Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College.
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Blood Diseases Hospital & Institute of Hematology, Chinese Academy of Medical Sciences & Peking Union Medical College.
Age Ageing. 2022 Jan 6;51(1). doi: 10.1093/ageing/afab211.
Multiple myeloma is a disease of the older people, whose prognoses are highly heterogeneous. The International Myeloma Working Group (IMWG) proposed a geriatric assessment (GA) based on age, functional status and comorbidities to discriminate between fit and frail patients. Given the multidimensional nature of frailty and the relatively recent exploration of frailty in the field of MM, reaching a consensus on the measurement of frailty in MM patients remains challenging.
We sought to assess the feasibility of performing a comprehensive GA (CGA) in older MM patients in a real-world and multicentre setting and to evaluate their baseline CGA profiles.
We studied 349 older patients with newly diagnosed MM (age range, 65-86 years). Our results showed that a CGA is feasible for older MM patients. Using the IMWG-GA criteria, we identified significantly more frail patients in our cohort comparing to in the IMWG cohort (43% vs 30%, P = 0.002). In the IMWG-GA 'fit' group, risk of malnutrition, depression and cognitive impairment remains. The median follow-up time was 26 months (range 1-38). The median overall survival (OS) was 34.7 months, and the estimated 3-year OS rate was 50%. A high MNA-SF score (MNA-SF ≥ 12), low GDS score (GDS ≤ 5) and high CCI score (CCI ≥ 2) can be used to predict the OS of older patients with newly diagnosed MM. This study is registered at www.clinicaltrials.gov (NCT03122327).
Our study justifies the need for a CGA in older patients with newly diagnosed MM.
多发性骨髓瘤是一种老年疾病，其预后高度异质。国际骨髓瘤工作组（IMWG）提出了一种基于年龄、功能状态和合并症的老年评估（GA），以区分健康和虚弱患者。鉴于虚弱的多维性质以及在 MM 领域对虚弱的相对近期探索，在 MM 患者中衡量虚弱仍然具有挑战性。
我们旨在评估在真实环境和多中心环境中对老年 MM 患者进行全面 GA（CGA）的可行性，并评估他们的基线 CGA 特征。
我们研究了 349 名新诊断为 MM 的老年患者（年龄范围 65-86 岁）。我们的结果表明，CGA 适用于老年 MM 患者。使用 IMWG-GA 标准，我们在队列中比在 IMWG 队列中发现了更多虚弱的患者（43%比 30%，P=0.002）。在 IMWG-GA“健康”组中，仍存在营养不良、抑郁和认知障碍的风险。中位随访时间为 26 个月（范围 1-38 个月）。中位总生存期（OS）为 34.7 个月，估计 3 年 OS 率为 50%。高 MNA-SF 评分（MNA-SF≥12）、低 GDS 评分（GDS≤5）和高 CCI 评分（CCI≥2）可用于预测新诊断为 MM 的老年患者的 OS。本研究在 www.clinicaltrials.gov（NCT03122327）注册。
我们的研究证明了对新诊断的 MM 老年患者进行 CGA 的必要性。
