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 Clinical Therapeutics School of Medicine National and Kapodistrian University of Athens Athens Greece;

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; and

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;

Medical Clinic and Polyclinic 2 Department of Internal Medicine 2 University Hospital Wuerzburg Germany;

Multiple Myeloma section National Cancer Institute Bethesda MD;

Myeloma Unit Division of Hematology University of Torino Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino Torino Italy;

Scientific Direction Istituto di Ricovero e Cura a Carattere Scientifico Referral Cancer Center of Basilicata Rionero in Vulture Italy;

Servicio de Hematología Hospital Universitario de Salamanca Centro de Investigación del Cáncer Instituto de Biología Molecular y Celular del Cáncer Universidad de Salamanca Centro Superior de Investigaciones Científicas Salamanca Spain;

Unit of Clinical Epidemiology Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino Torino Italy;

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Blood. 2015 Mar 26;125(13):2014-5. doi: 10.1182/blood-2015-02-626408. PubMed

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Br J Haematol. 2018 Jul;182(2):165-167. doi: 10.1111/bjh.15260. PubMed

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Blood. 2016 Mar 3;127(9):1213. doi: 10.1182/blood-2016-01-693390. PubMed

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Blood. 2016 Aug 18;128(7):1020. doi: 10.1182/blood-2016-07-727081. PubMed

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ClinicalTrials.gov
NCT01093196, NCT01190787, NCT01346787