Background/Objectives: Multiple myeloma (MM) predominantly affects older adults, a heterogeneous population. Comprehensive Geriatric Assessment (CGA) and abbreviated tools support individualized treatment planning. This study aimed to evaluate the feasibility of CGA and its impact on clinical outcomes in this subgroup of patients.Methods: Prospective, observational, and single-center study including patients aged ≥65 years assessed at MM diagnosis and one year later in an onco-hematogeriatrics clinic. A CGA was performed, and frailty was evaluated using the following: G8, Geriatric Assessment in Hematology (GAH), Clinical Frailty Scale (CFS), Frail-VIG Index (FI-VIG), modified Fried phenotype, International Myeloma Working Group Frailty Index (IMWG-FI), and Revised Myeloma Comorbidity Index (R-MCI). At one year, patients were reassessed; treatment response (IMWG criteria), adverse events (CTCAE v5.03), and mortality were recorded.Results: Fifty-five patients (mean age 78.0 ± 5.4 years, 58.2% female) diagnosed between December 2019 and May 2024 were included. CGA completion exceeded 90% at both time points. At one year, 9 patients (16.4%) had died, and 16 (29.1%) achieved complete response, with daratumumab-lenalidomide-dexamethasone (DRd) being the most used regimen. Frailty prevalence significantly declined (FRAIL:p= 0.012; CFS:p= 0.016; IMWG-FI:p= 0.020). GAH was significantly associated with ≥grade 3 hematologic toxicity (OR = 5.67,p= 0.004) and mortality (AUC = 0.750,p= 0.027). FI-VIG also predicted mortality (OR = 14.67,p= 0.026).Conclusions: CGA and its abbreviated forms are feasible and clinically valuable tools for identifying vulnerable older adults with MM, enabling treatment individualization and improved risk stratification.
背景/目的：多发性骨髓瘤主要影响老年人群，该群体具有高度异质性。综合老年评估及其简化工具可为个体化治疗决策提供支持。本研究旨在评估综合老年评估在该患者亚群中的实施可行性及其对临床结局的影响。 方法：本研究为前瞻性、观察性、单中心研究，纳入年龄≥65岁、在肿瘤血液老年门诊于多发性骨髓瘤诊断时及一年后接受评估的患者。研究实施综合老年评估，并采用以下工具评估衰弱状态：G8量表、血液学老年评估量表、临床衰弱量表、Frail-VIG指数、改良弗里德表型、国际骨髓瘤工作组衰弱指数及修订版骨髓瘤合并症指数。一年后对患者进行再评估，记录治疗反应（依据国际骨髓瘤工作组标准）、不良事件（CTCAE v5.03版）及死亡情况。 结果：共纳入2019年12月至2024年5月期间确诊的55例患者（平均年龄78.0±5.4岁，女性占58.2%）。两个时间点的综合老年评估完成率均超过90%。一年随访期内，9例患者死亡（16.4%），16例患者（29.1%）达到完全缓解，其中达雷妥尤单抗-来那度胺-地塞米松方案为最常用治疗方案。衰弱患病率显著下降（FRAIL量表：p=0.012；临床衰弱量表：p=0.016；国际骨髓瘤工作组衰弱指数：p=0.020）。血液学老年评估量表与≥3级血液学毒性显著相关（比值比=5.67，p=0.004），且对死亡率具有预测价值（曲线下面积=0.750，p=0.027）。Frail-VIG指数同样可预测死亡率（比值比=14.67，p=0.026）。 结论：综合老年评估及其简化工具是可行且具有临床价值的评估手段，能有效识别多发性骨髓瘤老年患者中的脆弱群体，为实现个体化治疗和优化风险分层提供依据。
肿瘤(癌症)患者之家