{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T23:23:03Z","timestamp":1792279383070,"version":"4.4.0"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81670189"],"award-info":[{"award-number":["81670189"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81471165"],"award-info":[{"award-number":["81471165"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013061","name":"Jilin Provincial Scientific and Technological Development Program","doi-asserted-by":"publisher","award":["20190201163JC"],"award-info":[{"award-number":["20190201163JC"]}],"id":[{"id":"10.13039\/501100013061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013061","name":"Jilin Provincial Scientific and Technological Development Program","doi-asserted-by":"publisher","award":["20190201042JC"],"award-info":[{"award-number":["20190201042JC"]}],"id":[{"id":"10.13039\/501100013061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Hematol Oncol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>It remains a substantial challenge to balance treatment efficacy and toxicity in geriatric patients with multiple myeloma (MM), primarily due to the dynamic nature of frailty. Here, we conducted a prospective study to evaluate the feasibility and benefits of dynamic frailty-tailored therapy (DynaFiT) in elderly patients. Patients with newly diagnosed MM (aged\u2009\u2265\u200965 years) received eight induction cycles of bortezomib, lenalidomide, and dexamethasone (daratumumab was recommended for frail patients), with treatment intensity adjusted according to longitudinal changes in the frailty category (IMWG-FI) at each cycle. Of 90 patients, 33 (37%), 16 (18%), and 41 (45%) were fit, intermediate fit, and frail at baseline, respectively. Of 75 patients who had geriatric assessment at least twice, 28 (37%) experienced frailty category changes at least once. At analysis, 15\/26 (58%) frail patients improved (27% became fit and 31% became intermediate fit), 4\/15 (27%) intermediate fit patients either improved or deteriorated (two for each), and 6\/30 (20%) fit patients deteriorated. During induction, 34\/90 (38%) patients discontinued treatment, including 10\/33 (30%) fit, 4\/16 (25%) intermediate fit, and 20\/41 (49%) frail; 14\/40 (35%) frail patients discontinued treatment within the first two cycles, mainly because of non-hematologic toxicity (mostly infections). For fit, intermediate-fit, and frail patients, the overall response rate was 100%, 93%, and 73%, respectively; one-year overall survival was 90%, 75%, and 54%, respectively. Therefore, the individualized DynaFiT is feasible and promising for heterogeneous elderly patients.<\/jats:p>","DOI":"10.1186\/s13045-024-01569-y","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T14:02:33Z","timestamp":1719237753000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Individualized dynamic frailty-tailored therapy (DynaFiT) in elderly patients with newly diagnosed multiple myeloma: a prospective study"],"prefix":"10.1186","volume":"17","author":[{"given":"Yingjie","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyue","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiling","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingcheng","family":"Yi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xintian","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yurong","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingxuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufeng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengru","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maozhuo","family":"Lan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengtuan","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2285-0818","authenticated-orcid":false,"given":"Yun","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2288-556X","authenticated-orcid":false,"given":"Fengyan","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,24]]},"reference":[{"key":"1569_CR1","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1182\/blood.2022017635","volume":"143","author":"T Facon","year":"2024","unstructured":"Facon T, Leleu X, Manier S. How I treat multiple myeloma in geriatric patients. Blood. 2024;143:224\u201332. https:\/\/doi.org\/10.1182\/blood.2022017635.","journal-title":"Blood"},{"key":"1569_CR2","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1038\/s41408-021-00524-1","volume":"11","author":"HC Lee","year":"2021","unstructured":"Lee HC, Ailawadhi S, Gasparetto CJ, Jagannath S, Rifkin RM, Durie BGM, et al. Treatment patterns and outcomes in elderly patients with newly diagnosed multiple myeloma: results from the Connect\u00ae MM Registry. Blood Cancer J. 2021;11:134. https:\/\/doi.org\/10.1038\/s41408-021-00524-1.","journal-title":"Blood Cancer J"},{"key":"1569_CR3","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1038\/s41375-021-01488-8","volume":"36","author":"T Facon","year":"2022","unstructured":"Facon T, Cook G, Usmani SZ, Hulin C, Kumar S, Plesner T, et al. Daratumumab plus Lenalidomide and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: frailty subgroup analysis of MAIA. Leukemia. 