Thèmes de Recherche

CRASH score in the older French Non Hodgkin Lymphoma receiving chemotherapy, feasability

Objective of this study:
To establish the predictive value and the interest of the CRASH score in a non selective French population with NHL.


  • Crash score is High in 32.4% in our cohort of very old patients (median age 81.8) with Non Hodgkin Lymphoma mainly due to hematological risk factor (Int-High 64.9%) more than non-hematological (High 24.3%) risk factor.
  • CRASH Score, Non Hematologic and Hematologic Risk Factor suggest frailty and risk of toxicity. Adverse effects after chemotherapy are oberved in 48.6% of the cohort. These results are lower than the results plublished by M. Extermann and al (1), maybe because of the adapted chimiotherapy regimen and of the comprehensive geriatric care.
  • Those results have to be confirmed into a prospective multicentric study network

CRASH score in the Older French patients with Non Hodgkin Lymphoma receiving chemotherapy

Objective of this study:

Validate CRASH score predictive value on adverse events in a geriatricpopulation of Non Hodgkin Lymphoma patients.


  • Among patients with Low or Med-Low CRASH score, n=35/40 (87%), have no adverse event.
  • Among patients with High or Med-HighCRASH score, n=36/77 (47%),have adverse events.
  • The data collected confirm the preliminary results presented in 2014 (SIOG Lisbonne) and highlight the good predictive value of CRASH score for adverse events occurrence.
  • Occurrence of adverse events is significantly different between the High group and Low group, p=0.0002. (Pearson's Chi-squared test)
  • CRASH score objectives that quite half patients with High or Med-High risk have serious adverse events associated with chemotherapy.
  • For most frail patients, management have to be adapted to their real health status.


  • According to these results, we started a personalized management with a proactive care organization for all patients of the High group CRASH score eligible to chemoherapy.
  • This personalised follow-up includes:
    • A close phone follow-up by the nurse care manager and a free direct oncall for patient.
    • Report to all the medical team when treatment starts:
      • Familly physician about hospitalization if necessary
      • Hospitals (refferal and peripheral hospitals)
      • Hematology and geriatrics departments
    • We are considering to evaluate the impact of this managment, on the occurrence of long-term serious side effects

CRASH score in the Older French patients with Non Hodgkin Lymphoma receiving chemotherapy, first results

Objective of this study:
to establish the predictive value and the interest of the CRASH score in a prospective non selective French population with NHL

These results are interesting but the small size of cases does’nt allow statistical analysis.
Inclusions will continue for about one year, with an objective of at least one hundred of patients.
We believe that the geriatric support of our older patients with Non Hodgkin Lymphoma must combine multiple items from the initial diagnosis:
Concerning the fragility of the patient: abbreviated geriatric assessmentYLD our GERh7 tool with or not a comprehensive geriatric assessment.
Regarding the chemotoxicity: assessment of the CRASH score.
We can then identify at best, the real health status of our patients, the potential risks and offer them a personalized and adapted clinical pathway and treatment.