| Purpose:Comprehensive geriatric assessment were performed in newly diagnosed elderly multiple myeloma patients to assess the patients’ physical status,including functional status,comorbidities,cognition,psychological,nutritional status.To explore the application of CGA in newly diagnosed elderly MM patients in China.It can provide a certain reference for clinicians to choose appropriate first-line treatment for elderly MM patients.Method:I inclued the newly diagnosed MM patients in Shengjing Hospital of China Medical University from July 2017 to November 2019.The selection criteria are:1)age≥65 years;2)no chemotherapy;3)consent to participate in the study and sign informed consent;4)clear awareness and can complete the questionnaire;The exclusion criteria are:1)refusal to sign informed consent books;2)combined with secondary amyloidosis;3)smoking myeloma;4)unconscious and unable to complete the questionnaire.Fifty-seven patients who met the above criteria were screened,and the selected patients completed the ECOG and CGA scores(including ADL,IADL,CCI,MMSE,MNA-SF,and GDS)before chemotherapy,and those patients were divided into healthy group,general healthy group,and weak group,according to ADL,IADL,CCI and age.In order to analyze survival and recurrence of patients,the Kaplan-Meier survival cures were used to evaluate the distribution of survival status.The McNemar tests were used to compare the difference between ECOG and CGA scores.And the rank sum tests were used to compare six items in CGA.SPSS 22.0 software were used to statistical analysisResult:1)52 patients completed all the CGA scales.12(30.8%)patients have absolutely right in the CGA scale.26(45.6%)were abnormal in daily activity scale(ADL),22(38.6%)were abnormal in instrumental daily activity scale(IADL),22(38.6%)were comorbidities(CCI)abnormal,27(51.9%)were abnormal in the Geriatric Depression Scale(GDS),9(17.3%)were cognitive dysfunction(MMSE),and 30(52.6%)were abnormal in the Simple Nutrition Assessment Scale(MNA-SF).After treatment,the number of patients with ADL,IADL,GDS,MMSE,and MNA-SF abnormalities were:18(36.7%);15(30.6%),11(23.4%),10(22.7%),17(34.7%).2)Patients were divided into health group(0 points),general health group(1 point),and debilitated group(>1 point)according to age,ADL,IADL,and CCI.The 1-year OS was 66.7%,50%,and 20.8%(X2=12.329,p=0.002),and the 1-year PFS were 46.7%,27.8%,and 8.3%(χ2=12.837,p=0.002).3)The ECOG and CGA methods are generally consistent in evaluating the physical function of patients.The CGA positive rate was 73.7%,and this value was higher than ECOG(49.1%).There was statistically significant in the difference study of CGA positive rate and ECOG in the paper.4)If the 12 patients with normal CGA scores(six items)are considered as "healthy group",the patients with abnormal number>1 are considered as "weak group".Compared with ECOG group,the two grouping methods have poor consistency in evaluating patients’ weak state.The CGA positive rate was 76.9%,and this value was higher than ECOG(42.3%).There was statistically significant in the difference study of CGA positive rate and ECOG in the paper.5)The six scales in CGA,with the exception of ADL,IADL,MNA-SF,the other three items have no significant correlation at different ages(P>0.05).Among ≤75 years,the healthy group was 35.7%,general healthy group was 38%,and the debilitated group was 26.2%;among 75-80 years,the general healthy group was 33.3%,and the debilitated group was 66.7%,when the age was>80 years,the proportion of the weak group increased to 100%.Conclusion:A considerable part of the CGA score of newly diagnosed elderly MM is abnormal.CGA scores can predict prognosis of patients;although ECOG is simple and easy to operate,CGA can evaluate patients more accurately and comprehensively,if all 6 items of CGA are involved,it may be more accurate to assess the patient’s physical status;senior age is not equal to weakness,and the age combined with CGA score may better assess the patient’s weakness. |
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