title: Treatment decisions for elderly patients with haematological malignancies: a dilemma.
abstract: Over the past decade, haematological malignant diseases have been diagnosed with increasing frequency in patients older than 65 years. The management of these diseases is particularly difficult in elderly patients, as non-tumour-related life expectancy is highly variable and the benefit-to-risk ratio for oncological treatments depends on comorbidities and pharmacological factors. Very few data are available in very old or frail patients, and management decisions are usually based on data obtained in younger patients. Patients might, therefore, be overtreated or undertreated without clear clinical or biological justification. In this Review we discuss the management of haematological malignant diseases in the elderly, with respect to biology or pharmacokinetic and pharmacodynamic features. We focus on acute myeloid leukaemia and aggressive lymphoma. Additionally, we discuss how the implementation of geriatric tools, such as comprehensive geriatric assessment scores, in the clinical management of elderly patients might help to adapt treatment to meet individual patients' needs.
authors: Comprehensive Anticancer Centre, Medical Oncology, Nice, France. frederic.peyrade@nice.unicancer.fr
authors: Frédéric
authors: F
authors: Peyrade
authors: Lauris
authors: L
authors: Gastaud
authors: Daniel
authors: D
authors: Ré
authors: Sandrine
authors: S
authors: Pacquelet-Cheli
authors: Antoine
authors: A
authors: Thyss
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D003661:Decision Support Techniques; D015577:Geriatric Assessment; D006304:Health Status; D019337:Hematologic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy; D008223:Lymphoma / Q000188:drug therapy; D018579:Patient Selection; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents