|Table of Contents|

Evaluation of four frailty models in elderly patients with multiple myeloma and their predictive efficacy in patient survival

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 05
Page:
921-926
Research Field:
Publishing date:

Info

Title:
Evaluation of four frailty models in elderly patients with multiple myeloma and their predictive efficacy in patient survival
Author(s):
LI Yujun; XU Jianmei; ZHANG Jiangbo; ZHAO Songying; WANG Jing; GUO Huimei; FAN Lixia; LIU Liyang; HUA Luoming; XUE Hua
Department of Hematology,Affiliated Hospital of Hebei University,Hebei Baoding 071000,China.
Keywords:
multiple myeloma; frailty; geriatric assessment; prognosis
PACS:
R733.3
DOI:
10.3969/j.issn.1672-4992.2023.05.026
Abstract:
Objective：To explore the agreement and prognostic value of stratification on survival of the International Myeloma working Group（IMWG) frailty score,Mayo score,British Myeloma Research Alliance Risk Profile（MRP) and IFM simplified frailty scale in the assessment of elderly multiple myeloma（MM).Methods:73 newly diagnosed MM patients aged 60 and over in our hospital were evaluated by IMWG frailty score,Mayo score,MRP score and IFM simplified frailty scale.Cohen's kappa and Kaplan-Meier methods were used for agreement analysis and survival analysis.Results:A total of 55 patients（75.3%) were identified as frail by at least one model,of which only 12 cases（30.8%) were identified by the four models.Although the IMWG frailty score was moderately consistent with MRP score and IFM simple score（Cohen's kappa 0.447~0.563,P<0.001),the agreement among the four models was lower（Cohen's kappa 0.226~0.563).The median overall survival time（OS,P=0.01,0.003,<0.001) and progression-free survival time（PFS,P=0.02,0.024,0.001) identified by IMWG frailty score,Mayo score and MRP score were statistically significant,while there was no significant difference in median OS（P=0.275） and PFS（P=0.287） of frailty patients identified by the four models.Conclusion:The agreement of the evaluation results of the four models in this study is lower.While the agreement of MRP score and IMWG frailty score is higher.The stratification efficiency of prognosis is better than the other models,which is more in line with the simple,objective and efficient needs of domestic elderly MM patients.

References:

