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Geriatric assessment predicts survival and toxicities in elderly myeloma patients: an International Myeloma Working Group report
A. Palumbo, S. Bringhen, MV. Mateos, A. Larocca, T. Facon, SK. Kumar, M. Offidani, P. McCarthy, A. Evangelista, S. Lonial, S. Zweegman, P. Musto, E. Terpos, A. Belch, R. Hajek, H. Ludwig, AK. Stewart, P. Moreau, K. Anderson, H. Einsele, BG....
Language English Country United States
Document type Journal Article, Meta-Analysis
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- MeSH
- Geriatric Assessment * MeSH
- Clinical Trials as Topic MeSH
- Cohort Studies MeSH
- Frail Elderly * MeSH
- Humans MeSH
- Multiple Myeloma drug therapy mortality MeSH
- Withholding Treatment statistics & numerical data MeSH
- Prognosis MeSH
- Antineoplastic Agents adverse effects therapeutic use MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Humans MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Meta-Analysis MeSH
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 survival was 84% in fit, 76% in intermediate-fitness (hazard ratio [HR], 1.61; P = .042), and 57% in frail (HR, 3.57; P < .001) patients. The cumulative 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 12 months 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).
Clinica di Ematologia Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona Ancona Italy
Clínica Universidad de Navarra Centro de Investigaciones Médicas Aplicadas Pamplona Spain
Department of Haematooncology and Faculty of Medicine University of Ostrava Ostrava Czech Republic
Department of Hematology and Medical Oncology Emory University Atlanta GA
Department of Hematology Erasmus Medical Center and HOVON Data Center Rotterdam The Netherlands
Department of Hematology Oncology Cedars Sinai Comprehensive Cancer Center Los Angeles CA
Department of Hematology Oncology Dana Farber Cancer Institute Boston MA
Department of Hematology University Hospital Hôtel Dieu Nantes France
Department of Hematology University Hospital Lille France
Department of Hematology VU University Medical Center Amsterdam The Netherlands
Department of Medical Oncology Dana Farber Cancer Institute Boston MA
Department of Medicine Roswell Park Cancer Institute Buffalo NY
Department of Oncology Hematology and Palliative Care Wilhelminen Vienna Austria
Department of Oncology University of Alberta Cross Cancer Institute Edmonton AB Canada
Division of Hematology College of Medicine Mayo Clinic Rochester MN
Division of Hematology Oncology Mayo Clinic Scottsdale AZ
Multiple Myeloma section National Cancer Institute Bethesda MD
References provided by Crossref.org
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