The importance of frailty assessment in multiple myeloma: a position statement from the Myeloma Scientific Advisory Group to Myeloma Australia

Author:

Sim Shirlene1ORCID,Kalff Anna2,Tuch Gina3,Mollee Peter45,Ho P. Joy67,Harrison Simon89,Gibbs Simon1011ORCID,Prince H. Miles8912,Spencer Andrew2,Joshua Douglas67,Lee Cindy13,Ling Silvia14,Murphy Nick15,Szabo Ferenc16,Szer Jeff89ORCID,Weber Nicholas17,Ward Christopher18,Talaulikar Dipti19ORCID,Zannettino Andrew20ORCID,Quach Hang19

Affiliation:

1. Department of Haematology St Vincent's Hospital Melbourne Victoria Australia

2. Department of Haematology Alfred Hospital Melbourne Victoria Australia

3. Department of Geriatric Medicine Alfred Health Melbourne Victoria Australia

4. Department of Haematology Princess Alexandra Hospital Brisbane Queensland Australia

5. Department of Medicine University of Queensland Queensland Brisbane Australia

6. Department of Haematology Royal Prince Alfred Hospital Sydney New South Wales Australia

7. Department of Medicine University of Sydney New South Wales Sydney Australia

8. Department of Haematology Peter MacCallum Cancer Centre and The Royal Melbourne Hospital Melbourne Victoria Australia

9. Department of Medicine The University of Melbourne Victoria Melbourne Australia

10. Department of Haematology Eastern Health Melbourne Victoria Australia

11. Department of Medicine Monash University Victoria Melbourne Australia

12. Department of Haematology Epworth Healthcare Melbourne Victoria Australia

13. Department of Clinical Haematology Royal Adelaide Hospital Adelaide South Australia Australia

14. Department of Haematology Liverpool Hospital Sydney New South Wales Australia

15. Department of Clinical Haematology Royal Hobart Hospital Hobart Tasmania Australia

16. Department of Haematology Royal Darwin Hospital Darwin Northern Territory Australia

17. Department of Haematology Royal Brisbane Hospital Brisbane Queensland Australia

18. Department of Haematology Royal North Shore Hospital Sydney New South Wales Australia

19. Department of Haematology The Canberra Hospital Canberra Australian Capital Territory Australia

20. Department of Experimental Haematology University of Adelaide Adelaide South Australia Australia

Abstract

AbstractMultiple myeloma (MM) is a disease of older people, yet factors relating to comorbidity and frailty may threaten treatment tolerability for many of this heterogenous group. There has been increasing interest in defining specific and clinically relevant frailty assessment tools within the MM population, with the goal of using these frailty scores, not just as a prognostic instrument, but also as a predictive tool to allow for a frailty‐adapted treatment approach. This paper reviews the various frailty assessment frameworks used in the evaluation of patients with MM, including the International Myeloma Working Group Frailty Index (IMWG‐FI), the Mayo Frailty Index and the simplified frailty scale. While the IMWG‐FI remains the most widely accepted tool, the simplified frailty scale is the most user‐friendly in busy day‐to‐day clinics based on its ease of use. This paper summarises the recommendations from the Myeloma Scientific Advisory Group (MSAG) of Myeloma Australia, on the use of frailty assessment tools in clinical practice and proposes a frailty‐stratified treatment algorithm to aid clinicians in tailoring therapy for this highly heterogeneous patient population.

Publisher

Wiley

Subject

Internal Medicine

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