Validating the Korean Geriatric Assessment Tool in Elderly Multiple Myeloma Patients: A Multicenter Study.

Abstract

Purpose: This study evaluates the Korean Cancer Study Group Geriatric Score-7 (KG-7) frailty screening tool's effectiveness in elderly multiple myeloma (MM) patients to prevent under and over-treatment.

Materials and methods: This prospective pilot cohort study included 100 elderly patients aged 70 and older with newly diagnosed MM who had not undergone transplantation from August 2020 to January 2022.

Results: The median age was 77 years, and 73% of patients were classified at International Staging System (ISS) stages 2 or 3. Using a 5-point cutoff on the KG-7 index (non-frail, score ≥ 5; frail, score < 5), 31% were categorized as frail. After a median follow-up of 26.8 months, the 3-year overall survival rate was 73.0%. There was no statistically significant association between any frailty index and the risk of death. However, frail patients defined by the simplified frailty index (HR, 2.49; 95% CI, 1.09-5.95; p=0.030) and by KG-7 (HR, 2.43; 95% CI, 1.03-5.86; p=0.043) had a significantly higher risk of grade 3-4 non-hematologic toxicity, whereas the IMWG definition did not. Over a 24-month tracking period, vulnerability as measured by KG-7 either improved or deteriorated.

Conclusion: The pilot study, which had a limited number of participants, did not demonstrate KG-7's effectiveness in predicting survival; however, it successfully predicted severe non-hematologic toxicities. We plan to conduct larger studies in elderly MM patients to determine whether KG-7 can help tailor their treatment regimens.