Cognitive Impairment Is Associated with Inferior Survival and Increased Non-Relapse Mortality in Older Allogeneic Hematopoietic Cell Transplant (alloHCT) Recipients: A Multicenter Retrospective Study

• Published in: Blood 2019-11, Vol.134 (Supplement_1), p.4606-4606
• Main Authors: Olin, Rebecca L., Fretham, Caitrin, Pasquini, Marcelo C., Arora, Mukta, Bhatt, Vijaya R., Derman, Benjamin, Giralt, Sergio A, Huang, Li-Wen, Koll, Thuy T., Lee, Sang Mee, Lin, Richard J, Pang, Linda, Popat, Uday, Weisdorf, Daniel J., Artz, Andrew S.
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2019-123598

Introduction: Use of alloHCT is increasing in older patients, but the best means of determining alloHCT candidacy is uncertain. Geriatric assessment (GA), including validated geriatric metrics such as Instrumental Activities of Daily Living (IADL), offers promise to improve prognostication and decision making. We identified a multicenter retrospective cohort of older patients (pts) with pre-alloHCT GA data and examined the impact of GA impairments on post-alloHCT outcomes as reported to the Center for International Blood and Marrow Transplant (CIBMTR) registry. Methods: Pts across 6 participating centers were included in the cohort who met the following inclusion criteria: first alloHCT performed in the U.S. from 2011-2017; age ≥50 years; consented to CIBMTR registry study; and GA incorporating an IADL score collected within 3 months prior to transplant. Additional pre-alloHCT geriatric metrics were collected where available and included: Medical Outcomes Study Physical Health score (MOS-PH), Timed Up and Go (TUG), and Blessed Orientation Memory Concentration (BOMC). Univariate regression analyses examined the effect of demographic, clinical, and geriatric covariates on overall survival (OS), progression-free survival (PFS) and non-relapse mortality (NRM). Variables significant at p