Patient-centered practice in elderly myeloma patients: an overview and consensus from the European Myeloma Network (EMN)

Alessandra Larocca¹, Sandra Maria Dold², Sonja Zweegman³, Evangelos Terpos⁴, Ralph Wäsch², Mattia D'Agostino⁵, Sophia Scheubeck², Hartmut Goldschmidt⁶, Francesca Gay⁵, Michele Cavo⁷, Heinz Ludwig⁸, Christian Straka⁹, Sara Bringhen⁵, Holger W Auner¹⁰, Jo Caers¹¹, Martin Gramatzki¹², Massimo Offidani¹³, Meletios A Dimopoulos⁴, Hermann Einsele¹⁴, Mario Boccadoro⁵, Pieter Sonneveld¹⁵, Monika Engelhardt²

Affiliations

¹ Myeloma Unit, Division of Hematology, University of Turin, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy. alelarocca@hotmail.com.
² Department of Medicine I, Hematology, Oncology & Stem Cell Transplantation, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
³ VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands.
⁴ National and Kapodostrian University of Athens, Athens, Greece.
⁵ Myeloma Unit, Division of Hematology, University of Turin, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
⁶ Medizinische Klinik, Abteilung Innere Medizin V, Universitätsklinikum Heidelberg und National Centrum für Tumorerkrankungen (NCT), Heidelberg, Germany.
⁷ Seràgnoli Institute of Hematology and Medical Oncology, University of Bologna, Bologna, Italy.
⁸ 1st Medical Department and Oncology, Wilhelminenspital Wien, Vienna, Austria.
⁹ Hematology & Oncology, Klinikum Schwabing, Munich, Germany.
¹⁰ Centre for Haematology, Department of Medicine, Imperial College London, London, UK.
¹¹ Department of Hematology, CHU de Liège, Liège, Belgium.
¹² Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany.
¹³ Clinica di Ematologia, AOU Ospedali Riuniti di Ancona, Ancona, Italy.
¹⁴ Department of Internal Medicine II, University Hospital Würburg, Würzburg, Germany.
¹⁵ Department of Hematology, Rotterdam, Netherlands.

PMID: 29880892
DOI: 10.1038/s41375-018-0142-9

Review

Patient-centered practice in elderly myeloma patients: an overview and consensus from the European Myeloma Network (EMN)

Alessandra Larocca et al. Leukemia. 2018 Aug.

. 2018 Aug;32(8):1697-1712.

doi: 10.1038/s41375-018-0142-9. Epub 2018 Apr 25.

Authors

Affiliations

¹ Myeloma Unit, Division of Hematology, University of Turin, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy. alelarocca@hotmail.com.
² Department of Medicine I, Hematology, Oncology & Stem Cell Transplantation, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
³ VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands.
⁴ National and Kapodostrian University of Athens, Athens, Greece.
⁵ Myeloma Unit, Division of Hematology, University of Turin, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
⁶ Medizinische Klinik, Abteilung Innere Medizin V, Universitätsklinikum Heidelberg und National Centrum für Tumorerkrankungen (NCT), Heidelberg, Germany.
⁷ Seràgnoli Institute of Hematology and Medical Oncology, University of Bologna, Bologna, Italy.
⁸ 1st Medical Department and Oncology, Wilhelminenspital Wien, Vienna, Austria.
⁹ Hematology & Oncology, Klinikum Schwabing, Munich, Germany.
¹⁰ Centre for Haematology, Department of Medicine, Imperial College London, London, UK.
¹¹ Department of Hematology, CHU de Liège, Liège, Belgium.
¹² Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany.
¹³ Clinica di Ematologia, AOU Ospedali Riuniti di Ancona, Ancona, Italy.
¹⁴ Department of Internal Medicine II, University Hospital Würburg, Würzburg, Germany.
¹⁵ Department of Hematology, Rotterdam, Netherlands.

PMID: 29880892
DOI: 10.1038/s41375-018-0142-9

Abstract

Multiple myeloma is a disease typical of the elderly, and, because of the increase in life expectancy of the general population, its incidence is expected to grow in the future. Elderly patients represent a particular challenge due to their marked heterogeneity. Many new and highly effective drugs have been introduced in the last few years and results from clinical trials are promising. Besides the availability of novel agents, a careful evaluation of elderly patients showed to be a key factor for the success of therapy. A geriatric assessment is a valid strategy to better stratify patients. In particular, different scores are available today to appropriately assess elderly patients and define their fitness/frailty status. The choice of treatment-transplantation, triplets, doublets, or reduced-dose therapies including novel agents-should depend on the patient's fitness status (fit, intermediate-fit or frail). Second-generation novel agents have also been evaluated as salvage therapy in the elderly, and these new agents certainly represent a further step forward in the treatment armamentarium for elderly patients with multiple myeloma.

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Patient-centered practice in elderly myeloma patients: an overview and consensus from the European Myeloma Network (EMN)

Affiliations

Patient-centered practice in elderly myeloma patients: an overview and consensus from the European Myeloma Network (EMN)

Authors

Affiliations

Abstract

Publication types

MeSH terms