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

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 ident...

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Podrobná bibliografia
Vydané v:	Blood Ročník 125; číslo 13; s. 2068
Hlavní autori:	Palumbo, Antonio, Bringhen, Sara, Mateos, Maria-Victoria, Larocca, Alessandra, Facon, Thierry, Kumar, Shaji K, Offidani, Massimo, McCarthy, Philip, Evangelista, Andrea, Lonial, Sagar, Zweegman, Sonja, Musto, Pellegrino, Terpos, Evangelos, Belch, Andrew, Hajek, Roman, Ludwig, Heinz, Stewart, A Keith, Moreau, Philippe, Anderson, Kenneth, Einsele, Hermann, Durie, Brian G M, Dimopoulos, Meletios A, Landgren, Ola, San Miguel, Jesus F, Richardson, Paul, Sonneveld, Pieter, Rajkumar, S Vincent
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States 26.03.2015
Predmet:	Aged Aged, 80 and over Antineoplastic Agents - adverse effects Antineoplastic Agents - therapeutic use Clinical Trials as Topic Cohort Studies Frail Elderly Geriatric Assessment Humans Multiple Myeloma - drug therapy Multiple Myeloma - mortality Prognosis Withholding Treatment - statistics & numerical data
ISSN:	1528-0020, 1528-0020
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Shrnutí:	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).
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1528-0020 1528-0020
DOI:	10.1182/blood-2014-12-615187