Prevalence of geriatric impairments and frailty categorization among real-world patients with multiple myeloma: a prospective cohort study (MFRAIL)

Abstract

There is limited knowledge regarding the prevalence of geriatric impairments and frailty among patients with multiple myeloma (MM) in a real-world setting. This study evaluated the distribution of frailty profiles among 116 patients with newly diagnosed or relapsed MM, using four common frailty scales. The proportion of patients classified as frail varied significantly, ranging from 15.5% to 56.9%, due to differences in how frailty was operationalized between each frailty measure. Functional, cognitive, and mobility impairments were common overall and irrespective of performance status. Analyses between frailty and treatment selection (dose reduction and doublet vs. triplet therapy) demonstrated significant differences in non-steroid MM drug dose reductions between frail vs. non-frail patients, as scored by the International Myeloma Working Group (IMWG) Frailty Index and Simplified Frailty Score (p < .05). A standardized approach to frailty assessment that is practical in application, and beneficial in guiding treatment selection and minimizing treatment related toxicity is necessary to provide optimal tailored care.

Keywords:

• Multiple myeloma
• frailty
• geriatric impairments

Author contributions

Conception and design: HM, GP, TW, and DL; data collection: HM and RC; analysis and interpretation of data: all authors; manuscript writing: IH and HM; approval of final article: all authors.

Disclosure statement

The Ottawa Hospital Research Institute, Ottawa, Canada – AM: honoraria/consultancy: BMS, Janssen, Forus, Sanofi, GSK, Pfizer, Amgen. Research funding: BMS.

Department of Oncology, McMaster University, Canada – HM: honoraria/consultancy: BMS, Janssen, Forus, Sanofi, Takeda, Pfizer, Amgen. Research funding: Pfizer, Janssen. MA: honoraria/consultancy Janssen, Pfizer, Beigene, Forus and Sanofi. GP: honoraria/consultancy: Takeda, Merck, Astra-Zeneca, Profound Medical.

Department of Medicine, University of Nebraska Medical Center/ Nebraska Medicine, USA – TW: honoraria/consultancy: Carevive, Pfizer, Sanofi.

Additional information

Funding

The study was funded by Janssen Inc. as an investigator initiated independent study. Dr. Hira Mian is supported by an early career award from Hamilton Health Sciences.