Geriatric assessment predicts survival and toxicities in elderly myeloma patients: An International Myeloma Working Group report

Antonio Palumbo, Sara Bringhen, Maria Victoria Mateos, Alessandra Larocca, Thierry Facon, Shaji K. Kumar, Massimo Offidani, Philip McCarthy, Andrea Evangelista, Sagar Lonial, Sonja Zweegman, Pellegrino Musto, Evangelos Terpos, Andrew Belch, Roman Hajek, Heinz Ludwig, A. Keith Stewart, Philippe Moreau, Kenneth Anderson, Hermann EinseleBrian G.M. Durie, Meletios A. Dimopoulos, Ola Landgren, Jesus F.San Miguel, Paul Richardson, Pieter Sonneveld, S. Vincent Rajkumar

Research output: Contribution to journalArticlepeer-review

327 Scopus citations

Abstract

We conducted a pooled analysis of 869 individual newly diagnosed elderly patient data from 3 prospective trials. At diagnosis, a geriatric assessment had been performed. An additive scoring system (range 0-5), based on age, comorbidities, and cognitive and physical conditions, was developed to identify 3 groups: fit (score = 0, 39%), intermediate fitness (score = 1,31%), and frail (score ≥2, 30%). The 3-year overall survivalwas 84%in fit, 76% in intermediate-fitness (hazard ratio [HR], 1.61; P = .042), and 57% in frail (HR, 3.57; P < .001) patients. Thecumulative incidence of grade ≥3 nonhematologic adverse events at 12 months was 22.2%in fit, 26.4%in intermediate-fitness (HR, 1.23; P = .217), and 34.0%in frail (HR, 1.74; P < .001) patients. The cumulative incidence of treatment discontinuation at 12months was 16.5%in fit, 20.8%in intermediate-fitness (HR, 1.41; P = .052), and 31.2% in frail (HR, 2.21; P < .001) patients. Our frailty score predicts mortality and the risk of toxicity in elderly myeloma patients. The International Myeloma Working group proposes this score for the measurement of frailty in designing future clinical trials. These trials are registered at www.clinicaltrials.gov as #NCT01093136 (EMN01), #NCT01190787 (26866138MMY2069), and #NCT01346787 (IST-CAR-506).

Original languageEnglish (US)
Pages (from-to)2068-2074
Number of pages7
JournalBlood
Volume125
Issue number13
DOIs
StatePublished - Mar 26 2015

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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