2022;36:1066\u201377. https:\/\/doi.org\/10.1038\/s41375-021-01488-8.","journal-title":"Leukemia"},{"key":"1569_CR4","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1016\/j.clml.2021.06.005","volume":"21","author":"M-V Mateos","year":"2021","unstructured":"Mateos M-V, Dimopoulos MA, Cavo M, Suzuki K, Knop S, Doyen C, et al. Daratumumab plus Bortezomib, melphalan, and prednisone versus bortezomib, melphalan, and prednisone in transplant-ineligible newly diagnosed multiple myeloma: Frailty subgroup analysis of ALCYONE. Clin Lymphoma Myeloma Leuk. 2021;21:785\u201398. https:\/\/doi.org\/10.1016\/j.clml.2021.06.005.","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"1569_CR5","doi-asserted-by":"publisher","first-page":"2758","DOI":"10.1200\/JCO.20.03143","volume":"39","author":"CAM Stege","year":"2021","unstructured":"Stege CAM, Nasserinejad K, van der Spek E, Bilgin YM, Kentos A, Sohne M, et al. Ixazomib, daratumumab, and low-dose dexamethasone in frail patients with newly diagnosed multiple myeloma: the Hovon 143 study. J Clin Oncol. 2021;39:2758\u201367. https:\/\/doi.org\/10.1200\/JCO.20.03143.","journal-title":"J Clin Oncol"},{"key":"1569_CR6","doi-asserted-by":"publisher","first-page":"102167","DOI":"10.1016\/j.eclinm.2023.102167","volume":"63","author":"K Groen","year":"2023","unstructured":"Groen K, Stege CAM, Nasserinejad K, de Heer K, van Kampen RJW, Leys RBL, et al. Ixazomib, daratumumab and low-dose dexamethasone in intermediate-fit patients with newly diagnosed multiple myeloma: an open-label phase 2 trial. EClinicalMedicine. 2023;63:102167. https:\/\/doi.org\/10.1016\/j.eclinm.2023.102167.","journal-title":"EClinicalMedicine"},{"key":"1569_CR7","doi-asserted-by":"publisher","first-page":"4748","DOI":"10.1182\/blood-2023-188672","volume":"142","author":"G Cook","year":"2023","unstructured":"Cook G, Pawlyn C, Royle K-L, Senior ER, Everritt D, Bird J, et al. Dynamic frailty assessment in transplant non-eligible newly diagnosed myeloma patients: initial data from UK Myeloma Research Alliance (UK-MRA) Myeloma XIV (FiTNEss): a frailty-adjusted therapy study. Blood. 2023;142:4748. https:\/\/doi.org\/10.1182\/blood-2023-188672.","journal-title":"Blood"},{"key":"1569_CR8","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1182\/blood-2023-180006","volume":"142","author":"F Smits","year":"2023","unstructured":"Smits F, Groen K, Levin M-D, Stege C, Van Kampen RJW, Van Der Spek E, et al. Dynamic frailty status enables better prediction of survival probability - results of the HOVON 143 study. Blood. 2023;142:342. https:\/\/doi.org\/10.1182\/blood-2023-180006.","journal-title":"Blood"},{"key":"1569_CR9","doi-asserted-by":"publisher","first-page":"1697","DOI":"10.1038\/s41375-018-0142-9","volume":"32","author":"A Larocca","year":"2018","unstructured":"Larocca A, Dold SM, Zweegman S, Terpos E, W\u00e4sch R, D\u2019Agostino M, et al. Patient-centered practice in elderly myeloma patients: an overview and consensus from the European Myeloma Network (EMN). Leukemia. 2018;32:1697\u2013712. https:\/\/doi.org\/10.1038\/s41375-018-0142-9.","journal-title":"Leukemia"},{"key":"1569_CR10","doi-asserted-by":"publisher","first-page":"2068","DOI":"10.1182\/blood-2014-12-615187","volume":"125","author":"A Palumbo","year":"2015","unstructured":"Palumbo A, Bringhen S, Mateos M-V, Larocca A, Facon T, Kumar SK, et al. Geriatric assessment predicts survival and toxicities in elderly myeloma patients: an International Myeloma Working Group report. Blood. 2015;125:2068\u201374. https:\/\/doi.org\/10.1182\/blood-2014-12-615187.","journal-title":"Blood"},{"key":"1569_CR11","doi-asserted-by":"publisher","first-page":"e143","DOI":"10.1016\/S2352-3026(21)00283-0","volume":"9","author":"NS Raje","year":"2022","unstructured":"Raje NS, Anaissie E, Kumar SK, Lonial S, Martin T, Gertz MA, et al. Consensus guidelines and recommendations for infection prevention in multiple myeloma: a report from the International Myeloma Working Group. 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Cancers (Basel). 2023;15:3469. https:\/\/doi.org\/10.3390\/cancers15133469.","journal-title":"Cancers (Basel)"}],"container-title":["Journal of Hematology &amp; Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13045-024-01569-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13045-024-01569-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13045-024-01569-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T14:07:21Z","timestamp":1719238041000},"score":1,"resource":{"primary":{"URL":"https:\/\/jhoonline.biomedcentral.com\/articles\/10.1186\/s13045-024-01569-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,24]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["1569"],"URL":"https:\/\/doi.org\/10.1186\/s13045-024-01569-y","relation":{},"ISSN":["1756-8722"],"issn-type":[{"value":"1756-8722","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,24]]},"assertion":[{"value":"23 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"All authors declare that they have no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the institutional review board (Approval # 21K048-002), and registered with the Chinese Clinical Trial Register (ChiCTR2100050220) and ClinicalTrials.gov (NCT06099912). The study was conducted in accordance with the Declaration of Helsinki and principles of good clinical practice. All patients provided written informed consent.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"48"}}