Abstract
Multiple myeloma is a disease of the elderly, with about a third of patients at diagnosis older than 75 years of age. Yet, the population of elderly patients is heterogeneous: older patients are more likely to have comorbidities and frailties complicating both their initial diagnosis and subsequent management, but these are not consistent across the group. Furthermore, patients with comorbidities and frailty are generally underrepresented in clinical trials. Despite the survival of myeloma patients increasing following the introduction of novel agents, older patients continue to have worse outcomes with increased treatment-related toxicity. Treatment tolerability is not defined by age alone, rather a combination of age, physical function, cognitive function, and comorbidities. These factors all influence patients’ tolerability of treatment and therefore treatment efficacy and should also be considered when reviewing the results of clinical trials. It is the nuances of determining how these factors interact that should influence initial treatment and ongoing management decisions and these will be discussed here.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 241-251 |
| Number of pages | 11 |
| Journal | Current Hematologic Malignancy Reports |
| Volume | 11 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jun 1 2016 |
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Keywords
- Elderly
- Multiple myeloma
- Treatment
ASJC Scopus subject areas
- Hematology
- Oncology
- Cancer Research
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Nuances in the Management of Older People With Multiple Myeloma. / Pawlyn, Charlotte; Gay, Francesca; Larocca, Alessandra; Roy, Vivek; Ailawadhi, Sikander.
In: Current Hematologic Malignancy Reports, Vol. 11, No. 3, 01.06.2016, p. 241-251.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Nuances in the Management of Older People With Multiple Myeloma
AU - Pawlyn, Charlotte
AU - Gay, Francesca
AU - Larocca, Alessandra
AU - Roy, Vivek
AU - Ailawadhi, Sikander
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Multiple myeloma is a disease of the elderly, with about a third of patients at diagnosis older than 75 years of age. Yet, the population of elderly patients is heterogeneous: older patients are more likely to have comorbidities and frailties complicating both their initial diagnosis and subsequent management, but these are not consistent across the group. Furthermore, patients with comorbidities and frailty are generally underrepresented in clinical trials. Despite the survival of myeloma patients increasing following the introduction of novel agents, older patients continue to have worse outcomes with increased treatment-related toxicity. Treatment tolerability is not defined by age alone, rather a combination of age, physical function, cognitive function, and comorbidities. These factors all influence patients’ tolerability of treatment and therefore treatment efficacy and should also be considered when reviewing the results of clinical trials. It is the nuances of determining how these factors interact that should influence initial treatment and ongoing management decisions and these will be discussed here.
AB - Multiple myeloma is a disease of the elderly, with about a third of patients at diagnosis older than 75 years of age. Yet, the population of elderly patients is heterogeneous: older patients are more likely to have comorbidities and frailties complicating both their initial diagnosis and subsequent management, but these are not consistent across the group. Furthermore, patients with comorbidities and frailty are generally underrepresented in clinical trials. Despite the survival of myeloma patients increasing following the introduction of novel agents, older patients continue to have worse outcomes with increased treatment-related toxicity. Treatment tolerability is not defined by age alone, rather a combination of age, physical function, cognitive function, and comorbidities. These factors all influence patients’ tolerability of treatment and therefore treatment efficacy and should also be considered when reviewing the results of clinical trials. It is the nuances of determining how these factors interact that should influence initial treatment and ongoing management decisions and these will be discussed here.
KW - Elderly
KW - Multiple myeloma
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=84962167099&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84962167099&partnerID=8YFLogxK
U2 - 10.1007/s11899-016-0323-4
DO - 10.1007/s11899-016-0323-4
M3 - Review article
C2 - 27038805
AN - SCOPUS:84962167099
VL - 11
SP - 241
EP - 251
JO - Current Hematologic Malignancy Reports
JF - Current Hematologic Malignancy Reports
SN - 1558-8211
IS - 3
ER -