An MDS-specific frailty index based on cumulative deficits adds independent prognostic information to clinical prognostic scoring.
Activities of Daily Living
Aged
Aged, 80 and over
Comorbidity
Female
Follow-Up Studies
Frailty
/ mortality
Humans
Male
Middle Aged
Myelodysplastic Syndromes
/ mortality
Prognosis
Prospective Studies
Quality of Life
Registries
/ statistics & numerical data
Risk Assessment
/ methods
Risk Factors
Survival Rate
Journal
Leukemia
ISSN: 1476-5551
Titre abrégé: Leukemia
Pays: England
ID NLM: 8704895
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
31
07
2019
accepted:
17
11
2019
revised:
30
10
2019
pubmed:
8
12
2019
medline:
30
9
2020
entrez:
8
12
2019
Statut:
ppublish
Résumé
The frailty index (FI) is based on the principle that the more deficits an individual has, the greater their risk of adverse outcomes. It is expressed as a ratio of the number of deficits present to the total number of deficits considered. We developed an MDS-specific FI using a prospective MDS registry and assessed its ability to add prognostic power to conventional prognostic scores in MDS. The 42 deficits included in this FI included measurements of physical performance, comorbidities, laboratory values, instrumental activities of daily living, quality of life and performance status. Of 644 patients, 440 were eligible for FI calculation. The median FI score was 0.25 (range 0.05-0.67), correlated with age and IPSS/IPSS-R risk scores and discriminated overall survival. With a follow-up of 20 months, survival was 27 months (95% CI 24-30.4). By multivariate analysis, age >70, FI, transfusion dependence, and IPSS were significant covariates associated with OS. The incremental discrimination improvement of the frailty index was 37%. We derived a prognostic score with five risk groups and distinct survivals ranging from 7.4 months to not yet reached. If externally validated, the MDS-FI could be used as a tool to refine the risk stratification of current clinical prognostication models.
Identifiants
pubmed: 31811236
doi: 10.1038/s41375-019-0666-7
pii: 10.1038/s41375-019-0666-7
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1394-1406Commentaires et corrections
Type : CommentIn
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