Personalized therapy in multiple myeloma according to patient age and vulnerability: A report of the European Myeloma Network (EMN)

Antonio Palumbo, Sara Bringhen, Heinz Ludwig, Meletios Dimopoilos, Joan Blade, Maria Mateos, Laura Rosinol, Mario Boccadoro, Michele Cavo, Henk Lokhorst, Sonja Zweegman, Evangelos Terpos, Faith Davies, Christoph Driessen, Peter Gimsing, Martin Gramatzki, Roman Hajek, Hans Johnsen, Fernando Leal Da Costa, Orhan SezerAndrew Spencer, Meral Beksac, Gareth Morgan, Hermann Einsele, Jesus San Miguel, Pieter Sonneveld

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239 Citations (Scopus)

Abstract

Most patients with newly diagnosed multiple myeloma (MM) are aged > 65 years with 30 aged > 75 years. Many elderly patients are also vulnerable because of comorbidities that complicate the management of MM. The prevalence of MM is expected to rise over time because of an aging population. Most elderly patients with MM are ineligible for autologous transplantation, and the standard treatment has, until recently, been melphalan plus prednisone. The introduction of novel agents, such as thalidomide, bortezomib, and lenalidomide, has improved outcomes; however, elderly patients withMM are more susceptible to side effects and are often unable to tolerate full drug doses. For these patients, lower-dose-intensity regimens improve the safety profile and thus optimize treatment outcome. Further research into the best treatment strategies for vulnerable elderly patients is urgently needed. Appropriate screening for vulnerability and an assessment of cardiac, pulmonary, renal, hepatic, and neurologic functions, as well as age > 75 years, at the start of therapy allows treatment strategies to be individualized and drug doses to be tailored to improve tolerability and optimize efficacy. Similarly, occurrence of serious nonhematologic adverse events during treatment should be carefully taken into account to adjust doses and optimize outcomes. A? 2011 by The American Society of Hematology.
Original languageEnglish
Pages (from-to)4519 - 4529
Number of pages11
JournalBlood
Volume118
Issue number17
DOIs
Publication statusPublished - 2011
Externally publishedYes

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