Optimizing Care for Frailty in Myeloma Patients

Frailty is a medical terms that refers to a decline in physical strength, nutrition, and cognitive function that makes it harder for someone to recover from medical treatments. For people with multiple myeloma, frailty can impact the ability to tolerate and respond to therapy.

In our HealthtTree tour, we had the opportunity to talk to the top myeloma experts at Memorial Sloan Kettering Cancer Center (MSKCC). Dr. Hamza Hashmi presented a new way to identify and support patients who are considered frail at the time of their multiple myeloma diagnosis. This can help doctors personalize care and avoid complications during treatment. This new protocol has been validated by the International Myeloma Working Group (IMWG). 

Supportive Services for Frail Patients

Patients identified as frail are referred to several supportive services to help improve their overall health before and during treatment. These referrals aim to address the full picture of a patient’s health, not just their cancer.

These services include:

• Physical and occupational therapy: To help with mobility, balance, and daily activities. This is especially important for patients who may be physically weak or at risk of falling.
• Nutrition counseling: For those who need nutritional guidance or are experiencing weight loss, dietitians help create meal plans that meet individual needs, improving strength and energy levels.
• Chronic condition management: People who have additional health issues, such as diabetes or kidney problems, are referred to specialists.
• Cognitive health support: Cognitive changes are evaluated by a neuropsychologist. If necessary, mental exercises are prescribed to help maintain memory and thinking skills.

Ongoing Monitoring to Track Progress

After the initial assessment and referrals, patients are reassessed every 3 to 6 months to track whether their frailty scores improve. This regular follow-up is key to understanding which interventions are effective and helps adjust care plans as needed.

For patients, this means that their care team is keeping a close eye on more than just blood counts or treatment response. They’re also looking at quality-of-life factors that can improve daily living and support long-term treatment success.

Combining Frailty Optimization with Adjusted Chemotherapy

MSKCC is also integrating this approach into a new clinical trial. In the trial, patients receive chemotherapy on a reduced or modified schedule. This means:

• Lower frequency or dosage of chemotherapy, which may be easier for frail patients to handle.
• Ongoing support from the frailty optimization team to keep patients as strong as possible throughout treatment.

By combining treatment with supportive care, therapy becomes more manageable and still effective even for those who might not normally qualify for a standard clinical trial due to health challenges such as frailty.

Take-Home Message

Patients often worry that being labeled as “frail” means fewer treatment options. This new protocol shows that frailty can be identified, monitored, and improved with supportive interventions. It offers a path forward for more people to access therapy that fits their needs.

The team at MSKCC believes that with personalized care and attention to overall health, frail patients can benefit from new therapies and live better with multiple myeloma.

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