［1］RASCHE L,KORTUM KM,RAAB MS,et al.The impact of tumor heterogeneity on diagnostics and novel therapeutic strategies in multiple myeloma［J］.Int J Mol Sci,2019,20(5):1248.
［2］GAO W,ZHENG Y,ZHANG R,et al.Incidence of multiple myeloma in Kailuan cohort：A prospective community-based study in China［J］.Cancer Epidemiol,2022,78:102168.
［3］WANG S,XU L,FENG J,et al.Prevalence and incidence of multiple myeloma in urban area in China：A national population-based analysis［J］.Front Oncol,2019,9:1513.
［4］LIU W,LIU J,SONG Y,et al.Mortality of lymphoma and myeloma in China,2004-2017：an observational study［J］.J Hematol Oncol,2019,12(1):22.
［5］LIU J,LIU W,MI L,et al.Incidence and mortality of multiple myeloma in China,2006-2016：an analysis of the global burden of disease study 2016［J］.J Hematol Oncol,2019,12(1):136.
［6］ZHONG YP,ZHANG YZ,LIAO AJ,et al.Geriatric assessment to predict survival and risk of serious adverse events in elderly newly diagnosed multiple myeloma patients：A multicenter study in China［J］.Chin Med J（Engl),2017,130(2):130-134.
［7］LAROCCA A,DOLD SM,ZWEEGMAN S,et al.Patient-centered practice in elderly myeloma patients：an overview and consensus from the European Myeloma Network（EMN)［J］.Leukemia,2018,32(8):1697-1712.
［8］JOAO C,GERALDES C,NEVES M,et al.Management of older and frail patients with multiple myeloma in the portuguese routine clinical practice：Deliberations and recommendations from an expert panel of hematologists［J］.J Geriatr Oncol,2020,11(8):1210-1216.
［9］ANTOINE-PEPELJUGOSKI C,BRAUNSTEIN MJ.Management of newly diagnosed elderly multiple myeloma patients［J］.Curr Oncol Rep,2019,21(7):64.
［10］MINA R,BRINGHEN S,WILDES TM,et al.Approach to the older adult with multiple myeloma［J］.Am Soc Clin Oncol Educ Book,2019,93(39):500-518.
［11］PALUMBO A,BRINGHEN S,MATEOS MV,et al.Geriatric assessment predicts survival and toxicities in elderly myeloma patients：an International Myeloma Working Group report［J］.Blood,2015,125(13):2068-2074.
［12］MILANI P,VINCENT RS,MERLINI G,et al.N-terminal fragment of the type-B natriuretic peptide（NT-proBNP) contributes to a simple new frailty score in patients with newly diagnosed multiple myeloma［J］.Am J Hematol,2016,91(11):1129-1134.
［13］COOK G,ROYLE KL,PAWLYN C,et al.A clinical prediction model for outcome and therapy delivery in transplant-ineligible patients with myeloma（UK myeloma research alliance risk profile)：a development and validation study［J］.Lancet Haematol,2019,6(3):e154-e166.
［14］REDDER L,KLAUSEN TW,VANGSTED AJ,et al.Validation of the UK myeloma research alliance risk profile,a new clinical prediction model for outcome in patients with newly diagnosed multiple myeloma not eligible for autologous stem cell transplantation，a population-based study from the Danish national multiple myeloma registry［J］.Br J Haematol,2020,193(1):119-124.
［15］MA K,YE J,WANG L,et al.Evaluation of the UK myeloma research alliance risk profile in Chinese patients with newly diagnosed multiple myeloma without autologous stem cell transplantation［J］.Onco Targets Ther,2021,14:2349-2361.
［16］FACON T,DIMOPOULOS MA,MEULEMAN N,et al.A simplified frailty scale predicts outcomes in transplant-ineligible patients with newly diagnosed multiple myeloma treated in the FIRST（MM-020) trial［J］.Leukemia,2020,34(1):224-233.
［17］PAWLYN C,CAIRNS D,KAISER M,et al.The relative importance of factors predicting outcome for myeloma patients at different ages：results from 3894 patients in the myeloma Ⅺ trial［J］.Leukemia,2020,34(2):604-612.
［18］DUMONTIER C,UNO H,HSHIEH T,et al.Randomized controlled trial of geriatric consultation versus standard care in older adults with hematologic malignancies［J］.Haematologica,2022,107(5):1172-1180.
［19］PARKER SG,MCCUE P,PHELPS K,et al.What is comprehensive geriatric assessment（CGA)? An umbrella review［J］.Age Ageing,2018,47(1):149-155.
［20］YAO Y,SUI WW,LIAO AJ,et al.Comprehensive geriatric assessment in newly diagnosed older myeloma patients：a multicentre,prospective,non-interventional study［J］.Age Ageing,2022,51(1):afab211.
［21］JENSEN CE,VOHRA SN,NYROP KA,et al.Geriatric-assessment-identified functional deficits among adults with multiple myeloma with normal performance status［J］.J Geriatr Oncol,2022,13(2):182-189.
［22］ENGELHARDT M,DOLD SM,IHORST G,et al.Geriatric assessment in multiple myeloma patients：validation of the International Myeloma Working Group（IMWG) score and comparison with other common comorbidity scores［J］.Haematologica,2016,101(9):1110-1119.
［23］GAY F,ENGELHARDT M,TERPOS E,et al.From transplant to novel cellular therapies in multiple myeloma：European Myeloma Network guidelines and future perspectives［J］.Haematologica,2018,103(2):197-211.
［24］MURILLO A,CRONIN AM,LAUBACH JP,et al.Performance of the International Myeloma Working Group myeloma frailty score among patients 75 and older［J］.J Geriatr Oncol,2019,10(3):486-489.
［25］GIRI S,WILLIAMS G,ROSKO A,et al.Simplified frailty assessment tools：are we really capturing frailty or something else［J］.Leukemia,2020,34(7):1967-1969.
［26］ISAACS A,FIALA M,TUCHMAN S,et al.A comparison of three different approaches to defining frailty in older patients with multiple myeloma［J］.J Geriatr Oncol,2020,11(2):311-315.
［27］CAIRNS D,PAWLYN C,ROYLE K,et al.Frailty-adjusted therapy in transplant non-eligible patients with newly diagnosed multiple myeloma（FiTNEss)：A UK myeloma research alliance study,myeloma XIV［J］.Blood,2019,134（Supplement_1):3153.

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Last Update: 2023-01-31