医学
逻辑回归
共病
内科学
骨髓增生异常综合症
霍奇金淋巴瘤
髓系白血病
老年肿瘤学
癌症
淋巴瘤
物理疗法
骨髓
作者
Marie Garric,Sandrine Sourdet,Bastien Cabarrou,Zara Steinmeyer,Martin Gauthier,Loïc Ysebaert,Odile Beyne‐Rauzy,Stéphane Gérard,Stéphanie Lozano,Delphine Bréchemier,Thomas Filleron,Loı̈c Mourey,Laurent Balardy
摘要
Hematological treatment decisions in older adults with hematological malignancies are complex. Our objective is to study the impact of a comprehensive geriatric assessment on hematological treatment decision in older patients and the factors associated with change in treatment plan.We conducted a cross-sectional analysis of patients aged 65 years and above with hematological malignancies, hospitalized between 2008 and 2019 at the University Cancer Institute of Toulouse. They were assessed by a geriatrician/nurse team using a comprehensive geriatric assessment (CGA). A penalized logistic regression model with elastic net regularization was used to identify factors associated with change in hematological treatment plan.A total of 424 patients were included. Main hematological malignancies were lymphoma (36.1 %), acute myeloid leukemia (26.9 %) and myelodysplastic syndrome (19.8%). Change in hematological treatment plan was suggested after CGA for 92 patients (21.7%). Factors associated with change in treatment plan were functional impairment according to ADL and IADL scale, mobility impairment, the presence of comorbidity defined by the Charlson score >1 and increasing age.A CGA has a significant impact on hematological treatment decision in older patients. Functional and mobility impairment, comorbidities and age are predictive factors of change in treatment plan.
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