Combination of Geriatric Assessment and Clinical Factors to Predict the Survival of Elderly Patients with Myeloma

Purpose

Elderly patients with newly diagnosed multiple myeloma (NDMM) show heterogeneous outcomes due to their potential risk, and lack of the standard-of-care risk stratification model. In this study, we proposed the prognostic model by analyzing the additive value of geriatric assessment and clinical factors.

Patients and Methods

The collected individual data from 131 elderly patients(≥65) with NDMM enrolled. An additive scoring system on the basis of top features predicting progression-free survival (PFS) and overall survival (OS) was developed.

Results

At a median follow-up of 23.7 months, age, ADL, PLT, CRP, CPC had the highest impact on OS and were used to construct OS risk model. Likewise, age, ADL, PLT, CRP, CPC for PFS risk model. A value was assigned to each risk feature according to their OS impact (age>75 5 points, ADL>4 3 points, PLT<100×10⁹/L 4 points, elevated CRP 3 points, CPC≥0.105% 2 points). And for PFS risk model, age>75, CCI ≥2, β2≥3.5mg/L, PLT<100×10⁹/L and CPC≥0.105% were assigned 2, 2, 3, 2, 2 points repectively. Patients were stratified into three risk groups according to the total additive score. Median OS was not reached versus NR versus 54 versus 56 months, and median PFS was NR versus 47 versus 23 months, respectively. Nomogram was also constructed using the same variables. the AUC values obtained from our nomogram were 0.742, 0.773 and 0.807 for predicting the 1-, 2- and 3-year OS rates, respectively, which were higher than those of both the MRP model (0.692, 0.691, 0.683) and IMWG-GA model (0.649, 0.634, 0.659). Additionally, 1-, 2- and 3-year PFS in our cohort yield value of 0.775, 0.782,0.774, respectively, which also exhibited superior performance compared to both the MRP model(0.646, 0.607, and 0.602), and the IMWG-GA model( 0.636, 0.506, and 0.576).

Conclusion

Our simple prognostic staging system allowing a better stratification of patients with elderly NDMM. The additive geriatric metrics of this score fosters its future implementation with new prognostic variables.

No relevant conflicts of interest to declare.