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Comment & Response
October 4, 2018

Cognitive Impairment Among Older Patients With Hematologic Cancers—Reply

Author Affiliations
  • 1Division of Aging, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
  • 2Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
  • 3Geriatric Research, Education, and Clinical Center, Veterans Affairs Boston Healthcare System, Boston, Massachusetts
JAMA Oncol. Published online October 4, 2018. doi:10.1001/jamaoncol.2018.4654

In Reply We appreciate the careful reading of our study1 by Tanimoto and colleagues and the provocative points they raise. We agree that marked anemia at the time of presentation might influence the physical and/or cognitive function of older patients with blood cancer. In this context, we have now assessed for a potential association between clinically significant anemia (hemoglobin ≤8 g/dL)2 and outcomes in the cohort of older patients with hematologic cancers in our study. We found no correlation between anemia and survival (χ2 = 1.07; P = .30), and no correlation between anemia and frailty status (robust vs prefrail/frail) as defined by the Fried phenotype (χ2 = 2.66; P = .10). Finally, we found no correlation between anemia (hemoglobin ≤8 g/dL) and a positive screening test for probable cognitive impairment by 5-word delayed recall (χ2 = 0.91; P = .34), even though impaired delayed recall was associated with worse overall survival in our study.1