A new tool for comprehensive geriatric assessment in elderly patients with acute myeloid leukemia:a pilot study from China

Background:Acute myeloid leukemia(AML)is a common type of hematological malignancy in elderly people.Geriatricians developed comprehensive geriatric assessment(CGA)methods for elderly patients;however,the tools used for CGA in AML are not uniform.Thus,we aimed to validate the instrumental activities of daily living(IADL)scales,age,comorbidities(Charlson Comorbidity Index),and albumin(IACA)index,which is a new tool for CGA,in elderly patients with AML.Methods:Patients aged>60 years who had been diagnosed with AML were screened for eligibility.Among the IACA low-,intermediate-,and high-risk groups,continuous variables were compared using the Mann-Whitney U test,and categorical variables were compared using/2 and Fisher exact tests.In addition,probabilities of overall survival(OS)were estimated using the Kaplan-Meier method.Results:A total of 21,34,and 6 patients were categorized into IACA low-risk(0 point),intermediate-risk(1-2 points),and high-risk(>3 points)groups,respectively.The rates of relapse/progression-related mortality were 23.8%,58.8%,and 100.0%in the IACA low-,intermediate-,and high-risk groups,respectively(χ^2=12.81,P<0.001).The 2-year probabilities of OS were 47.7%(95%confidence interval[CI]22.8%-72.6%)and 20.2%(95%CI 5.9%-34.5%)in the IACA low-and intermediate-risk groups,respectively(χ^2=5.99,P=0.014),which were significantly higher than those in the high-risk group(low-risk[47.7%(95%CI 22.8%-72.6%)]vs.high-risk[0],/=20.80,P<0.001;intermediate-risk[20.2%(95%CI 5.9%-34.5%)]vs.high-risk[0],χ^2=7.56,P=0.006;respectively).In the IACA low-risk group,the 2-year probability of OS in patients receiving induction chemotherapy(50.8%[95%CI 24.1%-77.5%])was significantly higher than that in those receiving best supportive care(0,χ^2=25.74,P<0.001).Conclusion:We suggest that the IACA index might be a simple and effective tool for comprehensive geriatric assessment in elderly AML patients.