Advances in the application of frailty scoring in the diagnosis and management of elderly patients with multiple myeloma (Review)

Multiple myeloma (MM) is a hematological malignancy that disproportionately affects elderly populations, with age being a key risk factor for disease progression and adverse outcomes. Frailty, a multifaceted geriatric syndrome characterized by reduced physiological reserve and increased vulnerability to stressors, is recognized as a pivotal factor influencing the diagnosis, prognosis and therapeutic management of elderly patients with MM. The present review explores the complex interplay between frailty and MM, discussing the underlying mechanisms, such as chronic inflammation, sarcopenia and immune dysfunction, that link these conditions. In addition, the clinical implications of frailty, including its association with higher treatment toxicity, prolonged hospitalization and diminished survival rates, are reviewed. The present study also aimed to evaluate commonly used frailty assessment tools, such as the International Myeloma Working Group frailty score and the Geriatric Assessment, and their use in guiding clinical decision‑making. Recent advancements in frailty scoring systems, which enable more precise risk stratification, are highlighted, emphasizing their role in tailoring individualized treatment strategies to balance efficacy and safety. Finally, the present review addresses current challenges in integrating dynamic frailty monitoring into routine clinical practice and outlines future directions, including the development of novel biomarkers and digital tools to enhance frailty assessment and improve long‑term patient outcomes.