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Updates on Hematologic Malignancies in the Older Adult: Focus on Acute Myeloid Leukemia, Chronic Lymphocytic Leukemia, and Multiple Myeloma

  • Geriatric Oncology (AR MacKenzie, Section Editor)
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Abstract

Purpose of Review

Hematologic malignancies are common and difficult to treat in older adults. In this review, we focus on recent updates in diseases with several novel agents relevant to older adults—acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), and multiple myeloma (MM).

Recent Findings

In AML, CPX-351 offers a new induction chemotherapy for secondary AML that prolongs survival, and venetoclax and IDH inhibitors are efficacious and well tolerated. In CLL, chemoimmunotherapy is being replaced by monoclonal antibodies and small molecule inhibitors that are more effective and better tolerated. In MM, new immunomodulatory drugs, proteasome inhibitors, and monoclonal antibodies have expanded treatment options for older patients.

Summary

The introduction of novel agents has dramatically shifted the landscape of therapeutic options for older adults with hematologic malignancies. Clinical trials in older adults are needed to expand treatment options for these patients.

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Authors and Affiliations

  1. Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, 505 Parnassus Ave, Hematology/Oncology Office, M1286, San Francisco, CA, 94143, USA

    Li-Wen Huang

  2. Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, 400 Parnassus Ave, Box 1270, San Francisco, CA, 94143, USA

    Sandy W. Wong

  3. Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, 400 Parnassus Ave, Box 0324, San Francisco, CA, 94143, USA

    Charalambos Andreadis & Rebecca L. Olin

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Sandy W. Wong has received research funding from Janssen, Celgene, and Roche.

Charalambos Andreadis has received research funding from Celgene, GlaxoSmithKline, Novartis, Amgen, and Pharmacyclics; has received compensation from Amgen for service as a consultant and from Celgene, Gilead, Pharmacyclics, and Genentech for service on advisory boards. His spouse is also an employee of Genentech.

Rebecca L. Olin has received research funding (salary support, principal investigator) from Astellas, Daiichi Sankyo, Pfizer, and Genentech, and has received compensation from Jazz Pharmaceuticals and Genentech for service as a consultant.

Li-Wen Huang declares that she has no conflict of interest. She is supported by the National Institute on Aging (T32AG000212).

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Huang, LW., Wong, S.W., Andreadis, C. et al. Updates on Hematologic Malignancies in the Older Adult: Focus on Acute Myeloid Leukemia, Chronic Lymphocytic Leukemia, and Multiple Myeloma. Curr Oncol Rep 21, 35 (2019). https://doi.org/10.1007/s11912-019-0778-2

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