Li Yujun, Zhao Songying, Xu Jianmei, Zhang Jiangbo, Wang Jing, Guo Huimei, Liu Liyang, Xue Hua
Qian Xi Nan People's Hospital, Xingyi, 562400, China.
Department of Hematology, Affiliated Hospital of Hebei University, Baoding, 071000, Hebei, China.
Discov Oncol. 2024 Oct 10;15(1):546. doi: 10.1007/s12672-024-01305-5.
The aim was to explore the effectiveness of the International Myeloma Working Group Frailty Index (IMWG-FI), Mayo Score, UK Myeloma Research Alliance Risk Profile (MRP), and Intergroupe Francophone du Myélome (IFM) simplified frailty scale for classifying frailty in elderly multiple myeloma (MM) patients and compare the validity of different frailty tools.
Eighty-four newly diagnosed MM patients aged ≥ 60 years in HeBei University Hospital were evaluated by the IMWG-FI, Mayo score, MRP score and IFM scale, and consistency and survival analyses were performed using Cohen's kappa coefficients and the Kaplan‒Meier method, respectively.
A total of 64 patients (76.2%) were identified as frail by at least one frailty tool; 14 (21.9%) were identified as frail by all four tools, and although moderate concordance was achieved between the IMWG-FI and MRP and the Mayo Score (0.432-0.474, P < 0.001), the concordance among the four assessment tools was relatively low (Cohen's kappa 0.218-0.474). The median overall survival (OS, P = 0.006, 0.025, and 0.028) and progression-free survival (PFS, P = 0.002, 0.006, and 0.03) of patients in the frail group and the nonfrail group identified by the IMWG-FI, Mayo score, and MRP were significantly different, while the median OS (P = 0.139) and PFS (P = 0.167) were not significantly different for the frail patients identified by the different frailty assessment tools.
In this study, the consistency of the different frailty assessment tools was low, whereas that between the MRP and IMWG-FI was high. Therefore, combining IMWG-FI and MRP may reduce assessment subjectivity and improve frailty identification.
探讨国际骨髓瘤工作组虚弱指数（IMWG-FI）、梅奥评分、英国骨髓瘤研究联盟风险概况（MRP）和法语国家骨髓瘤研究组（IFM）简化虚弱量表对老年多发性骨髓瘤（MM）患者虚弱程度分类的有效性，并比较不同虚弱评估工具的效度。
河北大学附属医院84例年龄≥60岁的新诊断MM患者接受IMWG-FI、梅奥评分、MRP评分和IFM量表评估，分别采用Cohen's kappa系数和Kaplan-Meier法进行一致性和生存分析。
共有64例患者（76.2%）被至少一种虚弱评估工具判定为虚弱；14例（21.9%）被所有四种工具判定为虚弱，尽管IMWG-FI与MRP以及梅奥评分之间达到了中度一致性（0.432 - 0.474，P < 0.001），但四种评估工具之间的一致性相对较低（Cohen's kappa 0.218 - 0.474）。IMWG-FI、梅奥评分和MRP判定的虚弱组和非虚弱组患者的中位总生存期（OS，P = 0.006、0.025和0.028）及无进展生存期（PFS，P = 0.002、0.006和0.03）有显著差异，而不同虚弱评估工具判定的虚弱患者的中位OS（P = 0.139）和PFS（P = 0.167）无显著差异。
本研究中，不同虚弱评估工具的一致性较低，而MRP与IMWG-FI之间的一致性较高。因此，联合使用IMWG-FI和MRP可能会降低评估主观性并提高虚弱识别能力。
