Dataset Information

The longitudinal relationship between immune cell profiles and frailty in patients with breast cancer receiving chemotherapy.

ABSTRACT:

Background

Frailty is associated with an increased risk of chemotherapy toxicity. Cellular markers of inflammation can help identify patients with frailty characteristics. However, the role of cellular markers of inflammation in identifying patients at risk of developing chemotherapy-induced frailty and their clinical utility are not fully understood.

Methods

This study was a secondary analysis of a large nationwide cohort study of women with stage I-IIIC breast cancer (n?=?581, mean age 53.4; range 22-81). Measures were completed pre-chemotherapy (T1), post-chemotherapy (T2), and 6?months post-chemotherapy (T3). Frailty was assessed at all three time points using a modified Fried score consisting of four self-reported measures (weakness, exhaustion, physical activity, and walking speed; 0-4, 1 point for each). Immune cell counts as well as neutrophil to lymphocyte ratio (NLR) and lymphocyte to monocyte ratio (LMR) were obtained at T1 and T2 time points. Separate linear regressions were used to evaluate the associations of (1) cell counts at T1 with frailty at T1, T2, and T3 and (2) change in cell counts (T2-T1) with frailty at T2 and T3. We controlled for relevant covariates and frailty at the T1 time point.

Results

From T1 to T2, the mean frailty score increased (1.3 vs 2.0; p?ConclusionsIn patients with breast cancer undergoing chemotherapy, cellular markers of inflammation are associated with frailty. Immune cell counts may help clinicians identify patients at risk of frailty during chemotherapy.

Trial registration

ClinicalTrials.gov , NCT01382082.

SUBMITTER: Gilmore N

PROVIDER: S-EPMC7863416 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

The longitudinal relationship between immune cell profiles and frailty in patients with breast cancer receiving chemotherapy.

Gilmore Nikesha N Mohile Supriya S Lei Lianlian L Culakova Eva E Mohamed Mostafa M Magnuson Allison A Loh Kah Poh KP Maggiore Ronald R Belcher Elizabeth E Conlin Alison A Weiselberg Lora L Ontko Mary M Janelsins Michelle M

Breast cancer research : BCR 20210205 1

<h4>Background</h4>Frailty is associated with an increased risk of chemotherapy toxicity. Cellular markers of inflammation can help identify patients with frailty characteristics. However, the role of cellular markers of inflammation in identifying patients at risk of developing chemotherapy-induced frailty and their clinical utility are not fully understood.<h4>Methods</h4>This study was a secondary analysis of a large nationwide cohort study of women with stage I-IIIC breast cancer (n = 581, m ...[more]

PMID: 33546731

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Project description:ObjectivesTo evaluate relationships between frailty and cognition longitudinally in adults 50 years and older with breast cancer receiving chemotherapy.DesignSecondary analysis of a prospective longitudinal observational study.SettingUniversity of Rochester NCI Community Oncology Research Program community oncology clinics.ParticipantsPatients with breast cancer age 50 and older receiving adjuvant/neoadjuvant chemotherapy (n = 376) and age-matched controls without cancer (n = 234).MeasurementsFrailty was assessed using a modified frailty score from self-reported assessments (weakness, exhaustion, physical activity, and gait speed). Cognition was assessed by patient report (Functional Assessment of Cancer Therapy-Cognition [FACT-Cog]) and objective measures. Frailty and cognition were measured at three time points (prechemotherapy [A1], postchemotherapy [A2], and 6 months postchemotherapy [A3]; similar time interval for controls). Linear regression models evaluated associations between frailty and cognition adjusting for covariates.ResultsThe average age was 59 years (standard deviation = 6.4 y). At baseline, patients with cancer had a higher mean frailty score (1.21 vs .73; P < .001) and lower mean FACT-Cog score (158.4 vs 167.3; P < .001) compared with controls. Objective cognitive measures were not statistically different. Longitudinal decline in FACT-Cog between A1 and A2 (P < .05) and between A1 and A3 (P < .01) was associated with increased frailty score in patients compared with controls. Longitudinal worsening in Controlled Oral Word Association (P < .05) and Trail-Making Test (P < .01) were associated with an increase in frailty between A1 and A2 in patients compared with controls; longitudinal decline in the Delayed Match to Sample test was associated with an increase in frailty between A1 and A3 (P < .05) in patients compared with controls. This finding remained significant for a subset analysis of those aged 65 and older.ConclusionIn patients with breast cancer aged 50 and older, longitudinal decline in FACT-Cog and objective measures of attention and memory were associated with increased frailty during treatment and up to 6 months posttreatment. Overall, our study suggests cognition and frailty are both important factors to assess in breast cancer patients. J Am Geriatr Soc 67:928-936, 2019.

Dataset Information

The longitudinal relationship between immune cell profiles and frailty in patients with breast cancer receiving chemotherapy.

Background

Methods

Results

Trial registration

Publications

The longitudinal relationship between immune cell profiles and frailty in patients with breast cancer receiving chemotherapy.

Similar Datasets

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