Identifying frailty in older people living with diffuse large B-cell lymphoma: a systematic review

Oscanoa T.J.; Romero-Ortuno R. · Acta Haematologica Polonica (2023) · DOI: 10.5603/ahp.94456

Resumen

Introduction: Diffuse large B-cell lymphoma (DLBCL) is a common neoplasm in older people; in this group, personalized therapies are important because while some patients are frailer, others are fitter. However, knowledge is lacking as to which frailty identification tools are most commonly used in older patients living with DLBCL. The aim of this systematic review was to address this knowledge gap. Material and methods: We searched the PubMed, EMBASE, and Cochrane databases and Google Scholar for studies published before December 2022. We included studies conducted with DLBCL patients aged 60 years or older, where a frailty classification (i.e. fit, unfit, or frail) had been reported in the context of prognostication and/or personalization of treatment. Results: Sixteen studies were included in our review, with a total of 8,705 DLBCL patients (mean age 76 years, 54% men). Overall, 42% were classified as ‘frail’, and 40% as ‘fit’. The most frequent frailty identification method was the Comprehensive Geriatric Assessment (CGA) (simplified: 75%, full: 13%), followed by the physical phenotype (6%) and the cumulative deficits index (6%) tools. The most common CGA domains utilized in the classification of frailty were the evaluation of basic activities of daily living (86%), instrumental activities of daily living (63%), comorbidities (81%), and geriatric syndromes (19%). Conclusion: Two in five DLBCL patients aged 60 years or older were classified as frail, and an almost equal proportion as fit, most commonly post-application of simplified CGA. More studies are required to validate specific frailty identification instruments in this population. Copyright

Instituciones: Universidad Nacional Mayor de San Marcos; Universidad de San Martín de Porres