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Dynamic Frailty in Myeloma: Indications for Prognosis and Management in Older Adults

By: Joshua D. Madera, MD
Posted: Monday, August 14, 2023

Frailty assessment tools are often static and are typically measured only at the time of multiple myeloma diagnosis, neglecting the potential changes in frailty over time. According to a study published in Blood Cancer Journal, frailty is dynamic and may improve or deteriorate over time. Therefore, measuring frailty after the initial diagnosis may better indicate a patient’s clinical outcomes than the initial frailty measurement, suggested Hira Mian, MD, of McMaster University, Hamilton, Canada, and colleagues.

A total of 4,617 patients with newly diagnosed multiple myeloma were recruited for the study using the Surveillance, Epidemiology, and End Results (SEER)-Medicare–linked databases. All patients had received treatment with novel drugs between 2004 and 2017. Frailty index scores were calculated for each patient at the time of diagnosis and at the 1-year, 2-year, and 3-year post-diagnosis intervals. These scores were correlated with patients’ overall survival.

At the time of diagnosis, moderately frail to severely frail patients constituted 39% of the study population. At the 1-year interval after diagnosis, there was a 16% improvement and a 33% deterioration in frailty index scores. At the 2-year interval, 35% of patients demonstrated improvement, and 17% of patients showed deterioration in frailty index scores. At the 3-year interval, 78% of patients demonstrated an improvement in frailty index scores, and 72% of patients showed deterioration in these scores. Furthermore, the ability of the calculated frailty index score at diagnosis to accurately predict patients’ overall survival at the 1-year, 2-year, and 3-year intervals was 0.63, 0.62, and 0.60, respectively.

Disclosure: For full disclosures of the study authors, visit

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