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Frailty Prevalence >8 Percent in Young Adult HCT Survivors

Frailty linked to subsequent risk of all-cause mortality after adjustment for confounders

TUESDAY, June 7, 2016 (HealthDay News) — Among young adult hematopoietic cell transplantation (HCT) survivors, the prevalence of frailty exceeds 8 percent and is associated with increased risk of mortality, according to a study published online June 2 in JAMA Oncology.

Mukta Arora, M.D., from the University of Minnesota in Minneapolis, and colleagues determined the prevalence of frailty in young adult HCT patients and siblings in a cohort study. Data were included for 998 HCT survivors who underwent transplant procedures between 1974 and 1998 and 297 frequency-matched siblings.

The researchers found that among young adult HCT patients the prevalence of frailty exceeded 8 percent. Compared with their siblings, HCT survivors were 8.4 times more likely to be frail (P = 0.003). Among HCT recipients, the risk of frailty was increased for allogeneic HCT recipients with chronic graft-versus-host disease (GvHD) or resolved chronic GvHD compared with autologous HCT (odds ratios, 15.02 and 2.7, respectively). For HCT recipients with and without frailty, the cumulative incidence of subsequent all-cause mortality was 39.3 and 14.7 percent, respectively, at 10 years (P < 0.001). After adjustment for relevant prognosticators, frailty correlated with a 2.76-fold increased risk of subsequent mortality (P < 0.001).

“The prevalence of frailty among young-adult HCT survivors approaches that seen in the elderly general population,” the authors write. “This study identifies vulnerable populations needing close monitoring to anticipate and manage morbidity and prevent mortality.”

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