Multiple myeloma in the very elderly patient: challenges and solutions

John Willan,1 Toby A Eyre,1,2 Faye Sharpley,1 Caroline Watson,1 Andrew J King,1,3 Karthik Ramasamy1,4 1Department of Hematology, 2Early Phase Clinical Trial Unit, Oxford University Hospitals National Health Service (NHS) Foundation Trust, Churchill Hospital, Oxford, UK; 3Weatherall Institute of Mol...

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Autores principales:	Willan J, Eyre TA, Sharpley F, Watson C, King AJ, Ramasamy K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Myeloma Elderly Diagnosis Treatment Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/be51f22e0b1e4d7cb4f53b243e07e937
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spelling	oai:doaj.org-article:be51f22e0b1e4d7cb4f53b243e07e9372021-12-02T00:07:30ZMultiple myeloma in the very elderly patient: challenges and solutions1178-1998https://doaj.org/article/be51f22e0b1e4d7cb4f53b243e07e9372016-04-01T00:00:00Zhttps://www.dovepress.com/multiple-myeloma-in-the-very-elderly-patient-challenges-and-solutions-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998John Willan,1 Toby A Eyre,1,2 Faye Sharpley,1 Caroline Watson,1 Andrew J King,1,3 Karthik Ramasamy1,4 1Department of Hematology, 2Early Phase Clinical Trial Unit, Oxford University Hospitals National Health Service (NHS) Foundation Trust, Churchill Hospital, Oxford, UK; 3Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, UK; 4National Institute for Health Research (NIHR) Biomedical Research Center Blood Theme, Oxford, UK Abstract: Diagnosis and management of myeloma in the very elderly patient is challenging. Treatment options have vastly improved for elderly myeloma patients but still require the clinician to personalize therapy. In this paper, we offer evidence-based, pragmatic advice on how to overcome six of the main challenges likely to arise: 1) diagnosis of myeloma in this age group, 2) assessment of the need for treatment, and the fitness for combination chemotherapy, 3) provision of the best quality of supportive care, 4) choice of combination chemotherapy in those fit enough for it, 5) treatment of relapsed myeloma, and 6) provision of end of life care. With an increased burden of comorbidities and a reduced resilience to treatment and its associated toxicities, the management of myeloma in this age group requires a different approach to that in younger patients to maximize both quality and length of life.Keywords: myeloma, elderly, diagnosis, treatment Willan JEyre TASharpley FWatson CKing AJRamasamy KDove Medical PressarticleMyelomaElderlyDiagnosisTreatmentGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 11, Pp 423-435 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Myeloma Elderly Diagnosis Treatment Geriatrics RC952-954.6
spellingShingle	Myeloma Elderly Diagnosis Treatment Geriatrics RC952-954.6 Willan J Eyre TA Sharpley F Watson C King AJ Ramasamy K Multiple myeloma in the very elderly patient: challenges and solutions
description	John Willan,1 Toby A Eyre,1,2 Faye Sharpley,1 Caroline Watson,1 Andrew J King,1,3 Karthik Ramasamy1,4 1Department of Hematology, 2Early Phase Clinical Trial Unit, Oxford University Hospitals National Health Service (NHS) Foundation Trust, Churchill Hospital, Oxford, UK; 3Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, UK; 4National Institute for Health Research (NIHR) Biomedical Research Center Blood Theme, Oxford, UK Abstract: Diagnosis and management of myeloma in the very elderly patient is challenging. Treatment options have vastly improved for elderly myeloma patients but still require the clinician to personalize therapy. In this paper, we offer evidence-based, pragmatic advice on how to overcome six of the main challenges likely to arise: 1) diagnosis of myeloma in this age group, 2) assessment of the need for treatment, and the fitness for combination chemotherapy, 3) provision of the best quality of supportive care, 4) choice of combination chemotherapy in those fit enough for it, 5) treatment of relapsed myeloma, and 6) provision of end of life care. With an increased burden of comorbidities and a reduced resilience to treatment and its associated toxicities, the management of myeloma in this age group requires a different approach to that in younger patients to maximize both quality and length of life.Keywords: myeloma, elderly, diagnosis, treatment
format	article
author	Willan J Eyre TA Sharpley F Watson C King AJ Ramasamy K
author_facet	Willan J Eyre TA Sharpley F Watson C King AJ Ramasamy K
author_sort	Willan J
title	Multiple myeloma in the very elderly patient: challenges and solutions
title_short	Multiple myeloma in the very elderly patient: challenges and solutions
title_full	Multiple myeloma in the very elderly patient: challenges and solutions
title_fullStr	Multiple myeloma in the very elderly patient: challenges and solutions
title_full_unstemmed	Multiple myeloma in the very elderly patient: challenges and solutions
title_sort	multiple myeloma in the very elderly patient: challenges and solutions
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/be51f22e0b1e4d7cb4f53b243e07e937
work_keys_str_mv	AT willanj multiplemyelomaintheveryelderlypatientchallengesandsolutions AT eyreta multiplemyelomaintheveryelderlypatientchallengesandsolutions AT sharpleyf multiplemyelomaintheveryelderlypatientchallengesandsolutions AT watsonc multiplemyelomaintheveryelderlypatientchallengesandsolutions AT kingaj multiplemyelomaintheveryelderlypatientchallengesandsolutions AT ramasamyk multiplemyelomaintheveryelderlypatientchallengesandsolutions
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Multiple myeloma in the very elderly patient: challenges and solutions

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