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Nuances in the Management of Older People With Multiple Myeloma

  • Multiple Myeloma (P Kapoor, Section Editor)
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Abstract

Multiple myeloma is a disease of the elderly, with about a third of patients at diagnosis older than 75 years of age. Yet, the population of elderly patients is heterogeneous: older patients are more likely to have comorbidities and frailties complicating both their initial diagnosis and subsequent management, but these are not consistent across the group. Furthermore, patients with comorbidities and frailty are generally underrepresented in clinical trials. Despite the survival of myeloma patients increasing following the introduction of novel agents, older patients continue to have worse outcomes with increased treatment-related toxicity. Treatment tolerability is not defined by age alone, rather a combination of age, physical function, cognitive function, and comorbidities. These factors all influence patients’ tolerability of treatment and therefore treatment efficacy and should also be considered when reviewing the results of clinical trials. It is the nuances of determining how these factors interact that should influence initial treatment and ongoing management decisions and these will be discussed here.

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Correspondence to Sikander Ailawadhi.

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Charlotte Pawlyn and Vivek Roy each declare no potential conflicts of interest.

Francesca Gay reports honoraria from Celgene and Janssen and is on the advisory board for Mundipharma, Janssen, and Sanofi.

Alessandra Larocca reports honoraria from Celgene and Janssen.

Sikander Ailawadhi reports honoraria from Takeda Oncology, Onyx-Amgen Pharmaceuticals, and Pharmacyclics.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Multiple Myeloma

Charlotte Pawlyn and Francesca Gay contributed equally to this work.

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Pawlyn, C., Gay, F., Larocca, A. et al. Nuances in the Management of Older People With Multiple Myeloma. Curr Hematol Malig Rep 11, 241–251 (2016). https://doi.org/10.1007/s11899-016-0323-4

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