FUNCTIONAL PREDICTORS OF CHEMOTHERAPY TOXICITY IN ELDERLY LYMPHOMA PATIENTS – A PROSPECTIVE PILOT STUDY
Bibliographic record
Abstract
Introduction: Treatment of lymphoma often includes curative intent chemotherapy. In older patients, oncologists often rely on their clinical impression and the patient's age to make treatment decisions. More objective measures may be more accurate and reproducible in predicting chemotherapy eligibility and toxicity. Methods: This is a single centre pilot feasibility study in patients ≥70 yrs with lymphoma, planned for systemic chemotherapy. Patients completed geriatric tools (eg. Hurria and CRASH questionnaires, gait speed test and grip strength, CSHA Frailty Scale) and physical tests were repeated with each cycle. Sarcopenia at the L3 level was measured on baseline and follow-up CT scans. Primary outcomes were feasibility, with correlation between chemotherapy toxicity and geriatric tools, as the main 2ry outcomes. Results: 30 patients were enrolled, with a median age of 77 yrs (range 69-90) and 59% being male. The treating diagnosis was DLBCL in most (59%). Chemotherapy treatments most commonly included RCHOP (59%). The chemotherapy was dose reduced from the start in 8 patients (28%), and in 3 pts during tx (10%). Using the Hurria score, 18 pts (60%) were intermediate and 5 (17%) high risk for chemotherapy toxicity. Similarly, CRASH identified 11 (38%) as medium-low, 15 (50%) as medium-high and 2 (7%) as high risk. The Hurria tool on median took 2 min (1-5 min) vs. 20 min (5-30min) for the CRASH score. Sixteen pts (53%) experienced CTCAE grade 3-5 toxicity. The most common gr ≥3 AE was febrile neutropenia (4 pts). Dose delays occurred in 9 pts (31%) and 5 pts (17%) required hospitalization. 2-yr OS was 73%. The CSHA frailty score, grip strength and sarcopenia worsened throughout treatment and had not recovered by the 1 mo visit post-treatment (Figure 1). On univariate analysis, only the CSHA frailty score and Hurria risk score were associated with Grade 3 or higher events (Tables 1). On multivariate analysis, the CSHA Frailty score and Hurria risk score retained significance for any AE, but only CSHA frailty for gr. 3 or higher events. Keywords: elderly; non-Hodgkin lymphoma (NHL).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".