Background: The prognostic value of the comprehensive geriatric assessment (CGA) is recognized by many in hematology. However, there is no consensus on the utilization of alternative abbreviated methods to assess disabilities in elderly patients with B-cell non-Hodgkin’s lymphomas (B-NHLs). Aim: The aim of this study was to prospectively analyze the prognostic value of selected CGA tools in predicting adverse events (AEs) and outcomes of R-CHOP or R-CHOP-like treatment in elderly patients with diffuse large B-cell lymphomas (DLBCLs) or mantle cell lymphomas (MCLs). Methods: All patients who participated in this study underwent the Katz Index of Independence in Activities of Daily Living (ADL), the Lawton Instrumental Activities of Daily Living (iADL) scale, the Vulnerable Elders Survey-13 (VES-13), the Groningen Frailty Index (GFI), and the Mini Nutritional Assessment Short Form (MNA-SF) before starting anticancer treatment. Selected clinical predictors were also included in the study. Results: A total of 62 patients with newly diagnosed DLBCLs or MCLs, treated with R-CHOP in the Department of Hematology, Blood Neoplasm and Bone Marrow Transplantation of Wroclaw University Hospital between 1 July 2018, and 1 July 2020, were included in the study. The median age upon initiation of the treatment was 72 years (range: 61–68). Multinomial logistic regression and Cox proportional hazard regression analysis demonstrated that the iADL scale was significantly associated with response to treatment (OR = 1.21, 95% CI: 1.02–1.44,p= 0.03), was inversely related to non-hematological AEs (OR = 0.81, 95% CI: 0.71–0.92,p= 0.001), and was a statistically significant predictor of longer overall survival (OS) (HR = 0.83, 95% CI: 0.79–0.89,p< 0.001) and longer progression-free survival (PFS) (HR = 0.91, 95% CI: 0.83–0.99,p= 0.03). Conclusions: These results underscore the effectiveness of the iADL scale as a quick, easy-to-use, and universal CGA tool for evaluating crucial functional status before treatment in elderly hematological patients with DLBCLs or MCLs.
背景：综合老年评估（CGA）的预后价值在血液学领域已获广泛认可。然而，对于采用何种简化的替代方法来评估老年B细胞非霍奇金淋巴瘤（B-NHL）患者的功能障碍，目前尚未达成共识。目的：本研究旨在前瞻性分析特定CGA工具对预测老年弥漫大B细胞淋巴瘤（DLBCL）或套细胞淋巴瘤（MCL）患者接受R-CHOP或类似方案治疗期间不良事件（AEs）及临床结局的预后价值。方法：所有入组患者在开始抗肿瘤治疗前均接受以下评估：卡茨日常生活活动能力指数（ADL）、劳顿工具性日常生活活动能力量表（iADL）、衰弱老人筛查量表-13（VES-13）、格罗宁根衰弱指数（GFI）以及简易营养评估简表（MNA-SF）。研究同时纳入了相关临床预测因子。结果：本研究共纳入2018年7月1日至2020年7月1日期间于弗罗茨瓦夫大学医院血液科、血液肿瘤与骨髓移植科接受R-CHOP方案治疗的62例新诊断DLBCL或MCL患者。治疗起始中位年龄为72岁（范围：61-68岁）。多项逻辑回归与Cox比例风险回归分析显示：iADL量表与治疗反应显著相关（OR=1.21，95% CI：1.02-1.44，p=0.03），与非血液学不良事件呈负相关（OR=0.81，95% CI：0.71-0.92，p=0.001），且是延长总生存期（OS）（HR=0.83，95% CI：0.79-0.89，p<0.001）与无进展生存期（PFS）（HR=0.91，95% CI：0.83-0.99，p=0.03）的统计学显著预测因子。结论：本研究结果证实iADL量表可作为快速、易用且普适的CGA工具，有效评估老年DLBCL或MCL血液肿瘤患者治疗前的关键功能状态。
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