Objective: To evaluate the feasibility and potential value of comprehensive geriatric assessment (CGA) in elderly (≥60 years) patients with newly diagnosed acute myeloid leukemia (AML) in China. Methods: The CGA results of 83 newly diagnosed AML (non-APL) patients from 16 hospitals in Beijing and Tianjin between March 2016 and December 2017 were prospectively collected and analyzed. The clinical data, treatment and follow-up information were also collected. Results: Of 83 newly diagnosed elderly AML patients, 81 patients (97.6%) completed all designated CGA assessment. The median number of impaired scales of the CGA assessment in the studied population was 2(0-6). Sixteen patients (19.3%) showed no impairments according to the geriatric assessment scales implem ented by this study. The distributions of impaired scales were as follows: impairment in ADL, 55.4%; IADL impairment, 42.2%; MNA-SF impairment, 48.2%; cognitive impairment, 15.7%; GDS impairment, 31.7%; HCT-CI impairment, 19.5%, respectively. In patients with "good" ECOG (n=46), the proportion of impairment for each CGA scale ranged from 6.5% to 37.0% and 32 patients (68.9%) had at least one impaired CGA scale. Survival analysis showed that the number of impaired scales of the CGA was significantly correlated with median overall survival (P=0.050). Conclusions: CGA was a tool with feasibility for the comprehensive evaluation in elderly AML patients in China. Combined with age and ECOG, CGA may be more comprehensive in assessing patients' physical condition.
目的： 探讨综合老年学评估（CGA）在中国初治老年急性髓系白血病（AML）患者中应用的可行性及评估结果。 方法： 前瞻性分析83例于2016年3月至2017年12月在京津地区16家医院住院治疗的非急性早幼粒细胞白血病的老年（年龄≥60岁）初治AML患者的临床资料、CGA结果、治疗和生存数据。 结果： 83例患者中，81例（97.6%）完成了所有的CGA评价。中位CGA量表异常个数为2（0~6）个，16例（19.3%）患者无任何CGA量表异常。46例（55.4%）患者存在日常活动量表（ADL）异常，35例（42.2%）患者存在工具性日常生活活动量表（IADL）异常，40例（48.2%）患者存在简易营养评估量表（MNA-SF）异常，13例（15.7%）患者存在认知异常，26例（31.7%）患者存在老年抑郁量表（GDS）异常，16例（19.5%）患者存在造血干细胞移植共病指数（HCT-CI）异常。在46例（55.4%）美国东部肿瘤协作组（ECOG）体能评估正常的患者中，CGA量表的异常比例为6.5%~37.0%，其中32例患者存在≥1个CGA量表异常。生存分析发现CGA异常数目与患者的中位总生存相关（P=0.050）。 结论： 在中国老年AML住院患者中行CGA具有临床可行性。.
Keywords: Comprehensive geriatric assessment; Elderly; Leukemia, myeloid, acute.