Optimizing quality of life in multiple myeloma patients: current options, challenges and recommendations.
Multiple myeloma (MM) is a plasma cell neoplasm with a chronic disease course that primarily affects elderly individuals. The introduction of novel agents such as thalidomide, lenalidomide and bortezomib has significantly improved the outcome for MM patients, including the elderly. Quality of life in MM is influenced by disease-related symptoms, treatment-related toxicity and treatment response. In addition to conventional endpoints as response, quality of life should be carefully evaluated during each therapeutic phase. Caring for older adults with MM is particularly challenging because of the heterogeneity of aging and the presence of comorbidities and frailty, with a potential risk of over- or under-treatment. Moreover, elderly patients may sometimes prioritize maintaining quality of life above prolonging survival. A careful evaluation of comorbidities and a geriatric assessment can facilitate risk-stratification of elderly patients to identify the older population fit enough to tolerate standard drug dosing, and to detect the frail patients who need age-adapted treatment.
Department of Hematology, University of Leuven, Herestraat 49, 3000 Leuven, Belgium.
Helena
H
Maes
Michel
M
Delforge
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016330:Frail Elderly; D006801:Humans; D009101:Multiple Myeloma / Q000188:drug therapy*; D011788:Quality of Life
D000970:Antineoplastic Agents
elderly; geriatric assessment; multiple myeloma; quality of life; tailored therapy