التفاصيل البيبلوغرافية
| العنوان: |
A Simple Frailty Score Predicts Survival and Early Mortality in Systemic AL Amyloidosis. |
| المؤلفون: |
Ríos-Tamayo, Rafael, Lecumberri, Ramón, Cibeira, María Teresa, González-Calle, Verónica, Alonso, Rafael, Domingo-González, Amalia, Landete, Elena, Encinas, Cristina, Iñigo, Belén, Blanchard, María-Jesús, Alejo, Elena, Krsnik, Isabel, Gómez-Bueno, Manuel, Garcia-Pavia, Pablo, Segovia-Cubero, Javier, Rosiñol, Laura, Lahuerta, Juan-José, Martínez-López, Joaquín, Bladé, Joan |
| المصدر: |
Cancers; May2024, Vol. 16 Issue 9, p1689, 13p |
| مصطلحات موضوعية: |
AMYLOIDOSIS diagnosis, STATISTICAL models, FRAIL elderly, AMYLOIDOSIS, AGE distribution, PEPTIDE hormones, MULTIVARIATE analysis, DECISION making in clinical medicine, OVERALL survival, COMORBIDITY, PATIENT aftercare |
| مستخلص: |
Simple Summary: Despite a lack of standardization and some open questions, a growing body of evidence supports the use of frailty to optimize the clinical management of patients with hematological malignancies. Several scores have been applied particularly to multiple myeloma, an entity that shares many characteristics with AL amyloidosis, both being frequently associated. To date, no study has focused on frailty in patients with AL amyloidosis. We aimed to define a practical evaluation of frailty and estimate its impact in survival in patients with systemic AL amyloidosis. 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. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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