Comparison of select risk prediction models relevant to older adults with multiple myeloma
| Factors associated with increased risk . | IMWG7 . | Revised Myeloma Comorbidity Index13 . | Geriatric Assessment in Hematology Scale16,17 . | Cancer and Aging Research Group Toxicity Tool*72,73 . | CRASH score†74 . | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Parameter . | Points . | Parameter . | Points . | Parameter . | Points . | Parameter . | Points . | Parameter . | Points . | |
| Age | Age 76-80 | 1 | 60-69 | 1 | — | ≥72 | 2 | — | ||
| Age >80 | 2 | ≥70 | 2 | — | — | |||||
| Performance/functional status | Any ADL dependence | 1 | KPS 80-90 | 2 | Gait speed ≤0.8 m/s | 1 | ≥1 falls in past 6 mo | 3 | ECOG 1-2 | 1 |
| Any IADL dependence | 1 | KPS < 70% | 3 | Any ADL dependence | 1 | Dependent in taking medications | 1 | ECOG 3-4 | 2 | |
| Limited in walking 1 block | 2 | |||||||||
| Comorbidities | Charlson Comorbidity Index ≥2 | 1 | Renal disease: eGFR < 60 | 1 | Diabetes, BMI > 25 kg/m2 | 1 | Creatinine clearance <34 mL/min | 3 | — | |
| Moderate/severe pulmonary disease | 1 | Cancer, lung disease, heart failure, or smoking‡ | ||||||||
| Medications/polypharmacy | — | — | ≥5 medications | 1 | — | |||||
| Nutrition | — | — | ≤8 on MNA-SF | 1 | — | MNA < 28 | 2 | |||
| Cognition | — | — | ≥3 errors on SPMSQ | 1 | — | MMS any errors | 2 | |||
| Psychosocial | — | — | Felt depressed 3-7 d of past week | 1 | Decreased social activities due to physical or emotional health | 1 | ||||
| Other | — | Moderate/severe frailty phenotype | 1 | Self-reported health fair or poor | 1 | Anemia | 3 | |||
| Hearing fair or worse | 2 | |||||||||
| Cytogenetics | — | Unfavorable | 1 | — | — | |||||
| Total score | Fit | 0 | Fit | 0-3 | Range | 0-8 | Range | 0-19 | Range | 0-8 |
| Intermediate fit | 1 | Intermediate | 4-6 | |||||||
| Frail | 2 | Frail | 7-9 | |||||||
| Factors associated with increased risk . | IMWG7 . | Revised Myeloma Comorbidity Index13 . | Geriatric Assessment in Hematology Scale16,17 . | Cancer and Aging Research Group Toxicity Tool*72,73 . | CRASH score†74 . | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Parameter . | Points . | Parameter . | Points . | Parameter . | Points . | Parameter . | Points . | Parameter . | Points . | |
| Age | Age 76-80 | 1 | 60-69 | 1 | — | ≥72 | 2 | — | ||
| Age >80 | 2 | ≥70 | 2 | — | — | |||||
| Performance/functional status | Any ADL dependence | 1 | KPS 80-90 | 2 | Gait speed ≤0.8 m/s | 1 | ≥1 falls in past 6 mo | 3 | ECOG 1-2 | 1 |
| Any IADL dependence | 1 | KPS < 70% | 3 | Any ADL dependence | 1 | Dependent in taking medications | 1 | ECOG 3-4 | 2 | |
| Limited in walking 1 block | 2 | |||||||||
| Comorbidities | Charlson Comorbidity Index ≥2 | 1 | Renal disease: eGFR < 60 | 1 | Diabetes, BMI > 25 kg/m2 | 1 | Creatinine clearance <34 mL/min | 3 | — | |
| Moderate/severe pulmonary disease | 1 | Cancer, lung disease, heart failure, or smoking‡ | ||||||||
| Medications/polypharmacy | — | — | ≥5 medications | 1 | — | |||||
| Nutrition | — | — | ≤8 on MNA-SF | 1 | — | MNA < 28 | 2 | |||
| Cognition | — | — | ≥3 errors on SPMSQ | 1 | — | MMS any errors | 2 | |||
| Psychosocial | — | — | Felt depressed 3-7 d of past week | 1 | Decreased social activities due to physical or emotional health | 1 | ||||
| Other | — | Moderate/severe frailty phenotype | 1 | Self-reported health fair or poor | 1 | Anemia | 3 | |||
| Hearing fair or worse | 2 | |||||||||
| Cytogenetics | — | Unfavorable | 1 | — | — | |||||
| Total score | Fit | 0 | Fit | 0-3 | Range | 0-8 | Range | 0-19 | Range | 0-8 |
| Intermediate fit | 1 | Intermediate | 4-6 | |||||||
| Frail | 2 | Frail | 7-9 | |||||||
ADL, activity of daily living; BMI, body mass index; CRASH, Chemotherapy Risk Assessment for High Age Patients; eGFR, estimated glomerular filtration rate; IADL, instrumental activity of daily living; KPS, Karnofsky Performance Status; MMS, Mini Mental Status Exam; MNA, Mini Nutritional Assessment; MNA-SF, Mini Nutritional Assessment—Short Form; SPMSQ, Short Portable Mental Status Questionnaire.
Developed and validated in solid tumor malignancies; original model includes points for gastrointestinal or genitourinary malignancies and chemotherapy type.
Developed and validated in primarily solid tumor malignancies; original model includes points for chemotherapy type. Variables listed are in the model for nonhematologic toxicity of chemotherapy.
See original publications16,17 for full details on scoring comorbidities.