The pharmacologic management of multiple myeloma in older adults

Expert Opinion on Pharmacotherapy
Jessica L DempseyHillard M Lazarus

Abstract

Multiple myeloma is a disease predominately affecting older adults. Pivotal to treating older adults is understanding their physiologic differences compared to younger subjects and how the complexity of therapies has an impact upon this patient population. Herein, the authors address the efficacy of chemotherapy regimens, decision-making for older adults, chemotherapy-associated toxicity and the approach to management. This review focuses on the complex treatment of older multiple myeloma patients and management of treatment-related adverse events. Balancing efficacy and managing toxicity is a challenge for older myeloma patients. This group is more susceptible to treatment toxicities due to a higher incidence of pre-existing comorbidities and underlying diminished physiologic reserve. Intensive therapies such as autologous hematopoietic cell transplant (AHCT), however, still should be considered for all multiple myeloma patients, including older adults. The continued development of novel therapies and increased use of multi-drug regimens has changed the treatment paradigms yet understanding the complexity of the aging adult in the context of various drugs is warranted.

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Citations

Apr 23, 2019·Journal of the American Geriatrics Society·Heidi D Klepin, Tanya M Wildes
May 22, 2020·Frontiers in Oncology·Arthur BobinXavier Leleu
Nov 8, 2020·Journal of Clinical Medicine·Hélène GardeneyStéphanie Guidez
Mar 13, 2021·Future Oncology·Joshua RichterMeletios Dimopoulos
May 4, 2021·Annals of Hematology·Marine SolanoAnne-Laure Clairet
Aug 19, 2021·Clinical Lymphoma, Myeloma & Leukemia·Ajai ChariSundar Jagannath

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