How I treat elderly patients with myeloma.
The clinical approach to older patients with myeloma has to be modified to take into account comorbidities and the likelihood of higher treatment-related toxicity. Individualization of management and adequate supportive therapy are important to obtain the best response while minimizing adverse effects. Corticosteroids, novel agents, conventional cytotoxic agents, and high-dose chemotherapy with autotransplantation (modalities used in younger patients) are also used in older patients, although the elderly undergo transplantation less frequently. The sequential use of active agents singly and in different combinations has improved response rates and survival of all patients with myeloma, including the elderly.
Mehta
Jayesh
J
Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA. j-mehta@northwestern.edu
Cavo
Michele
M
Singhal
Seema
S
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology; D048909:Diabetes Complications / Q000628:therapy; D004164:Diphosphonates / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D009101:Multiple Myeloma / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D010166:Palliative Care; D012074:Remission Induction; D051437:Renal Insufficiency / Q000150:complications; D013923:Thromboembolism / Q000209:etiology; D014182:Transplantation, Autologous
D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates