Multiple Myeloma Coverage from Every Angle

Frailty Index May Predict Survival in Newly Diagnosed Myeloma

By: Sarah Campen, PharmD
Posted: Tuesday, December 11, 2018

In older patients with multiple myeloma, frailty is a critical factor in selecting appropriate treatment recommendations. In a federally funded study published in the JCO Clinical Cancer Informatics, researchers used the Rockwood accumulation of deficits approach to develop a frailty index that incorporates functional and quality-of-life factors versus chronologic age alone. The tool was prognostic in predicting overall survival in patients with newly diagnosed multiple myeloma, revealing that each 10% increase in frailty index was associated with a 16% increased risk for death.

“Our results demonstrate that, for patients with multiple myeloma, chronological age alone is not a good measure for assessing overall health,” stated corresponding author Tanya M. Wildes, MD, MSCI, of Washington University School of Medicine, St. Louis, in an American Society of Clinical Oncology (ASCO) press release.

The investigators analyzed data from 2,692,361 patients without cancer older than age 66 in Medicare Health Outcomes Survey–linked databases. With this information, they created the deficit-accumulation frailty index, a 25-item scale including activities of daily living, chronic health conditions, functioning, general health, and mental health. Dr. Wildes and colleagues applied the frailty index to 305 patients with newly diagnosed myeloma to predict their outcomes. 

Among patients without cancer, each 10% increase in frailty index, equivalent to about 3 to 4 deficits on the 25-item scale, was associated with a 40% increased risk for death (P < .001). Approximately one-half (53%) of patients with multiple myeloma were considered frail; the estimated median overall survival of patients considered frail was 26.8 months, compared with 43.7 months for those who were not.

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