Background: The Comprehensive Geriatric Assessment (CGA) has proven to be a valuable tool for providing a more comprehensive health evaluation of allogeneic stem cell transplantation (allo-SCT) recipients.Methods: We prospectively developed and tested a new Simplified Geriatric Score-4 (SGS-4) on 135 consecutive patients aged ≥50 years who underwent allo-SCT between 2020 and 2023. Each CGA component was individually analyzed for its association with overall survival (OS), non-relapse mortality (NRM), and cumulative incidence of relapse (CIR). Then, we performed a two-factor analysis (FA) using oblimin rotation and Bartlett estimation on all CGA components and sex. Based on component weights, a simplified geriatric score-4 score (SGS-4) was created: [Gait Speed] + 2 × [Hand Grip] + Geriatric 8 + 1.5 × [Sex]. ROC analysis defined three fitness groups, frail (≤13), prefrail (>13–22.5), and fit (>22.5).Results: Reduced hand grip strength and impaired mini mental state examination (MMSE) were associated with worse OS and higher NRM. Vulnerable Elders Survey (VES-13) and Fondazione Italiana Linfomi (FIL) scores also indicated poorer OS, though with uneven group sizes. Other CGA domains and the Hematopoietic Cell Transplantation–Comorbidity Index (HCT-CI) showed no significant prognostic value. The SGS-4 effectively stratified patients into three fitness groups, with those in the frail category experiencing lower OS and an increased risk of relapse.Conclusions: The new Simplified Geriatric Score-4 (SGS-4) based on three CGA domains (gait speed, hand grip, Geriatric 8) and sex effectively predicts OS and CIR risk in patients aged ≥50 years undergoing allo-SCT. The study’s small sample size and disease heterogeneity warrant further validation in larger cohorts.
背景：综合老年评估（CGA）已被证实是评估异基因干细胞移植（allo-SCT）受者健康状况的有效工具。方法：我们前瞻性地开发并测试了一种新的简化老年评分-4（SGS-4），研究对象为2020年至2023年间连续接受allo-SCT的135名年龄≥50岁的患者。我们分别分析了每个CGA组成部分与总生存期（OS）、非复发死亡率（NRM）和累积复发率（CIR）的关联。随后，我们对所有CGA组成部分和性别进行了双因素分析（FA），采用斜交旋转和巴特利特估计。基于各组成部分的权重，创建了简化老年评分-4（SGS-4）：[步态速度] + 2 × [握力] + 老年8评分 + 1.5 × [性别]。通过ROC分析定义了三个体能组：虚弱（≤13分）、衰弱前期（>13–22.5分）和健康（>22.5分）。结果：握力下降和简易精神状态检查（MMSE）受损与较差的OS和较高的NRM相关。脆弱老年人调查（VES-13）和意大利淋巴瘤基金会（FIL）评分也提示较差的OS，尽管各组样本量不均。其他CGA领域和造血细胞移植合并症指数（HCT-CI）未显示出显著的预后价值。SGS-4能够有效将患者分为三个体能组，其中虚弱组患者的OS较低，复发风险增加。结论：基于三个CGA领域（步态速度、握力、老年8评分）和性别的新简化老年评分-4（SGS-4）能有效预测年龄≥50岁接受allo-SCT患者的OS和CIR风险。本研究样本量较小且疾病异质性较高，需要在更大规模队列中进一步验证。
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