Every year, more than 150,000 cases of multiple myeloma (MM) are diagnosed worldwide, and over 100,000 deaths caused by this malignancy are recorded. MM incidence is increasing globally, particularly in high-income countries and in the male population aged ≥ 50. While advances in treatment strategies have led to the improvement of survival over the past decades, MM remains incurable in a large percentage of cases. Importantly, about one-third of patients diagnosed with MM are >75 years old and are characterized by relatively low fitness or frailty. These patients are more vulnerable to stressors and present lower resistance to cancer and related treatments. Therefore, patients’ fitness and frailty should become part of the standard assessment in MM, and flexible therapeutic options should apply. A careful review of studies investigating the management of frail patients with MM strongly supports the use of a dynamic evaluation of effectiveness and adverse events associated with current treatments in the context of patient-specific frailty and co-morbidities.
全球每年新增多发性骨髓瘤确诊病例逾15万例，该恶性肿瘤导致的死亡病例超过10万例。多发性骨髓瘤发病率在全球范围内呈上升趋势，高收入国家及50岁以上男性群体尤为显著。尽管过去数十年治疗策略的进步提升了患者生存率，但多数病例仍无法根治。值得注意的是，约三分之一的多发性骨髓瘤确诊患者年龄超过75岁，其典型特征为体能状态相对低下或衰弱。这类患者对应激因素更为敏感，对癌症及相关治疗的耐受性较低。因此，患者体能状态与衰弱评估应纳入多发性骨髓瘤标准诊疗体系，并实施个体化治疗方案。对衰弱型多发性骨髓瘤患者管理研究的系统回顾表明，必须基于患者特异性衰弱状态及共病情况，对现行治疗方案的有效性与不良反应进行动态评估。
Challenges in Multiple Myeloma Therapy in Older and Frail Patients
肿瘤(癌症)患者之家