Pretreatment frailty is an independent prognostic factor among elderly patients with B‐cell lymphoma undergoing immunochemotherapy: A prospective observational cohort study in Taiwan

Background/purpose Frailty is a common clinical syndrome among the elderly; however, it is frequently neglected in patients with hematological malignancies, especially among the Asian population. This study is aimed to evaluate the prevalence and effect of frailty on survival outcomes in elderly Asi...

Full description

Saved in:
Bibliographic Details
Published in:Asia-Pacific journal of clinical oncology 2023-02, Vol.19 (1), p.62-70
Main Authors: Hung, Yu‐Shin, Chang, Hung, Wang, Po‐Nan, Kuo, Ming‐Chung, Su, Yi‐Jiun, Hung, Chia‐Yen, Hsueh, Shun‐Wen, Yeh, Kun‐Yun, Ho, Ya‐Wen, Chou, Wen‐Chi
Format: Article
Language:English
Subjects:
Aged
B-cell lymphoma
Cohort analysis
Frailty
Frailty - epidemiology
frailty assessment
Humans
Lymphoma
Lymphoma, B-Cell
Malignancy
Medical prognosis
Multivariate analysis
Observational studies
overall survival
Patients
Population studies
Prognosis
Prospective Studies
Rituximab
Taiwan - epidemiology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background/purpose Frailty is a common clinical syndrome among the elderly; however, it is frequently neglected in patients with hematological malignancies, especially among the Asian population. This study is aimed to evaluate the prevalence and effect of frailty on survival outcomes in elderly Asian patients with B‐cell lymphoma. Methods We prospectively enrolled 76 consecutive patients with age ≥ 65 years and newly diagnosed B‐cell lymphoma and were receiving immunochemotherapy in a medical center in Taiwan between August 2016 and December 2017. The frailty of all patients was assessed using a comprehensive geriatric assessment (CGA) within 7 days before immunochemotherapy. Results Twenty‐seven patients (36%) were allocated to the frail group based on CGA. With a median follow‐up duration of 26.5 (range, 1.7–39.8) months, the 1‐ and 2‐year survival rates were 68% and 58%, respectively, for all group of patients. In patients in the non‐frail group, the 1‐year and 2‐year survival rates were 81% and 71%, respectively, compared to 44% and 33%, respectively, in the frail group (hazard ratio [HR], 3.57, 95% confidence interval [CI], 1.74–7.30; p = 0.001). Age ≥ 75years (adjusted HR 2.57, 95% CI 1.02–6.47, p = 0.045), presence of B‐symptoms (adjusted HR 2.43, 95% CI 1.05–5.60, p = 0.038), and frailty (adjusted HR 3.03, 95% CI 1.29–7.11, p = 0.011) were independent prognostic factors in the multivariate analysis. Conclusion Frailty significantly influenced the survival outcome as an independent prognostic factor in elderly patients with B‐cell lymphoma undergoing immunochemotherapy. Pretreatment frailty assessment is critical to assist clinicians and patients with B‐cell lymphoma with prognosis prediction and counseling on an appropriate treatment goal. Frailty is a common clinical syndrome among the elderly; however, it is frequently neglected in patients with hematological malignancies, especially among the Asian population. This is the first study to evaluate the prevalence rate and effect of frailty on survival outcome in elderly patients undergoing immunochemotherapy for the treatment of B‐cell lymphoma in Taiwan. This study found a negative association between the numbers of geriatric dimensional impairment and survival outcome. Pretreatment frailty assessment is essential to assist clinicians and patients with B‐cell lymphoma with prognosis prediction and counseling on an appropriate treatment goal.
ISSN:1743-7555
1743-7563
DOI:10.1111/ajco.13661