Frailty assessment in adults undergoing allogeneic hematopoietic cell transplantation: insights from a multicenter GETH-TC study to optimize outcomes and care

This multicenter prospective study sponsored by the Grupo Español de Transplante Hematopoyético y Terapia Celular (GETH-TC) explores the use of frailty assessments in allo-HCT candidates. Frailty was measured using the HCT Frailty Scale at first consultation and HCT admission in 404 adults from 15 H...

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Detalles Bibliográficos
Autores: Salas, María Queralt, Solano, María Teresa, Baile-González, Mónica, Acera Gómez, Marina, Fox, Laura, Pérez Artigas, María Del Mar, Santamaría, Ana, Quintela González, María Del Carmen, Sánchez Salinas, Andrés, Salmerón Camacho, Joaquina M, Illana Álvaro, Verónica, Abdallahi-Lefdil, Zahra, Cornago Navascues, Javier, Pardo, Laura, Fernández-Luis, Sara, Vega Suárez, Leddy Patricia, Villar, Sara, Beorlegui-Murillo, Patricia, Esquirol, Albert, Izquierdo García, Isabel, Rodríguez González, Sonia, Mussetti, Alberto, Lavilla, Esperanza, Lopez-Marín, Javier, Filaferro, Silvia, Cedillo, Ángel, Bento De Miguel, Leyre, Sureda, Anna
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/21758
Acceso en línea:https://hdl.handle.net/20.500.13003/21758
Access Level:acceso abierto
Palabra clave:Aged
Young Adult
Hematopoietic Stem Cell Transplantation
Transplantation, Homologous
Spain
Adult
Humans
Middle Aged
Male
Frailty
Prospective Studies
Female
Treatment Outcome
Fragilidad
Resultado del Tratamiento
Femenino
Masculino
Trasplante de Células Madre Hematopoyéticas
Humanos
Persona de Mediana Edad
Estudios Prospectivos
Adulto Joven
Anciano
Adulto
Trasplante Homólogo
España
Descripción
Sumario:This multicenter prospective study sponsored by the Grupo Español de Transplante Hematopoyético y Terapia Celular (GETH-TC) explores the use of frailty assessments in allo-HCT candidates. Frailty was measured using the HCT Frailty Scale at first consultation and HCT admission in 404 adults from 15 HCT programs in Spain. Based on the results, patients were classified into fit, pre-frail and frail categories. Allo-HCT outcomes were analyzed according to the results obtained from the HCT Frailty Scale. Data was collected prospectively and all patients signed informed consent. At first consultation, 102 (26.2%) patients were classified as fit, 248 (61.4%) as pre-frail, and 50 (12.4%) as frail. During the study, 62 (15.2%) patients participated in a pre-habilitation program. Among non-pre-habilitated patients (n=342), the proportion of fit patients decreased from 26.6% to 16.7%, while frail patients increased from 12.7% to 19.9%. In contrast, pre-habilitated patients (n=62) showed improvements, with fit patients increasing from 24.2% to 46.8%, and frail patients decreasing from 9.7% to 3.2%. Multivariate analysis confirmed lower OS (HR 2.52, P=0.002) and higher NRM (HR 2.69, P=0.013) in frail patients at HCT admission compared to fit ones, with a trend towards lower OS in pre-frail patients (HR 1.54, P=0.097). This study highlights the feasibility of incorporating the HCT Frailty Scale into clinical practice, confirms its negative impact of frailty on transplant outcomes, and suggests that frailty is dynamic and potentially reversible through pre-transplant interventions.

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