评估复发/难治性多发性骨髓瘤患者的虚弱状态：患者报告的虚弱表型与国际骨髓瘤工作组虚弱指数的比较

Assessing frailty in patients with relapsed/refractory multiple myeloma: A comparison between the patient-reported frailty phenotype and the International Myeloma Working Group frailty index.

作者信息

Krepper Daniela, Sparano Francesco, Giesinger Johannes M, Gaidano Gianluca, Niscola Pasquale, Codeluppi Katia, Antonioli Elisabetta, Califano Catello, Floro Lajos, Annibali Ombretta, Fozza Claudio, Tafuri Agostino, Mazza Patrizio, Potenza Leonardo, Vignetti Marco, Cavo Michele, Petrucci Maria Teresa, Efficace Fabio

机构信息

Department of Psychiatry, Psychotherapy Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria.

Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy.

出版信息

J Geriatr Oncol. 2025 Jul;16(6):102266. doi: 10.1016/j.jgo.2025.102266. Epub 2025 Jun 4.

DOI:10.1016/j.jgo.2025.102266

PMID:40472573

Abstract

INTRODUCTION

The International Myeloma Working Group Frailty Index (IMWG FI) is one of the most used frailty assessment tools in patients with multiple myeloma (MM). A patient-centered frailty tool based on patient-reported outcomes (PROs) has been recently proposed for patients with relapsed/refractory MM (RRMM): the Patient-Reported Frailty Phenotype (PRFP). This cross-sectional analysis aimed to replicate the PRFP within a real-world setting and to describe health-related quality of life (HRQoL) profiles based on this new patient-centered frailty classification.

MATERIALS AND METHODS

This analysis was based on baseline data from a multi-center prospective observational study that included adult patients with RRMM. Frailty was assessed using the IMWG FI, and HRQoL was evaluated with the EORTC QLQ-C30 and its myeloma module (QLQ-MY20). For this analysis, the PRFP was also calculated, and Cohen's kappa was computed to examine the agreement between the two frailty assessment approaches. Descriptive statistics were used to investigate the HRQoL profiles of patients classified as frail, pre-frail, and fit.

RESULTS

Five hundred eleven patients were enrolled. The median age was 69.8 years, and 44 % were female. According to IMWG FI and PRFP, 24.5 % and 25.1 % of patients were classified as frail, with a weighted Cohen's kappa of 0.27, indicating fair agreement. Frail patients, as classified by the PRFP, reported higher treatment side effects, disease symptoms, and worse future perspectives and body image compared to pre-frail and fit patients.

DISCUSSION

Current findings suggest that the PRFP may be a valuable tool to assess frailty in patients with RRMM. However, further prospective studies are needed to better understand the value of PROs in a more accurate assessment of frailty in the RRMM setting.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT03190525.

摘要

引言

国际骨髓瘤工作组衰弱指数（IMWG FI）是多发性骨髓瘤（MM）患者中使用最广泛的衰弱评估工具之一。最近，针对复发/难治性MM（RRMM）患者提出了一种基于患者报告结局（PRO）的以患者为中心的衰弱工具：患者报告衰弱表型（PRFP）。本横断面分析旨在在现实环境中重现PRFP，并基于这种新的以患者为中心的衰弱分类描述健康相关生活质量（HRQoL）概况。

材料与方法

本分析基于一项多中心前瞻性观察性研究的基线数据，该研究纳入了成年RRMM患者。使用IMWG FI评估衰弱情况，并使用欧洲癌症研究与治疗组织核心问卷（EORTC QLQ-C30）及其骨髓瘤模块（QLQ-MY20）评估HRQoL。对于本分析，还计算了PRFP，并计算了科恩kappa系数以检验两种衰弱评估方法之间的一致性。使用描述性统计来研究被分类为衰弱、衰弱前期和健康的患者的HRQoL概况。