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Multiple myeloma gammopathies

Simplified frailty assessment tools: are we really capturing frailty or something else?

Leukemia volume 34, pages 1967–1969 (2020)Cite this article

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In their recent paper “A simplified frailty scale predicts outcomes in transplant-ineligible patients with newly diagnosed multiple myeloma treated in the FIRST (MM-020) trial” [1], Facon et al. propose a simple, dichotomous, easy-to-use frailty score to predict clinical outcomes among transplant-ineligible older adults with multiple myeloma (MM) [1]. Using data from the FIRST trial, the authors classified patients into frail/nonfrail based on age, comorbidities, and Eastern Cooperative Oncology Group performance status (ECOG PS). Patients categorized as frail had significantly worse progression-free survival and overall survival (OS), as well as higher rates of grade 3/4 treatment-related toxicities [1]. We congratulate the authors for development of a simple, practical tool that uses routinely measured variables to improve treatment decision-making in older adults with myeloma. However, we caution readers against abandoning more established frailty assessment tools, providing a brief overview of relevant literature to date.

MM is a disease of aging. Because older patients are at an increased risk of treatment-related toxicity, there is a need to personalize treatment strategies based on their anticipated tolerance of treatment [2]. However, chronological age does not adequately capture this vulnerability due to the heterogeneity of patients in physical and psychological functioning.

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References

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Authors and Affiliations

  1. Institute for Cancer Outcomes and Survivorship, Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, 1600 7th Avenue South, Lowder 500, Birmingham, AL, 35294, USA

    Smith Giri & Grant Williams

  2. Division of Hematology/Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA

    Ashley Rosko

  3. Division of Hematology/Oncology, The University of Washington/Fred Hutchinson Cancer Center, Seattle, WA, USA

    Shakira J. Grant

  4. Department of Oncology, McMaster University, Hamilton, ON, Canada

    Hira S. Mian

  5. Division of Hematology/Oncology, The University of North Carolina-Chapel Hill Comprehensive Cancer Center, Chapel Hill, NC, USA

    Sascha Tuchman

  6. Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands

    Sonja Zweegman

  7. Division of Medical Oncology, Washington University School of Medicine, St Louis, MO, USA

    Tanya M. Wildes

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  1. Smith Giri
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Correspondence to Smith Giri.

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SZ reports research funding from Takeda, Janssen, and Celgene; TW reports research funding from Janssen and consultancy with Carevive system; none of the other authors have relevant conflicts of interest to disclose.

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Giri, S., Williams, G., Rosko, A. et al. Simplified frailty assessment tools: are we really capturing frailty or something else?. Leukemia 34, 1967–1969 (2020). https://doi.org/10.1038/s41375-020-0712-5

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