Electronic frailty index predicts CAR-T outcomes in older adults
Very frail older patients had worse overall survival (HR=1.64) and event-free survival (HR=2.02) after CAR-T therapy than robust or prefrail peers.
Blood Advances
Researchers retrospectively evaluated 260 adults aged 65 and older who received commercial CAR-T therapy for multiple myeloma or B-cell non-Hodgkin lymphoma. The team calculated an automated electronic frailty index, classifying patients as robust, prefrail, frail, or very frail. Overall, 10% were robust, 25% prefrail, 28% frail, and 37% very frail. After adjusting for confounders, very frail patients had significantly worse overall survival (hazard ratio 1.64) and event-free survival (hazard ratio 2.02). Being frail alone was not significantly associated with overall or event-free survival. However, frail and very frail patients had higher odds of grade 3 or higher toxicity, with odds ratios of 3.28 and 4.84, respectively. Both groups also spent fewer days alive and out of the hospital in the first 30 days.
Why it matters
The findings highlight how biological frailty, rather than chronological age alone, influences severe toxicity and survival in older adults undergoing cellular immunotherapy.
Caveats
The study was retrospective and analyzed patients from a single healthcare system, meaning the automated tool requires prospective validation in broader cohorts.
The paper
An Electronic Frailty Index Is Associated with Outcomes in Older Adults Receiving CAR-T Therapy
Show 8 more authors
Isabel Neckermann, Olivia Y. Cheung, Bharati D. Kochar, Ariela R. Orkaby, Matthew J. Frigault, Jeremy S. Abramson, Areej El- Jawahri, Richard Andrew Newcomb,Massachusetts General Hospital · Global Cancer Institute
Blood Advances · 2 Oct 2026