Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

A Simple Frailty Score Predicts Survival and Early Mortality in Systemic AL Amyloidosis

Rafael Ríos-Tamayo
* ORCID logo ,
Ramón Lecumberri
ORCID logo ,
Maria Teresa Cibeira
,
Veronica Gonzalez-Calle
,
Rafael Alonso
,
Amalia Domingo
,
Elena Landete
,
Cristina Encinas
,
Belén Iñigo
,
Maria Jesus Blanchard
,
Elena Alejo
,
Isabel Krsnik
ORCID logo ,
Manuel Gómez-Bueno
,
Pablo Garcia-Pavia
,
Javier Segovia-Cubero
,
Laura Rosiñol
ORCID logo ,
Juan-José Lahuerta
ORCID logo ,
Joaquín Martínez-López
,
Joan Bladé
Version 1 : Received: 9 April 2024 / Approved: 10 April 2024 / Online: 10 April 2024 (09:14:36 CEST)

A peer-reviewed article of this Preprint also exists.

Ríos-Tamayo, R.; Lecumberri, R.; Cibeira, M.T.; González-Calle, V.; Alonso, R.; Domingo-González, A.; Landete, E.; Encinas, C.; Iñigo, B.; Blanchard, M.-J.; Alejo, E.; Krsnik, I.; Gómez-Bueno, M.; Garcia-Pavia, P.; Segovia-Cubero, J.; Rosiñol, L.; Lahuerta, J.-J.; Martínez-López, J.; Bladé, J. A Simple Frailty Score Predicts Survival and Early Mortality in Systemic AL Amyloidosis. Cancers 2024, 16, 1689. Ríos-Tamayo, R.; Lecumberri, R.; Cibeira, M.T.; González-Calle, V.; Alonso, R.; Domingo-González, A.; Landete, E.; Encinas, C.; Iñigo, B.; Blanchard, M.-J.; Alejo, E.; Krsnik, I.; Gómez-Bueno, M.; Garcia-Pavia, P.; Segovia-Cubero, J.; Rosiñol, L.; Lahuerta, J.-J.; Martínez-López, J.; Bladé, J. A Simple Frailty Score Predicts Survival and Early Mortality in Systemic AL Amyloidosis. Cancers 2024, 16, 1689.

Abstract

Systemic AL amyloidosis is a challenging disease for which many patients are considered frail in daily clinical practice. However, no study has so far addressed frailty and its impact on the outcome of these patients. We built a simple score to predict mortality based on three frailty-associated variables: age, ECOG performance status (<2 vs. 2) and NT-proBNP (<8500 vs. 8500 ng/L). Four-hundred and sixteen consecutive newly diagnosed patients diagnosed at ten sites from the Spanish Myeloma Group were eligible for the study. The score was developed in a derivation cohort from a referral center, and it was externally validated in a multicenter cohort. On multivariate analysis the three variables were independent predictors of survival. The score was able to discriminate four groups of patients in terms of overall survival and early mortality in both cohorts. Comorbidity was also analyzed with the Charlson comorbidity index, but it did not reach statistical significance in the model. A nomogram was created to easily estimate the mortality risk of each patient at each time point. This score is a simple, robust, and efficient approach to dynamically assess frailty-dependent mortality both at diagnosis and throughout the follow-up. The optimal treatment for frail AL amyloidosis patients remains to be determined but we suggest that the estimation of frailty-associated risk could complement current staging systems, adding value in clinical decision-making in this complex scenario.

Keywords

AL amyloidosis; survival; early mortality; frailty

Subject

Medicine and Pharmacology, Hematology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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