Pilot prospective study of Frailty and Functionality in routine clinical assessment in allogeneic hematopoietic cell transplantation.
María Queralt SalasAtenafu G EshetuOra BascomLeeann WilsonWilson LamArjun Datt LawIvan PasicDennis Dong Hwan KimFotios V MichelisZeyad Al-ShaibaniArmin GerbitzAuro ViswabandyaJeffrey Howard LiptonJonas MattssonShabbir M H AlibhaiRajat KumarPublished in: Bone marrow transplantation (2020)
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.
Keyphrases
- clinical practice
- healthcare
- community dwelling
- end stage renal disease
- primary care
- chronic kidney disease
- public health
- ejection fraction
- newly diagnosed
- cardiovascular disease
- randomized controlled trial
- risk factors
- prognostic factors
- clinical trial
- bone marrow
- peritoneal dialysis
- coronary artery disease
- metabolic syndrome
- insulin resistance
- low dose
- climate change
- health information