Miller Hannah Louise, Sharpley Faye Amelia
Christie @ Macclesfield, Macclesfield Hospital, Victoria Road, Macclesfield SK10 3BL, UK.
Hematol Rep. 2023 Feb 21;15(1):151-156. doi: 10.3390/hematolrep15010015.
Frailty is a hot topic in the field of multiple myeloma (MM). Clinicians have realised that frail myeloma patients can struggle with treatment, resulting in dose reductions and treatment discontinuation, which risk shorter progression-free and overall survival. Efforts have focused on the validity of existing frailty scores and on the development of new indices to identify frail patients more accurately. This review article explores the challenges of the existing frailty scores, including the International Myeloma Working Group (IMWG) frailty score, the revised Myeloma Co-morbidity Index (R-MCI), and the Myeloma Risk Profile (MRP). We conclude that the missing link is for frailty scoring to translate into a tool useful in real-world clinical practice. The future of frailty scores lies in their ability to be woven into clinical trials, to create a robust clinical evidence base for treatment selection and dose modification, and also to identify a cohort of patients who merit additional support from the wider MM multidisciplinary team.
衰弱是多发性骨髓瘤（MM）领域的一个热门话题。临床医生已经意识到，衰弱的骨髓瘤患者在治疗中可能会遇到困难，导致剂量减少和治疗中断，这会缩短无进展生存期和总生存期。人们的努力集中在现有衰弱评分的有效性以及开发更准确识别衰弱患者的新指标上。这篇综述文章探讨了现有衰弱评分面临的挑战，包括国际骨髓瘤工作组（IMWG）衰弱评分、修订后的骨髓瘤合并症指数（R-MCI）和骨髓瘤风险概况（MRP）。我们得出的结论是，缺失的环节在于将衰弱评分转化为在现实世界临床实践中有用的工具。衰弱评分的未来在于它们能够融入临床试验，为治疗选择和剂量调整建立强大的临床证据基础，并且还能识别出值得更广泛的MM多学科团队给予额外支持的患者群体。
