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A Simple Frailty Score Predicts Survival and Early Mortality in Systemic AL Amyloidosis.

Authors :
Ríos-Tamayo R
Lecumberri R
Cibeira MT
González-Calle V
Alonso R
Domingo-González A
Landete E
Encinas C
Iñigo B
Blanchard MJ
Alejo E
Krsnik I
Gómez-Bueno M
Garcia-Pavia P
Segovia-Cubero J
Rosiñol L
Lahuerta JJ
Martínez-López J
Bladé J
Source :
Cancers [Cancers (Basel)] 2024 Apr 26; Vol. 16 (9). Date of Electronic Publication: 2024 Apr 26.
Publication Year :
2024

Abstract

Systemic AL amyloidosis is a challenging disease for which many patients are considered frail in daily clinical practice. However, no study has so far addressed frailty and its impact on the outcome of these patients. We built a simple score to predict mortality based on three frailty-associated variables: age, ECOG performance status (<2 vs. ≥2) and NT-proBNP (<8500 vs. ≥8500 ng/L). Four-hundred and sixteen consecutive newly diagnosed patients diagnosed at ten sites from the Spanish Myeloma Group were eligible for the study. The score was developed in a derivation cohort from a referral center, and it was externally validated in a multicenter cohort. Multivariate analysis showed that the three variables were independent predictors of survival. The score was able to discriminate four groups of patients in terms of overall survival and early mortality in both cohorts. Comorbidity was also analyzed with the Charlson comorbidity index, but it did not reach statistical significance in the model. A nomogram was created to easily estimate the mortality risk of each patient at each time point. This score is a simple, robust, and efficient approach to dynamically assess frailty-dependent mortality both at diagnosis and throughout follow-up. The optimal treatment for frail AL amyloidosis patients remains to be determined but we suggest that the estimation of frailty-associated risk could complement current staging systems, adding value in clinical decision-making in this complex scenario.

Details

Language :
English
ISSN :
2072-6694
Volume :
16
Issue :
9
Database :
MEDLINE
Journal :
Cancers
Publication Type :
Academic Journal
Accession number :
38730641
Full Text :
https://doi.org/10.3390/cancers16091689