title: Individualizing treatment decisions for older adults with hematologic malignancies.
abstract: Hematologic malignancies are a common cause of morbidity and mortality among older adults, who represent the majority of patients diagnosed with these diseases. Treatment options and disease outcomes have improved in recent years because of the development of novel treatment strategies and the design of elderly-specific clinical trials. Despite this, extrapolation of clinical trial data to patients routinely seen in practice is challenging because of the presence of multimorbidity and functional impairments. Individualized treatment decision making requires not only an understanding of underlying tumor biology but also careful estimation of an older patient's anticipated ability to withstand the stresses of therapy. This article will discuss approaches to standardizing patient assessment strategies and tailoring therapeutic decisions for older adults with hematologic malignancies with a focus on acute myeloid leukemia (AML), allogeneic bone marrow transplantation, multiple myeloma (MM), and chronic lymphocytic leukemia (CLL).
authors.affiliation: From the Comprehensive Cancer Center of Wake Forest University, Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC; Department of Medicine, Division of Hematologic Malignancies and Cell Therapy, Duke University Medical Center, Durham, NC; Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy; Department I of Internal Medicine and Center of Integrated Oncology Köln Bonn, University of Cologne, Köln, Germany.
authors.forename: Heidi D
authors.initials: HD
authors.lastname: Klepin
authors.forename: David
authors.initials: D
authors.lastname: Rizzieri
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
authors.forename: Valeria
authors.initials: V
authors.lastname: Magarotto
authors.forename: Barbara
authors.initials: B
authors.lastname: Eichhorst
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016026:Bone Marrow Transplantation; D015897:Comorbidity; D015577:Geriatric Assessment; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D060828:Induction Chemotherapy; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000628:therapy; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D025202:Molecular Diagnostic Techniques; D009101:Multiple Myeloma / Q000628:therapy; D057285:Precision Medicine; D012307:Risk Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome