Najla El Jurdi, Hok Sreng Te, Qing Cao, Char Napurski, Shuo Wang, Andre Robinson, Mukta Arora, Heba ElHusseini, Fiona He, Laura J Niedernhofer, Bharat Thyagarajan, Anna Prizment, Shernan Holtan, Anne Hudson Blaes, Matthew J Yousefzadeh
{"title":"乳腺癌和造血细胞移植幸存者长期体能下降和生活质量下降与虚弱和虚弱前期有关。","authors":"Najla El Jurdi, Hok Sreng Te, Qing Cao, Char Napurski, Shuo Wang, Andre Robinson, Mukta Arora, Heba ElHusseini, Fiona He, Laura J Niedernhofer, Bharat Thyagarajan, Anna Prizment, Shernan Holtan, Anne Hudson Blaes, Matthew J Yousefzadeh","doi":"10.18632/aging.206109","DOIUrl":null,"url":null,"abstract":"<p><p>Physical frailty as a sign of accelerated aging is not well characterized in breast cancer (BC) and hematopoietic cell transplant (HCT) survivors and its correlation with outcomes and quality of life (QOL) is not defined. We conducted a prospective study to determine the prevalence of frailty in adult BC and HCT survivors, examine its impact on QOL, and determine its association with <i>p16<sup>INK4a</sup></i>, a molecular biomarker for biological aging. The study included 59 BC and 65 HCT survivors. Median age was 60 years (range 27-81), 68.5% were female and 49.2% were 18-59 vs. 51.8% ≥60 years old. A total of 71 (57.3%) were \"fit\" (frailty score 0) vs. 53 (42.7%) were pre-frailty/frail (frailty scores ≥1), and of the latter 17 (32.1%) were BC and 36 (67.9%) HCT patients. On multivariate analysis, patients >60 years were twice as likely to be frail (OR 2.04, 95% CI, 0.96-4.33; p=0.07), HCT were more likely to be frail compared to BC patients, and female HCT had 2.43 (95% CI, 0.92-6.40) and male HCT patients had 3.25 (95% CI, 1.37-7.72) times higher risk of frail; p=0.02. Frailty was associated with significant decline in QOL, measured by Medical Outcomes Study (MOS) Short Form 36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS), and FACT (Functional Assessment of Cancer Therapy) scores. <i>p16<sup>INK4a</sup></i> expression was higher in those who were frail, older than 60, and with higher expression in frail vs. fit patients who are 18-59 years. Our study highlights the high prevalence of frailty in survivors with detrimental effects on physical and overall wellbeing, and supports an association between frailty and the senescence marker <i>p16<sup>INK4a</sup></i>.</p>","PeriodicalId":55547,"journal":{"name":"Aging-Us","volume":null,"pages":null},"PeriodicalIF":3.9000,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Frailty and pre-frailty associated with long-term diminished physical performance and quality of life in breast cancer and hematopoietic cell transplant survivors.\",\"authors\":\"Najla El Jurdi, Hok Sreng Te, Qing Cao, Char Napurski, Shuo Wang, Andre Robinson, Mukta Arora, Heba ElHusseini, Fiona He, Laura J Niedernhofer, Bharat Thyagarajan, Anna Prizment, Shernan Holtan, Anne Hudson Blaes, Matthew J Yousefzadeh\",\"doi\":\"10.18632/aging.206109\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Physical frailty as a sign of accelerated aging is not well characterized in breast cancer (BC) and hematopoietic cell transplant (HCT) survivors and its correlation with outcomes and quality of life (QOL) is not defined. We conducted a prospective study to determine the prevalence of frailty in adult BC and HCT survivors, examine its impact on QOL, and determine its association with <i>p16<sup>INK4a</sup></i>, a molecular biomarker for biological aging. The study included 59 BC and 65 HCT survivors. Median age was 60 years (range 27-81), 68.5% were female and 49.2% were 18-59 vs. 51.8% ≥60 years old. A total of 71 (57.3%) were \\\"fit\\\" (frailty score 0) vs. 53 (42.7%) were pre-frailty/frail (frailty scores ≥1), and of the latter 17 (32.1%) were BC and 36 (67.9%) HCT patients. On multivariate analysis, patients >60 years were twice as likely to be frail (OR 2.04, 95% CI, 0.96-4.33; p=0.07), HCT were more likely to