Background/Objectives:Multiple myeloma (MM) is a plasma cell neoplasm predominantly diagnosed in older adults. However, the significance of defining patient frailty, as well as identifying the most suitable and reliable tools for its assessment, remains to be firmly established.Methods: This retrospective observational study investigated 36 patients aged 65 or older who underwent Comprehensive Geriatric Assessment (CGA). The average patient age was 76 (SD 6.22), with 33.3% being female. Patients were evaluated using the International Myeloma Working Group Frailty Index (IMWG-FI) and the 40-item Rockwood’s Frailty Index (FI) at the Oncogeriatrics clinic of the IRCCS Polyclinic San Martino Hospital, Genoa, Italy between December 2017 and August 2021. Laboratory, cancer-specific, demographic, and clinical variables were collected. Survival analysis and frailty comparison were conducted using Stata version 17.0.Results: Stepwise multivariate analysis identified the Numerical Rating Scale (NRS) (HR 1.40, 95% CI 1.09–1.78,p= 0.008) and Rockwood’s Frailty Index (FI) (HR 2.23, 95% CI 1.29–3.87,p= 0.004) as significant prognostic predictors, adjusted for sex, ISS stage, and multimorbility. Comparison between Rockwood’s FI and IMWG-FI using Spearman correlation coefficient showed no statistically significant correlation (r = 0.268,p= 0.114). Multivariate Cox model, adjusting for sex, International Staging System (ISS) stage, and Cumulative Illness Rating Scale (CIRS) comorbidity index demonstrated the superior predictive ability of Rockwood’s FI over IMWG-FI (C-index 0.775 vs. 0.749).Conclusions: The 40-item Rockwood FI emerges as a valuable tool for prognostication in old MM patients, demonstrating non-inferiority to the traditional IMWG-FI in predictive accuracy, emphasizing the importance of a comprehensive approach considering both disease-specific and patient-related factors.
背景/目的：多发性骨髓瘤（MM）是一种主要发生于老年人群的浆细胞肿瘤。然而，明确患者衰弱状态的定义意义，以及确定最适宜、可靠的评估工具，仍有待进一步确立。方法：本回顾性观察性研究纳入了36名接受老年综合评估（CGA）的65岁及以上患者。患者平均年龄为76岁（标准差6.22），其中33.3%为女性。研究于2017年12月至2021年8月期间在意大利热那亚IRCCS圣马蒂诺综合医院肿瘤老年病学门诊进行，使用国际骨髓瘤工作组衰弱指数（IMWG-FI）和40项Rockwood衰弱指数（FI）对患者进行评估。收集了实验室指标、肿瘤特异性指标、人口统计学及临床变量。使用Stata 17.0版进行生存分析和衰弱评估工具比较。结果：逐步多变量分析确定，在调整了性别、ISS分期和共病情况后，数字评定量表（NRS）（风险比1.40，95%置信区间1.09–1.78，p=0.008）和Rockwood衰弱指数（FI）（风险比2.23，95%置信区间1.29–3.87，p=0.004）是显著的预后预测因子。使用Spearman相关系数比较Rockwood FI与IMWG-FI，未显示出统计学显著相关性（r=0.268，p=0.114）。在调整了性别、国际分期系统（ISS）分期和累积疾病评定量表（CIRS）共病指数的多变量Cox模型中，Rockwood FI显示出优于IMWG-FI的预测能力（C指数0.775对比0.749）。结论：40项Rockwood FI是老年MM患者预后评估的有效工具，其在预测准确性上不劣于传统的IMWG-FI，强调了在评估中综合考虑疾病特异性因素和患者相关因素的重要性。
肿瘤(癌症)患者之家