Comorbidities cluster with impaired functional capacities and depressive mood and predict adverse outcome in older patients with hematological malignancies

Abstract

This study evaluates prevalence of comorbidities and their association with impairments in older patients with hematological malignancies at initial diagnosis (n = 209). At least one comorbidity was present in 62.2%, 68.5% and 93.8% as defined by CCI (Charlson Comorbidity Index), Cumulative Illness Rating Scale–Geriatric (CIRS-G) and HCT-Comorbidity Index, respectively. Severe comorbidities (CIRS-G Grade 3/4) were present in 57.9%. The mean number of affected organ systems was 3.6 (CIRS-G categories), with diabetes (18.2%), congestive heart failure and prior solid tumors (each 17.7%) detected most frequently. Comorbidities were significantly correlated with reduced functional and objective physical capacities, impaired performance and depressive mood. Both CCI and CIRS-G were found to be prognostic factors for OS (p < 0.05). CCI scoring of comorbidities, diagnosis MDS/AML and a body mass index <23kg/m² were independent adverse predictors for OS. This first prospective analysis reveals a prognostic significance of comorbidities. Clustering of comorbidities with impairments suggests common mechanisms.

Keywords:

• Comorbidity
• cancer
• geriatric
• assessment
• elderly
• clustering

Disclosure statement

All authors confirm that they have no conflict of interest in relation to this work.

Additional information

Funding

Part of this study was supported by the project Translational Implementation of genetic evidence in the management of MDS (TRIAGE-MDS, Austrian Science Fund I 1576) within the TRANSCAN - Primary and secondary prevention of cancer call (ERA Net). Verein Senioren-Krebshilfe (RS) supported this study.