzed in patients diagnosed between May 2016 and March 2021.

Results: Ninety-three consecutive patients (55.9% of them were women) were included in this analysis, with a median age of 81.1 years (+/- 5.7). 23 patients (24.7%) were classified as robust (type I), 30 patients (32.3%) as pre-frail (type II) with potentially reversable impairments, 38 patients (40.9%) as frail (type III), and only 2 patients (2.2%) as unfit (type IV). Patients’ characteristics are shown in Table 1. All patients received antineoplastic therapy. Treatment modifications were carried out in 64.5% of patients based on CGA results. In the follow-up, with a median follow-up 27.3 months (range 18-74 months), the relapse rate was of 25.8%, with no differences between groups. Overall survival was around 2-fold higher among the fit patients (type I) (42.5 ±19.6 months) than in the disabled patient’s group (types III-IV) (23.7 ±20.5 months) (p 0.002) Statistically significant differences in overall survival (p 0.002), response to treatment (p<0.001) and likelihood of increased frailty at the end of treatment (p 0.024) were observed among groups, with type III-IV patients showing worse overall survival (Figure 1), lower response rates, and higher incidence of frailty.

Conclusion: Systematic CGA allows physicians to address the functional reserve or resilience in older patients with lymphoma in the need of antineoplastic treatment. A frailty-guide approach to care may allow to improve clinical outcomes in this group of high-risk patients.

Disclosures: Lopez Garcia: Beigene: Consultancy; Janssen: Consultancy, Speakers Bureau; Roche: Consultancy, Speakers Bureau; Astrazeneca: Consultancy, Speakers Bureau. Morillo: ABBVIE: Honoraria; GSK: Honoraria. Cordoba: Fundacion Jimenez Diaz University Hospital: Current Employment; F. Hoffmann-La Roche Ltd, Takeda, Abbvie, Janssen, AstraZeneca, Lilly, BeiGene, BMS, Genmab, Incyte, Gilead: Consultancy; F. Hoffmann-La Roche Ltd, Takeda, Abbvie, Janssen, AstraZeneca, Lilly, BeiGene, BMS, Genmab, Incyte, Gilead: Speakers Bureau; European Hematology Association (EHA), Spanish Society Hematology (SEHH): Membership on an entity's Board of Directors or advisory committees.

*signifies non-member of ASH