58 / 154
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A B S T R A C T S
SIOG recommendations. Were excluded geriatric fit patients,
PTS requiring palliative care.
Early CM has consisted in a personalized telephonic
follow-up with the nurse case manager at week 1 and 2 after
chemotherapy and a nurse or geriatric consultation at week 3
to 4 in outpatient clinic for the second cycle of chemotherapy.
Geriatrics interventions consist in 1) modification of
the home care management plan, 2) prescription of more
supportive care 3) modification of chemotherapy.
Results:
22 included PTS, mean age 79 years (70 to 95 years),
68% (15/22) older than 80. Sex ratio was 0.83. Histological
subtypes: lymphoma (DLCB, MCL, follicular) 36% (8), myeloma
27% (6), MDS or AML 23% (5), CLL 14% (3).
61 early case management performed: 39 phones follow
up /44 planed, 5 calls without answer and 22/22 geriatric or
nurse consultations. Interventions has been necessary in
19/22 as: increased nurse care in 68%, (15 PTS) among 4 of
them upgrading has been necessary after second evaluation;
social support 36% (8 PTS) mainly because of absence of
caregiver; intensified support care in 32% (7 PTS) as nutritional
intervention, specific care for grade 3 toxicity (general
practitioner visit, upgrading nausea management, growth
factor injection), chemotherapy dose decreasing in 14% (3 PTS)
because of poor quality of life after haematologist evaluation.
We observed: no interrupted or differed chemotherapy, no
emergency department visits or unplanned rehospitalisation,
no deaths. 95% (21/22 PTS) were satisfied of this management.
Conclusion:
This early case management in malignant
hematologic patients management is the first report in this
selected population. Preliminary results demonstrate his
easily feasibility. The real impact on chemotherapy plan,
frailty management, adverse occurrence and unplanned
hospitalisation need more inclusion and follow up, going on
until May 2017.
Disclosure of interest:
None declared
Keywords:
Hematological malignancies, chemotherapy, case
management
O09
DEPRESSION IS ASSOCIATED WITH SLEEP DISTURBANCE IN
OLDER ADULTS WITH CANCER
K. P. Loh
1,
*, J. Zittel
2
, S. Kadambi
2
, C. Pandya
1
, A. Magnuson
1
,
M. Flannery
3
, K. M. Mustian
4
, W. Dale
5
, S. G. Mohile
1
1
Hematology/Oncology,
2
Medicine,
3
Cancer Control,
4
Surgery,
University of Rochester/Strong Memorial Hospital, Rochester,
5
Geriatrics & Palliative Medicine, University of Chicago Medicine,
Chicago, USA
Introduction:
Sleep disturbance is a common toxicity
in elderly cancer patients. Prior studies found that sleep
disturbance often co-exists with fatigue, pain and depression
in the cancer population. However, the studied populations
were heterogeneous including both young and old patients.
Objectives:
The aim of this study was to examine the
prevalence of sleep disturbance and co-existing fatigue,
pain and depression, and evaluate if the presence of these
symptoms were associated with sleep disturbance in older
adult cancer patients. We also sought to identify socio-
demographics, clinical and treatment characteristics
associated with sleep disturbance in this population.
Methods:
Our study cohort consisted of 408 patients with
solid and hematologic malignancies who were referred to the
Specialized Oncology Care & Research in the Elderly (SOCARE)
clinics at the Universities of Rochester and Chicago from May
2011 to October 2015. Fatigue was self-reported (yes/no), pain
was assessed using a 1-10 Likert scale (
7 was considered
positive), and depression was evaluated using the Geriatric
Depression Scale (
5 was considered positive). The primary
outcome was the presence of sleep disturbance which was
self-reported (yes/no). Multivariate logistic regression was
used to identify variables (age, race, education level, working
status, gender, cancer type, cancer stage, prior history of
cancer and cancer treatments, fatigue, pain and depression)
associated with sleep disturbance.
Results:
The median age of the patients was 80 years (SD
7.0, range 55-97); 37% female and 78% had a high school
diploma or less. Of the cancer subtypes, 21%, 15%, 23%, 5%
and 3% were gastrointestinal, lung, genitourinary, breast and
hematologic malignancies, respectively.Thirty-four percent of
patients had advanced cancer (stage III or IV) and almost half
were treated with palliative intent (48%). Sleep disturbance
was self-reported in 40% of the patients, and 16%, 15% and
27% of the total sample had co-existing depression, pain and
fatigue, respectively. Patients with depression, pain or fatigue
were more likely to report sleep disturbance compared to
patients without these symptoms: depression (53% vs. 34%,
P=0.0003), pain (48% vs. 33%, P=0.009) and fatigue (49% vs.
25%, P<0.001). On multivariable analysis, female gender [Odds
ratio (OR) 2.37, 95% Confidence Interval (CI) 1.15-4.89) and
depression (OR 2.33, 95% CI 1.16-4.68) were independently
associated with sleep disturbance.
Conclusion:
In our study, 40% of older adults with cancer
reported disturbed sleep, indicating that clinicians should
proactively screen for sleep disturbance. Individuals with
depression, pain, or fatigue reported higher rates of sleep
disturbance. Notably, high risk individuals included older
adults who were female and depressed. On the other hand,
cancer diagnosis, stage and treatments were not associated
with sleep disturbance. Future studies should explore
treatments that target both depression and sleep disturbance.
Disclosure of interest:
None declared
Keywords:
Depression, sleep
O10
A PHASE II RCT OF THREE EXERCISE DELIVERY METHODS
IN OLDER MEN WITH PROSTATE CANCER ON ANDROGEN
DEPRIVATION THERAPY
S. Alibhai
1,
*, D. Santa Mina
2
, P. Ritvo
3
, C. Sabiston
4
, M. Krahn
4
,
G. Tomlinson
4
, P. Warde
2
, A. Matthew
2
, S. Durbano
2
, M. O’Neill
2
,
R. Segal
5
, N. Culos-Reed
6
1
Medicine,
2
University Health Network,
3
Cancer Care Ontario,
4
University of Toronto, Toronto,
5
The Ottawa Hospital Cancer
Centre, Ottawa,
6
University of Calgary, Calgary, Canada