Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea.
Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea.
Sci Rep. 2021 Nov 25;11(1):22907. doi: 10.1038/s41598-021-02433-6.
The number of elderly people is rapidly growing, and the proportion of elderly patients with multiple myeloma (MM) continues to increase. This study aimed to develop a frailty assessment tool based on clinical data and to estimate its feasibility in elderly patients with MM. This study analyzed data from 728 elderly transplant-ineligible patients with newly diagnosed MM who were treated between January 2010 and October 2019. Our clinical frailty index included age (< 75, and ≥ 75 years), Charlson comorbidity index (CCI; < 3 and ≥ 3), and Eastern Cooperative Oncology Group performance status score (ECOG score; 0, 1-2, and ≥ 3). Patients were classified as fit, intermediate, or frail if they had a score of 0, 1, or ≥ 2, respectively. The overall survival rates differed significantly according to frailty (fit vs. intermediate: hazard ratio [HR] = 2.41; 95% confidence interval [CI] = 1.43-4.06; P = 0.001; fit vs. frail: HR = 4.61; 95% CI = 2.74-7.77; P < 0.001 and intermediate vs. frail: HR = 1.91, 95% CI = 1.49-2.45, P < 0.001, respectively). The frail had significantly shorter EFS compared with the fit and intermediate group in our frailty index (fit vs. intermediate: HR = 1.34, 95% CI = 0.92-1.96, P = 0.132; fit vs. frail: HR = 2.06, 95% CI = 1.40-3.02, P < 0.001; and intermediate vs. frail: HR = 1.53, 95% CI = 1.22-1.92, P < 0.001, respectively). The new clinical frailty index, which is based on age, CCI, and ECOG PS, can easily assess frailty in elderly patients with MM and can be helpful in predicting survival outcomes in real world clinical setting.
老年人的数量正在迅速增加，多发性骨髓瘤（MM）老年患者的比例持续上升。本研究旨在基于临床数据开发一种衰弱评估工具，并评估其在 MM 老年患者中的可行性。本研究分析了 2010 年 1 月至 2019 年 10 月间新诊断为 MM 的 728 名不适合移植的老年患者的数据。我们的临床衰弱指数包括年龄（<75 岁和≥75 岁）、Charlson 合并症指数（<3 和≥3）和东部合作肿瘤学组体能状态评分（ECOG 评分；0、1-2 和≥3）。如果患者的评分为 0、1 或≥2，则分别将其归类为健康、中度衰弱或衰弱。根据衰弱程度，总生存率差异显著（健康与中度衰弱：危险比 [HR] = 2.41；95%置信区间 [CI] = 1.43-4.06；P = 0.001；健康与衰弱：HR = 4.61；95%CI = 2.74-7.77；P<0.001；中度衰弱与衰弱：HR = 1.91，95%CI = 1.49-2.45，P<0.001）。在我们的衰弱指数中，衰弱患者的 EFS 明显短于健康和中度衰弱患者（健康与中度衰弱：HR = 1.34，95%CI = 0.92-1.96，P = 0.132；健康与衰弱：HR = 2.06，95%CI = 1.40-3.02，P<0.001；中度衰弱与衰弱：HR = 1.53，95%CI = 1.22-1.92，P<0.001）。基于年龄、CCI 和 ECOG PS 的新临床衰弱指数可以轻松评估 MM 老年患者的衰弱程度，并有助于预测真实临床环境中的生存结果。
