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Impact of Chemotherapeutic Treatments in Patients Aged 75 Years and Over Treated for Lymphoid Hematological Malignancy

Not Applicable
Recruiting
Conditions
Neoplasm, Plasma Cell
Lymphoma
Interventions
Procedure: Comprehensive Geriatric Assessment
Registration Number
NCT05101759
Lead Sponsor
University Hospital, Toulouse
Brief Summary

The aim of the study is to assess the prevalence of functional decline in elderly patients treated with chemotherapy or immunochemotherapy for lymphoid hematologic malignancies. For this purpose, each patient benefits at inclusion (D0) of a standardized gerontological evaluation, and 3 and 6 months post-inclusion.

Detailed Description

The aim of this study is to contribute to the improvement of the hematological management of elderly patients. Indeed, the majority of hematological malignancies are diagnosed in subjects aged 65 years and over. Hematologists are therefore increasingly confronted with the complexity of managing elderly patients. The high prevalence of comorbidities and/or geriatric syndromes (cognitive disorders, malnutrition, loss of functional autonomy, etc.) contributes to the great heterogeneity of this population and to the complexity of therapeutic decisions.

The comprehensive geriatric assessment (CGA), recommended by the International Society of of Onco-Geriatrics (SIOG), allows to better understand this heterogeneity and to define an individualized management. Numerous studies have demonstrated the value of the CGA in predicting the risk of treatment toxicity and morbidity in geriatric hematology. However, beyond life expectancy, the maintenance of quality of life and/or functional autonomy represent major parameters to be integrated into the therapeutic decision. These two parameters are not sufficiently taken into account in hematology clinical trials. In the vast majority of these studies, the criteria of interest remain purely hematological (overall survival, toxicity, relapse-free survival, etc.). This approach may even be responsible for an increased risk of toxicity when the chemotherapy protocols proposed to elderly patients are based on the same objectives as those for younger subjects. It therefore seems essential to change the paradigm by integrating major geriatric criteria into the methodology of clinical trials of hematological malignancies in elderly patients.

The main objective of our study is therefore to evaluate the prevalence of functional decline in a population of elderly patients treated with chemotherapy or immuno-chemotherapy for lymphoid hemopathies. For this purpose, each patient benefits at inclusion (D0) of a standardized gerontological evaluation, and 3 and 6 months post-inclusion.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Male or female 75 years of age or older,
  • Lymphoid hemopathies (diffuse large cell B-cell lymphoma (DLBCL), follicular lymphoma, marginal zone lymphoma, Hodgkin's lymphoma and T-cell lymphoma, chronic lymphocytic leukemia (CLL)) or plasma cell and/or lymphoplasmacytic hemopathies (multiple myeloma or Waldenström disease).
  • World Health Organization (WHO) performance index 0-3,
  • Patients requiring first or second line chemotherapy and/or immunotherapy associated or not to targeted therapy,
  • Patients with a life expectancy of more than 3 months,
  • Persons affiliated or benefiting from a social insurance,
  • Free, informed and written consent signed by the participant and the investigator (at the latest on the day of inclusion and before any examination required by the research).
Exclusion Criteria
  • Myeloid hemopathies,
  • Patient included in a clinical trial that potentially interferes with the purpose of the study (geriatric interventional study, early drug study),
  • Patient under court protection, guardianship or curator

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Geriatric Follow-up (Comprehensive Geriatric Assessment)Comprehensive Geriatric AssessmentA systematic reassessment of geriatric parameters
Primary Outcome Measures
NameTimeMethod
Functional Decline6 months

Rate of patients with functional decline at 6 months. Functional decline was defined as a loss of 0.5 points or more on the Activities Daily Living scale (ADL) at 6 months compared with inclusion.

Secondary Outcome Measures
NameTimeMethod
Functional performance6 months

A loss of at least 1 point in the Short Physical Performance Battery (SPPB) score

Toxicity assessed according to NCI-CTCAE v56 months

Events of Toxicity will be assessed according to NCI-CTCAE v5

Institutionalization6 months

Ratio of institutionalized patients to total patients

Early death6 months

Ratio of the number of patients who died early

Trial Locations

Locations (1)

University Hospital Toulouse

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Toulouse, France

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