Journal of geriatric oncology · 2026
Mapping the capacity for geriatric blood Cancer Care in Latin America: A cross- sectional survey of current status and future priorities.
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Vaquera-Alfaro Héctor A, De Las Fuentes-Cepeda Alejandra, Campos-González Luisa C, Ordoñez-Ayala Alia Guadalupe, Córdova-Lucio Carlos Emir, Verduzco-Aguirre Haydeé, Córdoba Raúl, Malpica Luis, Korin Laura, Perini Guilherme Fleury, Villela Luis, Idrobo Henry, Castro Denisse, Valvert Fabiola, Oliver Ana Carolina, Beltrán Brady, Peña Camila, Viera María Alejandra Torres, Quiroz Alfredo, von Glasenapp Alana, Ríos Jímenez Rosa, Rangel Patiño Juan, Candelaria Myrna, Diaz-Duque Adolfo, Gómez-Almaguer David, Colunga-Pedraza Perla R
Аннотация
INTRODUCTION: Older adults with cancer face unique challenges in disease management. Limited awareness among health professionals of their specific needs, combined with variable resources across institutions, can negatively impact outcomes and quality of life. This study aimed to assess the human, infrastructural, and educational resources for managing hematological malignancies in older adults in Latin America, to inform future efforts tailored to the region's specific needs.
MATERIALS AND METHODS: A cross-sectional survey-based study was conducted among hematologists practicing in Latin America. Participants responded on behalf of their institution, with one response included per center. The survey was distributed through the official networks of the Grupo de Estudio Latinoamericano de Linfoproliferativos (GELL). The questionnaire assessed center-level data covering workforce and infrastructure, clinical practices, research activity, supportive care, and future priorities in the management of patients aged ≥65 years with hematological malignancies. Data were analyzed descriptively.
RESULTS: A total of 73 centers from 16 countries completed the survey. Only 27% (n = 20) had dedicated clinics for older adults. While 59% (n = 43) had access to geriatricians, only 8% had geriatric hematology/oncology specialists available. Formal training programs were available in only 9.6% (n = 7) of centers. Of the centers with geriatricians available, 58% (n = 25) referred patients based on age, while only 2.3% used geriatric assessment results. The Clinical Frailty Scale was the most common geriatric assessment tool among non-transplant patients (53%, n = 39) and transplant candidates (73%, n = 24). Among transplant centers, 48% (n = 16) maintained strict age limits for eligibility. Adapted treatment protocols were implemented in 53% (n = 39) of centers overall but were significantly less common in public institutions (38% vs. 70-71% in private/academic, p = 0.025). Among research-active centers, 36% (n = 16) never enrolled older adults in clinical trials. Early palliative care was available in only 23% (n = 17) of centers. Establishing dedicated clinics or multidisciplinary teams was identified as the highest priority for improving care (47%, n = 34).
DISCUSSION: Critical gaps in geriatric hematologic oncology capacity were evident across the trained workforce, infrastructure, and tailored care models. These findings suggest that resource-adapted strategies are needed to build local expertise and improve the integration of geriatric principles into the management of older adults with hematological malignancies.
MATERIALS AND METHODS: A cross-sectional survey-based study was conducted among hematologists practicing in Latin America. Participants responded on behalf of their institution, with one response included per center. The survey was distributed through the official networks of the Grupo de Estudio Latinoamericano de Linfoproliferativos (GELL). The questionnaire assessed center-level data covering workforce and infrastructure, clinical practices, research activity, supportive care, and future priorities in the management of patients aged ≥65 years with hematological malignancies. Data were analyzed descriptively.
RESULTS: A total of 73 centers from 16 countries completed the survey. Only 27% (n = 20) had dedicated clinics for older adults. While 59% (n = 43) had access to geriatricians, only 8% had geriatric hematology/oncology specialists available. Formal training programs were available in only 9.6% (n = 7) of centers. Of the centers with geriatricians available, 58% (n = 25) referred patients based on age, while only 2.3% used geriatric assessment results. The Clinical Frailty Scale was the most common geriatric assessment tool among non-transplant patients (53%, n = 39) and transplant candidates (73%, n = 24). Among transplant centers, 48% (n = 16) maintained strict age limits for eligibility. Adapted treatment protocols were implemented in 53% (n = 39) of centers overall but were significantly less common in public institutions (38% vs. 70-71% in private/academic, p = 0.025). Among research-active centers, 36% (n = 16) never enrolled older adults in clinical trials. Early palliative care was available in only 23% (n = 17) of centers. Establishing dedicated clinics or multidisciplinary teams was identified as the highest priority for improving care (47%, n = 34).
DISCUSSION: Critical gaps in geriatric hematologic oncology capacity were evident across the trained workforce, infrastructure, and tailored care models. These findings suggest that resource-adapted strategies are needed to build local expertise and improve the integration of geriatric principles into the management of older adults with hematological malignancies.