Given that there are only a few prospective studies with conflicting results, we investigated the prognostic value of multiparameter geriatric assessment (GA) domains on tolerance and outcomes after intensive chemotherapy in older adults with acute myeloid leukemia (AML). In all, 105 newly diagnosed patients with AML who were older than age 60 years and who received intensive chemotherapy consisting of cytarabine and idarubicin were enrolled prospectively. Pretreatment GA included evaluations for social and nutritional support, cognition, depression, distress, and physical function. The median age was 64 years (range, 60-75 years), and 93% had an Eastern Cooperative Oncology Group performance score <2. Between 32.4% and 69.5% of patients met the criteria for impairment for each domain of GA. Physical impairment by the Short Physical Performance Battery (SPPB) and cognitive dysfunction by the Mini-Mental State Examination in the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Assessment Packet (MMSE-KC) were significantly associated with nonfatal toxicities, including grade 3 to 4 infections (SPPB, P = .024; MMSE-KC, P = .044), acute renal failure (SPPB, P = .013), and/or prolonged hospitalization (≥40 days) during induction chemotherapy (MMSE-KC, P = .005). Reduced physical function by SPPB and depressive symptoms by the Korean version of the short form of geriatric depression scales (SGDS-K) were significantly associated with inferior survival (SPPB, P = .027; SGDS-K, P = .048). Gait speed and sit-and-stand speed were the most powerful measurements for predicting survival outcomes. Notably, the addition of SPPB and SGDS-K, gait speed and SGDS-K, or sit-and-stand speed and SGDS-K significantly improved the power of existing survival prediction models. In conclusion, GA improved risk stratification for treatment decisions and may inform interventions to improve outcomes for older adults with AML. This study was registered at the Clinical Research Information Service as #KCT0002172.

中文翻译：

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老年病学评估可预测接受强化治疗的老年 AML 患者的非致命毒性和生存率。

鉴于只有少数前瞻性研究的结果相互矛盾，我们研究了多参数老年评估 (GA) 领域对急性髓细胞白血病 (AML) 老年人强化化疗后耐受性和结果的预后价值。总共有 105 名新诊断的 60 岁以上的 AML 患者接受了由阿糖胞苷和伊达比星组成的强化化疗。治疗前 GA 包括对社会和营养支持、认知、抑郁、痛苦和身体功能的评估。中位年龄为 64 岁（范围为 60-75 岁），93% 的东部肿瘤协作组表现评分<2。32.4% 至 69.5% 的患者符合 GA 各个领域的损伤标准。韩国版阿尔茨海默病登记处 (CERAD) 评估包 (MMSE-KC) 中的短期体能电池 (SPPB) 造成的身体损伤和小型精神状态检查的认知功能障碍与非致命性显着相关毒性，包括诱导期间的 3 至 4 级感染（SPPB，P = .024；MMSE-KC，P = .044）、急性肾功能衰竭（SPPB，P = .013）和/或住院时间延长（≥40 天）化疗（MMSE-KC，P = .005）。SPPB 降低的身体机能和韩国版短版老年抑郁量表 (SGDS-K) 的抑郁症状与较差的生存率显着相关 (SPPB, P = .027; SGDS-K, P = .048)。步态速度和坐立速度是预测生存结果的最有力指标。值得注意的是，SPPB 和 SGDS-K、步态速度和 SGDS-K 或坐立速度和 SGDS-K 的加入显着提高了现有生存预测模型的能力。总之，GA 改善了治疗决策的风险分层，并可能为改善老年人 AML 结局的干预措施提供信息。该研究在临床研究信息服务中心注册为#KCT0002172。