Authors of this article discuss the role of frailty assessments in managing older adults with multiple myeloma (MM). Frailty scores, including the IMWG score, are valuable tools for predicting treatment tolerance and guiding decisions regarding stem cell transplant and non-transplant therapies. The IMWG score and other frailty scales incorporate age, comorbidities, and physical performance to determine the patient’s fitness level and potential for treatment-related toxicity. This approach helps clinicians tailor treatments, considering both biological age and disease factors. The case study of a 70-year-old woman highlights how frailty scoring influences treatment decisions, as she was classified as intermediate-fit, which informed her personalized therapy plan, including reduced-intensity treatments.

Researchers also explore the challenges of applying frailty scoring in clinical practice, particularly when deciding between transplant and non-transplant strategies. While frailty scores offer important insights, their limitations mean that clinical decisions still rely on patient preferences, life expectancy, and disease biology. The case study emphasizes the importance of shared decision-making, as the patient, despite being classified as intermediate-fit, opted for non-transplant therapy. Ongoing studies are needed to refine these tools and incorporate them into routine clinical practice.

Reference: Grant SJ, Freeman CL, Rosko AE. Treatment of Older Adult or Frail Patients with Multiple Myeloma. Hematology Am Soc Hematol Educ Program. 2021;2021(1):46-54. doi: 10.1182/hematology.2021000231.