TABLE 1.
Geriatric Variable Assessment in MM Populations
| Study | Geriatric Domains | Population | Status | Endpoints |
|---|---|---|---|---|
| IMWG frailty score 201516 | Age | NDMM age ≥ 65 years | Fit | OS |
| ADL/IADL | Median age, 74 years (range, 70–78 years) | Intermediate fit | PFS | |
| Comorbidities | Nontransplantation | Frail | Drug discontinuation | |
| Clinical trial population (n = 869) | Toxicity | |||
| Freiburg Comorbidity Index (I-MCI) 201317 | KPS | Chart audit | Fit | OS |
| Lung disease* | Symptomatic MM | Intermediate fit | ||
| Renal disease | Median age, 62 years (range, 27–90 years) | Frail | ||
| Transplantation and nontransplantation (n = 466) | ||||
| R-MCI 201718 | Age | NDMM | Fit | OS |
| KPS | Median age, 63 years (range, 21–93 years) | Intermediate fit | PFS | |
| Lung disease* | Transplantation and nontransplantation (n = 801) | Frail | ||
| Renal disease | ||||
| Frailty** | ||||
| Cytogenetics | ||||
| Comorbidities | ||||
| GAH 201519,20 | Medications | Patients with MM | Score ≤ 1 | OS |
| Gait speed | GAH original cohort | Score 2–6 | ||
| Mood | Median age, 76 years (range, 71–81 years; validation cohort; n = 60 MM/164 total) | Score > 6 | ||
| ADL | ||||
| Health status | ||||
| Nutrition | ||||
| Mental status | ||||
| Comorbidities | ||||
| Edmonton frailty, Schutz et al 201721 | Cognitive impairment | Chart audit age > 65 years | Fit | OS |
| Depression | NDMM | Vulnerable | ||
| Medications | Median age, 77 years (range, 65–98 years; n = 150) | Frail | ||
| Urinary incontinence | ||||
| Functional impairment | ||||
| Gait disturbance/falls | ||||
| Low weight | ||||
| Prior hospitalization | ||||
| Wildes et al, GA 201822 | Age | NDMM | NA | Transplantation recipient status |
| IADL | Median age, 71 years (SD, ±5.1 years) | |||
| Cognition | Transplantation and nontransplantation (n = 40) | |||
| Mental health inventory | ||||
| TUG | ||||
| Medications | ||||
| Comorbidities | ||||
| Rosko et al, GA 201823 | Nutrition | Transplantation MM | NA | Length of stay |
| KPS | Median age, 59.5 years (range, 36–75 years; n = 100) | Hospitalization | ||
| Self-report function | EFS | |||
| Fatigue | Change in deficits | |||
| Hand grip | ||||
| Gait disturbance | ||||
| Anxiety/depression | ||||
| Social support | ||||
| Cognition | ||||
| Frailty index 201824 | ADL | SEER-Medicare database age > 66 years | Cumulative deficits frailty index | OS |
| Comorbidities | NDMM | |||
| Physical function | Median age, 74 years (range, 66–110; n = 30b) | |||
| General health | ||||
| Mental health | ||||
| Murillo et al25 | IMWG frailty | Patients with MM age > 75 years | Fit/intermediate fit/frail | OS |
| IMWG vs. Fried Model26 | score Frailty** | Median age, 79 years (n = 107) | Robust/pre-frail/frail |
Abbreviations: ADL, activities of daily living; EFS, event-free survival; FEV1, forced expiratory volume; FVC, forced vital capacity; GA, geriatric assessment; GAH, geriatric assessment in hematology; IADL, instrumental ADL; I-MCI, Intial-Myeloma Comorbidity Index; IMWG, International Myeloma Working Group; KPS, Karnofsky performance status; MM, multiple myeloma; NA, not applicable; NDMM, newly diagnosed MM; OS, overall survival; PFS, progression-free survival; R-MCI, Revised Myeloma Comorbidity Index; SD, standard deviation; SEER, Surveillance, Epidemiology, and End Results; TLC, total lung capacity; TUG, Timed up and Go.
Lung disease: dyspnea, FEV1//FVC, FEV1, TLC, respiratory insufficiency.
Frailty: weakness, poor endurance, low physical activity, slow gait speed.