Management of Newly Diagnosed Elderly Multiple Myeloma Patients
Autor: | Marc Justin Braunstein, Crystal Antoine-Pepeljugoski |
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Rok vydání: | 2019 |
Předmět: |
0301 basic medicine
Pediatrics medicine.medical_specialty Frail Elderly Newly diagnosed Comorbidity 03 medical and health sciences 0302 clinical medicine Autologous stem-cell transplantation Quality of life Older patients medicine Humans Autologous transplant Geriatric Assessment Multiple myeloma Aged Aged 80 and over Performance status business.industry Organ dysfunction Disease Management medicine.disease 030104 developmental biology Oncology 030220 oncology & carcinogenesis medicine.symptom business Multiple Myeloma |
Zdroj: | Current oncology reports. 21(7) |
ISSN: | 1534-6269 |
Popis: | Given the median age at diagnosis of 69, multiple myeloma (MM) is commonly identified among elderly individuals. Over-treatment of the frail may lead to unnecessary morbidity, while under-treatment of fit elderly patients may prevent improvement in organ function; both instances reducing quality of life. Here, we summarize assessments of frailty and include considerations in managing newly diagnosed elderly MM patients. Eligibility criteria for studies of anti-myeloma agents have traditionally relied on performance status and comorbidities; however, geriatric and myeloma-specific frailty assessments are beginning to be incorporated for more accurate stratification of patients for treatment. The IMWG and R-MCI scores are validated metrics that predict survival in elderly MM patients. In addition, dose-attenuated induction regimens and conditioning before autologous transplant may decrease morbidity in elderly MM patients. Although MM remains incurable, multi-drug regimens have the ability to prolong survival of both untreated and relapsed elderly patients. Older patients require a highly individualized approach since they may have preexisting organ dysfunction, worse frailty scores, and variable goals of care. |
Databáze: | OpenAIRE |
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