Frailty dynamics and their impact on QoL in patients undergoing autologous HCT for multiple myeloma: Results from a...

This prospective multicentre study evaluates the utility of the haematopoietic cell transplantation (HCT) Frailty Scale in 269 adults with multiple myeloma (MM) undergoing autologous haematopoietic cell transplantation (auto-HCT). Frailty was assessed in all patients at the first consultation, at transplant admission and on day +100. Quality of life (QoL) was measured using the EuroQol (EQ-5D-5L) questionnaire. At the first consultation, 23.8% were fit, 57.6% pre-frail and 18.6% frail. Frailty was associated with advanced disease stage, reduced Karnofsky Performance Status and older age. At HCT admission, 32.3% of patients showed changes in frailty status, confirming its dynamic nature. Frail patients had higher readmission rates (14.7%) and significantly lower QoL (p < 0.001) compared to others. Although differences in non-relapsed mortality (NRM) were not statistically significant, frail and pre-frail patients showed higher 1-year NRM (4.8% and 3.4%) compared to fit patients (0%). By day +100, 33.6% were fit, 55.9% pre-frail and 8.2% frail, with frail patients continuing to report poorer QoL. In conclusion, the HCT Frailty Scale is a valuable tool for identifying and monitoring frailty in MM patients undergoing auto-HCT. As frailty status evolves over time, ongoing assessment is essential to guide personalized care, reduce complications and improve outcomes and QoL.