title: Personalizing therapy for older adults with lymphoid malignancies: options and obstacles.
abstract: Increasing age is both a risk factor for and a negative prognostic factor in lymphoid malignancies. The disparities in outcomes between older and younger adults with lymphoid malignancies may reflect age-related differences in treatment and in biology of disease. Lymphomas in older adults are biologically more aggressive. Only small age-related differences in the frequency of cytogenetic abnormalities are seen in multiple myeloma. No major differences in the biology of chronic lymphocytic leukemia (CCL) are seen across the age spectrum. Chemotherapy and immunotherapy in older adults with lymphoid malignancies are marked by greater vulnerability to toxicity of therapy. Excessive toxicity can result in poorer outcomes, either directly through treatment-related mortality, or through decreased dose intensity. Thus, new approaches to predict toxicity of therapy and stratified treatment algorithms based on risk of toxicity are needed. Herein we detail some of the promising approaches to predicting toxicity and tailoring treatment for older adults with lymphoid malignancies.
authors.affiliation: From the Washington University School of Medicine, St. Louis, MO; University Hospital, Cologne, Germany; Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Wildes
authors.affiliation: From the Washington University School of Medicine, St. Louis, MO; University Hospital, Cologne, Germany; Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Valentin
authors.initials: V
authors.lastname: Goede
authors.affiliation: From the Washington University School of Medicine, St. Louis, MO; University Hospital, Cologne, Germany; Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Paul
authors.initials: P
authors.lastname: Hamlin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000628:therapy*; D008223:Lymphoma / Q000628:therapy*; D009101:Multiple Myeloma / Q000628:therapy*; D057285:Precision Medicine / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents