P-152: CORRELATION OF THE G8 SCREENING EXAM WITH THE COMPREHENSIVE GERIATRIC ASSESSMENT IN ELDERLY UNDERGOING AUTOLOGOUS HEMATOPOETIC STEM CELL TRANSPLANTATION – EXPERIENCE FROM A SINGLE CENTER IN BRAZIL

Introduction:
Older Adults patients are frequently becoming candidates for autologous hematopoietic cell transplantation (AHSCT) due to the aging population and the increase in incidence of hematological diseases in these population. Advancing age brings geriatric syndromes and vulnerabilities that affect the functional capacity of them. Comprehensive geriatric assessment (CGA) is a multidimensional tool used to identify older adults at increased risk of complications and assist in therapeutic decisions, but it is time-consuming and requires a multidisciplinary team. The G8 is a screening tool that could facilitate the identification of patients who benefited from CGA, but no analysis was done in the AHSCT setting to our knowledge. Furthermore, in the context of multiple myeloma (MM), there are other tools such as the R-MCI and the IMWG score to evaluate older adults patients.

Methods:
Retrospective, single-center study with analysis of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of G8 in relation to CGA. Consider CGA changed if ≥ 2 variables changed and G8 changed if ≤ 14 points.

Results:
53 patients undergoing autologous HCT were able to be analyzed with all the variables: plasma cell dyscrasias (PCD) (37 patients) and lymphomas (16 patients). The median age was 67 years in both groups. In the group of PCD and lymphomas, the majority presented low risk according to HCT-CI, 67% and 62%, respectively. Cognitive function, emotional and nutritional status were predominantly normal in both groups. Most patients (60% of PCD and 67% of lymphomas) only showed changes in the functionality test (hand grip). Polypharmacy was common in 70% of patients in the PCD group and in 73% of patients in the lymphoma group. According to Fried's criteria, 46% of patients were defined as “fit” in the PCD group, while 50% of patients in the lymphoma group were classified as vulnerable. Regarding the CARG Toxicity scale, we observed that 54% in the PCD group were classified as low risk, while 67% of patients in the lymphoma group were intermediate risk. In our sample, in both groups the majority of patients presented altered results in the G8 test (62% in both groups). On the IMWG scale, the majority of patients, 75.7%, were classified as "Fit", in contrast to R-MCI, with intermediate/high risk predominating (62.2%). Progression-free survival was 55% in lymphomas and 70% in PCD, without statistical significance. The sensitivity of CGA in relation to G8 was 65%, specificity 60%, PPV 94% and NPV 15%.

Conclusions: The older adults are at greater risk of developing geriatric syndromes and having poor outcomes in HCT. The study did not find that G8 a screening tool was sensitive and specific to replace the need of CGA, as weel, we were unable to correlate the IMWG and R-MCI scales with outcomes. However, CGA remains the best method for evaluating older adults transplant candidates, reflecting results similar to other studies.