Department of Haematology, St Vincent's Hospital, Melbourne, Victoria, Australia.
Department of Haematology, Alfred Hospital, Melbourne, Victoria, Australia.
Intern Med J. 2023 May;53(5):819-824. doi: 10.1111/imj.16049. Epub 2023 May 10.
Multiple myeloma (MM) is a disease of older people, yet factors relating to comorbidity and frailty may threaten treatment tolerability for many of this heterogenous group. There has been increasing interest in defining specific and clinically relevant frailty assessment tools within the MM population, with the goal of using these frailty scores, not just as a prognostic instrument, but also as a predictive tool to allow for a frailty-adapted treatment approach. This paper reviews the various frailty assessment frameworks used in the evaluation of patients with MM, including the International Myeloma Working Group Frailty Index (IMWG-FI), the Mayo Frailty Index and the simplified frailty scale. While the IMWG-FI remains the most widely accepted tool, the simplified frailty scale is the most user-friendly in busy day-to-day clinics based on its ease of use. This paper summarises the recommendations from the Myeloma Scientific Advisory Group (MSAG) of Myeloma Australia, on the use of frailty assessment tools in clinical practice and proposes a frailty-stratified treatment algorithm to aid clinicians in tailoring therapy for this highly heterogeneous patient population.
多发性骨髓瘤（MM）是一种老年疾病，但与合并症和虚弱相关的因素可能会威胁到这一异质性群体中许多人的治疗耐受性。人们越来越关注在 MM 人群中定义特定的、具有临床相关性的虚弱评估工具，其目的是使用这些虚弱评分，不仅作为预后工具，还作为预测工具，以实现基于虚弱程度的治疗方法。本文综述了用于评估 MM 患者的各种虚弱评估框架，包括国际骨髓瘤工作组虚弱指数（IMWG-FI）、梅奥虚弱指数和简化虚弱量表。尽管 IMWG-FI 仍然是最广泛接受的工具，但基于其易用性，简化虚弱量表在繁忙的日常临床中最便于使用。本文总结了澳大利亚骨髓瘤协会骨髓瘤科学咨询小组（MSAG）关于在临床实践中使用虚弱评估工具的建议，并提出了一种基于虚弱程度的治疗算法，以帮助临床医生为这一高度异质性的患者群体量身定制治疗方案。
