Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 May:137:18-26.
doi: 10.1016/j.critrevonc.2019.02.011. Epub 2019 Feb 27.

Special considerations for the treatment of multiple myeloma according to advanced age, comorbidities, frailty and organ dysfunction

Muhammad Asad Fraz  1 , Faiza Hassan Warraich  2 , Sami Ullah Warraich  1 , Muhammad Junaid Tariq  1 , Zabih Warraich  3 , Ali Younas Khan  1 , Muhammad Usman  1 , Awais Ijaz  1 , Pavan Tenneti  4 , Adeela Mushtaq  5 , Faisal Akbar  6 , Zaina Shahid  7 , Zeeshan Ali  8 , Hafiz Muhammad Fazeel  1 , Cesar Rodriguez  9 , Aboo Nasar  10 , Ali McBride  11 , Faiz Anwer  12
Affiliations
Review

Special considerations for the treatment of multiple myeloma according to advanced age, comorbidities, frailty and organ dysfunction

Muhammad Asad Fraz et al. Crit Rev Oncol Hematol. 2019 May.

Abstract

Multiple Myeloma (MM) is primarily a disease of old age with a median age of sixty-nine years at diagnosis. The development of novel therapies for induction and use of autologous stem cell transplantation has resulted in improved clinical outcomes and better quality of life for MM patients. Elderly patients, comprising the majority of MM population, have a higher incidence of age-related comorbidities, frailty and organ dysfunction which complicates the coordination of treatment and limits the selection of therapies. Even in the era of multiple chemotherapeutic options, the clinical heterogeneity of the myeloma patients' demands personalized treatments which often require dose-adjustments or dose delays. The use of reduced-dose regimens and various comorbidity indices has improved clinical outcome and regimen tolerability in MM patients with renal, neurological and bone abnormalities. We focus on advancements in the treatment of multiple myeloma with the goal to guide clinicians towards patient-specific management.

Keywords: Comorbidities; Dose modifications; Dose reduction; Elderly; Frailty; Multiple myeloma; Personalized therapy.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

This manuscript is original research, has not been previously published and has not been submitted for publication elsewhere while under consideration. Authors declare no conflict of interest with this manuscript.

References

    1. Collins CD. Problems monitoring response in multiple myeloma. Cancer imaging : the official publication of the International Cancer Imaging Society. 2005;5 Spec No A:S119–26. - PMC - PubMed
    1. Cancer Stat Facts: Myeloma 2018. [Available from: https://seer.cancer.gov/statfacts/html/mulmy.html.
    1. Ma CKK, Clancy L, Simms R, Burgess J, Deo S, Blyth E, et al. Adjuvant Peptide Pulsed Dendritic Cell Vaccination in Addition to T Cell Adoptive Immunotherapy for Cytomegalovirus Infection in Allogeneic Hematopoietic Stem Cell Transplantation Recipients. Biology of Blood and Marrow Transplantation. 2018;24(1):71–7. - PubMed
    1. Palumbo A, Bringhen S, Ludwig H, Dimopoulos MA, Blade J, Mateos MV, et al. Personalized therapy in multiple myeloma according to patient age and vulnerability: a report of the European Myeloma Network (EMN). Blood. 2011;118(17):4519–29. - PubMed
    1. Ward BW, Schiller JS. Prevalence of multiple chronic conditions among US adults: estimates from the National Health Interview Survey, 2010. Preventing chronic disease. 2013;10:E65. - PMC - PubMed

Substances