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

被引：579

作者：

Palumbo, Antonio ^{[1
]}

Bringhen, Sara ^{[1
]}

Mateos, Maria-Victoria ^{[2
]}

Larocca, Alessandra ^{[1
]}

Facon, Thierry ^{[3
]}

Kumar, Shaji K. ^{[4
]}

Offidani, Massimo ^{[5
]}

McCarthy, Philip ^{[6
]}

Evangelista, Andrea ^{[7
]}

Lonial, Sagar ^{[8
]}

Zweegman, Sonja ^{[9
]}

Musto, Pellegrino ^{[10
]}

Terpos, Evangelos ^{[11
]}

Belch, Andrew ^{[12
]}

Hajek, Roman ^{[13
,14
]}

Ludwig, Heinz ^{[15
]}

Stewart, A. Keith ^{[16
]}

Moreau, Philippe ^{[17
]}

Anderson, Kenneth ^{[18
]}

Einsele, Hermann ^{[19
]}

Durie, Brian G. M. ^{[20
]}

Dimopoulos, Meletios A. ^{[11
]}

Landgren, Ola ^{[21
]}

San Miguel, Jesus F. ^{[22
]}

Richardson, Paul ^{[23
]}

Sonneveld, Pieter ^{[24
,25
]}

Rajkumar, S. Vincent ^{[4
]}

机构：

[1] Univ Turin, Div Hematol, Myeloma Unit, Azienda Osped Univ Citta Salute & Sci Torino, Turin, Italy

[2] Univ Salamanca, CSIC, Hosp Univ Salamanca, Serv Hematol,Ctr Invest Canc,Inst Biol Mol & Celu, E-37008 Salamanca, Spain

[3] Univ Hosp, Dept Hematol, Lille, France

[4] Mayo Clin, Div Hematol, Coll Med, Rochester, MN USA

[5] Azienda Osped Univ Osped Ancona, Clin Ematol, Ancona, Italy

[6] Roswell Pk Canc Inst, Dept Med, Buffalo, NY 14263 USA

[7] Azienda Osped Citta Salute & Sci Torino, Clin Epidemiol Unit, I-10126 Turin, Italy

[8] Emory Univ, Dept Hematol & Med Oncol, Atlanta, GA 30322 USA

[9] Vrije Univ Amsterdam, Med Ctr, Dept Hematol, Amsterdam, Netherlands

[10] Referral Canc Ctr Basilicata, Ist Ricovero & Cura Carattere Sci, Sci Direct, Rionero In Vulture, Italy

[11] Univ Athens, Sch Med, Dept Clin Therapeut, Athens 11528, Greece

[12] Univ Alberta, Dept Oncol, Cross Canc Inst, Edmonton, AB, Canada

[13] Univ Ostrava, Dept Haematooncol, CZ-70103 Ostrava, Czech Republic

[14] Univ Ostrava, Fac Med, Ostrava, Czech Republic

[15] Wilhelminen, Dept Oncol Hematol & Palliat Care, Vienna, Austria

[16] Mayo Clin, Div Hematol Oncol, Scottsdale, AZ USA

[17] Univ Hosp Hotel Dieu, Dept Hematol, Nantes, France

[18] Dana Farber Canc Inst, Dept Hematol Oncol, Boston, MA 02115 USA

[19] Univ Hosp, Dept Internal Med 2, Med Clin & Polyclin 2, Wurzburg, Germany

[20] Cedars Sinai Comprehens Canc Ctr, Dept Hematol Oncol, Los Angeles, CA USA

[21] NCI, Multiple Myeloma sect, Bethesda, MD 20892 USA

[22] Univ Navarra Clin, Ctr Invest Med Aplicadas, Pamplona, Spain

[23] Dana Farber Canc Inst, Dept Med Oncol, Boston, MA 02115 USA

[24] Erasmus MC, Dept Hematol, Rotterdam, Netherlands

[25] HOVON Data Ctr, Rotterdam, Netherlands

来源：

BLOOD | 2015年 / 125卷 / 13期

关键词：

MULTIPLE-MYELOMA; OLDER; AGE; DEXAMETHASONE; LENALIDOMIDE; METAANALYSIS; BORTEZOMIB; THALIDOMIDE; POPULATION; PREDNISONE;

D O I：

10.1182/blood-2014-12-615187

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：2068 / 2074

页数：7

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