be frail compared to BC patients, and female HCT had 2.43 (95% CI, 0.92-6.40) and male HCT patients had 3.25 (95% CI, 1.37-7.72) times higher risk of frail; p=0.02. Frailty was associated with significant decline in QOL, measured by Medical Outcomes Study (MOS) Short Form 36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS), and FACT (Functional Assessment of Cancer Therapy) scores. <i>p16<sup>INK4a</sup></i> expression was higher in those who were frail, older than 60, and with higher expression in frail vs. fit patients who are 18-59 years. Our study highlights the high prevalence of frailty in survivors with detrimental effects on physical and overall wellbeing, and supports an association between frailty and the senescence marker <i>p16<sup>INK4a</sup></i>.</p>\",\"PeriodicalId\":55547,\"journal\":{\"name\":\"Aging-Us\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-09-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Aging-Us\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.18632/aging.206109\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CELL BIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aging-Us","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.18632/aging.206109","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CELL BIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
在乳腺癌(BC)和造血细胞移植(HCT)幸存者中,身体虚弱作为加速衰老的一种迹象还没有得到很好的描述,而且其与预后和生活质量(QOL)的相关性也没有确定。我们进行了一项前瞻性研究,以确定成年 BC 和 HCT 幸存者中虚弱的普遍程度,检查其对 QOL 的影响,并确定其与 p16INK4a(生物老化的分子生物标志物)的关联。该研究包括 59 名 BC 和 65 名 HCT 幸存者。中位年龄为60岁(27-81岁),68.5%为女性,49.2%为18-59岁,51.8%≥60岁。共有 71 人(57.3%)为 "健康"(虚弱评分为 0),53 人(42.7%)为虚弱前期/虚弱(虚弱评分≥1),后者中有 17 人(32.1%)为 BC 患者,36 人(67.9%)为 HCT 患者。多变量分析显示,年龄大于 60 岁的患者体弱的可能性是 BC 患者的两倍(OR 2.04,95% CI,0.96-4.33;P=0.07),与 BC 患者相比,HCT 患者体弱的可能性更大,女性 HCT 患者体弱的风险是 BC 患者的 2.43 倍(95% CI,0.92-6.40),男性 HCT 患者体弱的风险是 BC 患者的 3.25 倍(95% CI,1.37-7.72);P=0.02。体弱与患者生活质量的显著下降有关,体弱可通过医学结果研究(MOS)短表 36(SF-36)身体成分总结(PCS)和精神成分总结(MCS)以及癌症治疗功能评估(FACT)评分来衡量。p16INK4a在体弱、年龄大于 60 岁的患者中表达较高,在 18-59 岁的体弱患者中表达较高。我们的研究强调了体弱在幸存者中的高患病率,这对身体和整体健康都有不利影响,并支持体弱与衰老标志物 p16INK4a 之间的关联。
Frailty and pre-frailty associated with long-term diminished physical performance and quality of life in breast cancer and hematopoietic cell transplant survivors.
Physical frailty as a sign of accelerated aging is not well characterized in breast cancer (BC) and hematopoietic cell transplant (HCT) survivors and its correlation with outcomes and quality of life (QOL) is not defined. We conducted a prospective study to determine the prevalence of frailty in adult BC and HCT survivors, examine its impact on QOL, and determine its association with p16INK4a, a molecular biomarker for biological aging. The study included 59 BC and 65 HCT survivors. Median age was 60 years (range 27-81), 68.5% were female and 49.2% were 18-59 vs. 51.8% ≥60 years old. A total of 71 (57.3%) were "fit" (frailty score 0) vs. 53 (42.7%) were pre-frailty/frail (frailty scores ≥1), and of the latter 17 (32.1%) were BC and 36 (67.9%) HCT patients. On multivariate analysis, patients >60 years were twice as likely to be frail (OR 2.04, 95% CI, 0.96-4.33; p=0.07), HCT were more likely to be frail compared to BC patients, and female HCT had 2.43 (95% CI, 0.92-6.40) and male HCT patients had 3.25 (95% CI, 1.37-7.72) times higher risk of frail; p=0.02. Frailty was associated with significant decline in QOL, measured by Medical Outcomes Study (MOS) Short Form 36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS), and FACT (Functional Assessment of Cancer Therapy) scores. p16INK4a expression was higher in those who were frail, older than 60, and with higher expression in frail vs. fit patients who are 18-59 years. Our study highlights the high prevalence of frailty in survivors with detrimental effects on physical and overall wellbeing, and supports an association between frailty and the senescence marker p16INK4a.