Patient-reported geriatric impairments linked to treatment toxicity in older adults with myeloma

Researchers prospectively evaluated patient-reported comprehensive geriatric assessment (CGA) domains and treatment outcomes in 90 adults aged ≥60 years with newly diagnosed or relapsed/refractory multiple myeloma starting a new therapy. Participants completed electronic CGA and patient-reported outcome questionnaires at baseline and four months. Outcomes included treatment toxicity, treatment adaptations, health care use, and health-related quality of life (HRQOL). A cumulative deficit frailty index incorporated CGA and HRQOL domains.

Mean age was 72 years, and geriatric impairments were common, particularly in physical function. Older age, comorbidities, functional limitations, and anxiety were significantly associated with high-grade nonhematologic toxicity. Frailty affected 22% of participants and was associated with worse baseline HRQOL and increased high-grade nonhematologic toxicity, but not treatment adaptations or health care use. Patient-reported toxicity rates exceeded clinician-reported rates. Average CGA and HRQOL scores remained stable over four months, although individual trajectories varied.

The findings support attention to patient-reported function and symptoms during myeloma treatment and suggest a role for longitudinal geriatric assessment. However, this small observational study establishes associations rather than causation. The available abstract does not provide effect estimates, detailed treatment regimens, or toxicity rates, limiting assessment of the magnitude and applicability of the findings.