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Pilot prospective study of Frailty and Functionality in routine clinical assessment in allogeneic hematopoietic cell transplantation

Authors :
Salas, Maria Queralt
Atenafu, Eshetu G.
Bascom, Ora
Wilson, Leeann
Lam, Wilson
Law, Arjun Datt
Pasic, Ivan
Kim, Dennis (Dong Hwan)
Michelis, Fotios V.
Al-Shaibani, Zeyad
Gerbitz, Armin
Viswabandya, Auro
Lipton, Jeffrey Howard
Mattsson, Jonas
Alibhai, Shabbir M. H.
Kumar, Rajat
Source :
Bone Marrow Transplantation; January 2021, Vol. 56 Issue: 1 p60-69, 10p
Publication Year :
2021

Abstract

A Frailty and Functionality evaluation for alloHCT was implemented using existing resources. We describe the implementation of this evaluation across all ages and at first consultation, and correlate results with posttransplant outcomes in 168 patients. The evaluation consists of: Clinical Frailty Scale (CFS), Instrumental Activities of Daily Living (IADL), grip strength (GS), timed up and go test (TUGT), self-rated health question (SRH), Single question of Falls, albumin and C-Reactive Protein (CRP) levels. Median time to perform the evaluation was 5–6?min. Median age was 58 years (range: 19–77) and median follow-up was 5.3 months. TUGT?>?10?s (HR 2.92; p?=?0.003), raised CRP (HR 4.40; p?<?0.001), and hypoalbuminemia (HR 2.10; p?=?0.043) were significant risk factors for worse overal survival (OS). CFS?=?3 (HR 3.11; p?=?0.009), TUGT?>?10?s (HR 3.47; p?=?0.003), GS (HR 2.56; p?=?0.029), SRH (<excellent) (HR 3.8?×?106; p?<?0.001), elevated CRP (HR 11.8; p?<?0.001), and hypoalbuminemia (HR 4.6; p?<?0.001), were significant predictors for worse non relapse mortality (NRM). On multivariable analysis, TUGT?>?10?s and raised CRP were significant predictors for worse OS and NRM. SRH (<excellent) was a significant predictor for higher NRM. Frailty and Functionality can be assessed in routine clinical practice in alloHCT and may be predictive of short-term outcomes.

Details

Language :
English
ISSN :
02683369 and 14765365
Volume :
56
Issue :
1
Database :
Supplemental Index
Journal :
Bone Marrow Transplantation
Publication Type :
Periodical
Accession number :
ejs53668200
Full Text :
https://doi.org/10.1038/s41409-020-0979-1