TY - JOUR
T1 - Geriatric assessment predicts survival and toxicities in elderly myeloma patients
T2 - An International Myeloma Working Group report
AU - Palumbo, Antonio
AU - Bringhen, Sara
AU - Mateos, Maria Victoria
AU - Larocca, Alessandra
AU - Facon, Thierry
AU - Kumar, Shaji K.
AU - Offidani, Massimo
AU - McCarthy, Philip
AU - Evangelista, Andrea
AU - Lonial, Sagar
AU - Zweegman, Sonja
AU - Musto, Pellegrino
AU - Terpos, Evangelos
AU - Belch, Andrew
AU - Hajek, Roman
AU - Ludwig, Heinz
AU - Stewart, A. Keith
AU - Moreau, Philippe
AU - Anderson, Kenneth
AU - Einsele, Hermann
AU - Durie, Brian G.M.
AU - Dimopoulos, Meletios A.
AU - Landgren, Ola
AU - Miguel, Jesus F.San
AU - Richardson, Paul
AU - Sonneveld, Pieter
AU - Rajkumar, S. Vincent
PY - 2015/3/26
Y1 - 2015/3/26
N2 - 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).
AB - 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).
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U2 - 10.1182/blood-2014-12-615187
DO - 10.1182/blood-2014-12-615187
M3 - Article
C2 - 25628469
AN - SCOPUS:84926205248
SN - 0006-4971
VL - 125
SP - 2068
EP - 2074
JO - Blood
JF - Blood
IS - 13
ER -