{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T13:31:24Z","timestamp":1783603884341,"version":"3.55.0"},"reference-count":25,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2023,7,2]],"date-time":"2023-07-02T00:00:00Z","timestamp":1688256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Fragility scales are intended to help in therapeutic decisions. Here, we asked if the fragility assessment in MM patients \u2265 75 years old qualified for treatment by the local physician correlates with the choice of treatment: a two- or three-drug regimens. Between 7\/2018 and 12\/2019, we prospectively enrolled 197 MM patients at the start of treatment from the 13 Polish Myeloma Group centers. The data to assess fragility were prospectively collected, but centrally assessed fragility was not disclosed to the local center. The activity of daily living (ADL) could be assessed in 192 (97.5%) and was independent in 158 (80.2%), moderately impaired in 23 (11.7%), and 11 (5.6%) in completely dependent. Patients with more than three comorbidities made up 26.9% (53 patients). Thus, according to the Palumbo calculator, 43 patients were in the intermediate fitness group (21.8%), and the rest belonged to the frailty group (153, 77.7%). Overall, 79.7% of patients (157) received three-drug regimens and 20.3% (40) received two-drug regimens. In each ECOG group, more than three out of four patients received three-drug regimens. According to the ADL scale, 82.3% of the independent 65.2% of moderately impaired, and 81.8% of the dependent received three-drug regimens. Out of 53 patients with at least four comorbidities, 71.7% received three-drug regimens, and the rest received two-drug regimens. Thirty-four patients from the intermediate fit group (79.0%), and 123 (79.9%) from the frail group received three-drug regimens. Early mortality occurred in 25 patients (12.7%). No one discontinued treatment due to toxicity. To conclude, MM patients over 75 are mainly treated with triple-drug regimens, not only in reduced doses, regardless of their frailty scores. However, the absence of prospective fragility assessment did not negatively affect early mortality and the number of treatment discontinuations, which brings into question the clinical utility of current fragility scales in everyday practice.<\/jats:p>","DOI":"10.3390\/cancers15133469","type":"journal-article","created":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:49:27Z","timestamp":1688345367000},"page":"3469","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Real-World Evidence on the Fragility and Its Impact on the Choice of Treatment Regimen in Newly Diagnosed Patients with Multiple Myeloma over 75 Years of Age"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2067-2715","authenticated-orcid":false,"given":"Agata","family":"Tyczy\u0144ska","sequence":"first","affiliation":[{"name":"Department of Hematology and Transplantology, Medical University of Gda\u0144sk, 80-214 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7253-826X","authenticated-orcid":false,"given":"Marcela Krzys\u0142awa","family":"Krzempek","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1284-2638","authenticated-orcid":false,"given":"Alexander Jorge","family":"Cortez","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9796-8365","authenticated-orcid":false,"given":"Artur","family":"Jurczyszyn","sequence":"additional","affiliation":[{"name":"Plasma Cell Dyscrasia Center, Department of Hematology, Jagiellonian University Medical College, 31-008 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Godlewska","sequence":"additional","affiliation":[{"name":"Department of Hematology, Medical University of Bialystok, M. Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Ciep\u0142uch","sequence":"additional","affiliation":[{"name":"Copernicus Regional Oncology Center, 80-803 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edyta","family":"Subocz","sequence":"additional","affiliation":[{"name":"Department of Hematology, Military Institute of Medicine, 01-755 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janusz","family":"Ha\u0142ka","sequence":"additional","affiliation":[{"name":"Department of Hematology, Military Institute of Medicine, 01-755 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kulikowska de Na\u0142\u0119cz","sequence":"additional","affiliation":[{"name":"Department of Hematology, State Hospital, 45-221 Opole, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Wi\u015bniewska","sequence":"additional","affiliation":[{"name":"Department of Oncology and Chemotherapy, Nicolas Copernicus State Hospital, 75-581 Koszalin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"\u015awiderska","sequence":"additional","affiliation":[{"name":"Department of Hematology, University Hospital of Karola Marcinkowski in Zielona G\u00f3ra, 65-046 Zielona G\u00f3ra, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Waszczuk-Gajda","sequence":"additional","affiliation":[{"name":"Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4562-6264","authenticated-orcid":false,"given":"Joanna","family":"Drozd-Soko\u0142owska","sequence":"additional","affiliation":[{"name":"Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Guzicka-Kazimierczak","sequence":"additional","affiliation":[{"name":"Department of Hematology, Pomeranian Medical University, 70-204 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamil","family":"Wi\u015bniewski","sequence":"additional","affiliation":[{"name":"Department of Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Porowska","sequence":"additional","affiliation":[{"name":"Department of Oncology and Hematology, Central Clinical Hospital, Ministry of the Interior, 01-150 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanda","family":"Knopi\u0144ska-Pos\u0142uszny","sequence":"additional","affiliation":[{"name":"Department of Hematology, Gdynia Oncology Center, 81-519 Gdynia, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janusz","family":"K\u0142oczko","sequence":"additional","affiliation":[{"name":"Department of Hematology, Medical University of Bialystok, M. Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Rzepecki","sequence":"additional","affiliation":[{"name":"Department of Hematology, Military Institute of Medicine, 01-755 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dariusz","family":"Woszczyk","sequence":"additional","affiliation":[{"name":"Department of Hematology, State Hospital, 45-221 Opole, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Symonowicz","sequence":"additional","affiliation":[{"name":"Department of Oncology and Chemotherapy, Nicolas Copernicus State Hospital, 75-581 Koszalin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3858-8180","authenticated-orcid":false,"given":"Grzegorz W\u0142adys\u0142aw","family":"Basak","sequence":"additional","affiliation":[{"name":"Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Zdziarska","sequence":"additional","affiliation":[{"name":"Department of Hematology, Pomeranian Medical University, 70-204 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Jamroziak","sequence":"additional","affiliation":[{"name":"Department of Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0986-8936","authenticated-orcid":false,"given":"Jan M.","family":"Zaucha","sequence":"additional","affiliation":[{"name":"Department of Hematology and Transplantology, Medical University of Gda\u0144sk, 80-214 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,2]]},"reference":[{"key":"ref_1","unstructured":"Isaacs, B. 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