基于多学科团队所面临挑战的老年多发性骨髓瘤患者老年医学支持观点性建议

Multiple Myeloma (MM) predominantly affects older adults, with a median diagnosis age of 70 years, posing challenges in management due to frailty, comorbidities, and age-related physiological changes. As the aging population grows, the prevalence of MM in older patients is expected to rise, requiring improved clinical strategies.

This consensus report outlines a multidisciplinary framework for the identification, geriatric assessment (GA), and management of older adults with MM, emphasizing the role of frailty assessments, such as the IMWG frailty score, in tailoring treatments. The objective is to develop a working model tailored to the Quebec context. A meeting on May 7, 2024 brought together experts to discuss improving access to GA and developing strategies for implementing geriatric management tools. Unmet needs include the lack of standardized screening tools, limited access to specialized geriatric oncology services, and inconsistent treatment approaches. Personalized care is critical in addressing frailty, comorbidities, patient preference, and functional status.

This report proposes a structured referral pathway involving age-based triaging and criteria for geriatric consultation. Multidisciplinary teams, including geriatricians, are essential for optimizing care and improving outcomes, with a focus on quality of life and effective therapies. Standardized practices and collaborative approaches are vital for addressing the complexities of MM in this vulnerable population.