# Frailty in Patients With Hematologic Malignancies and Patients Undergoing Hematopoietic Stem Cell Transplantation: A Systematic Review

## TL;DR

This review examines how frailty affects patients with blood cancers and those undergoing stem cell transplants, finding that it increases with age and worsens outcomes.

## Contribution

The study systematically reviews the relationship between frailty and clinical outcomes in hematologic malignancy patients and HSCT recipients.

## Key findings

- Frailty was associated with increased age and worse clinical outcomes in patients undergoing HSCT.
- Frailty was also observed in younger patients, indicating it is not exclusive to the elderly.
- Frailty was linked to abnormal nutritional status, comorbidities, and reduced social support and mental health.

## Abstract

Hematopoietic stem cell transplantation (HSCT) is associated with significant morbidity and mortality. Frailty further increases these risks in recipients of HSCT. This systematic review analyzes the extent of frailty in patients with hematologic malignancies and patients undergoing HSCT, and explores the associations between frailty and age, and clinical outcomes.

CINAHL (EBSCO), Embase (Ovid), and Medline were searched for quantitative studies including assessment tools aimed at identifying frailty or vulnerability. Two reviewers independently assessed eligibility, extracted data from the included articles, performed a quality appraisal, and analyzed the findings through narrative synthesis.

Of the 5190 abstracts screened, 17 articles involving 17 different tools describing frailty were identified. Frailty was characterized as abnormal nutritional status, comorbidities, and an impact on social support, physical activity, and mental health. Frailty was associated with increased age but was also shown in younger patients. Moreover, frailty was associated with worse clinical outcomes.

Patients with hematologic malignancies and patients undergoing HSCT were at risk of frailty, and frailty was associated with older age and worse clinical outcomes.