Advances in Management for Older Adults With Hematologic Malignancies

Abstract

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Diffuse large B-cell lymphoma in octogenarians aged 85 and older can benefit from treatment with curative intent: a report on 129 patients prospectively registered in the Elderly Project of the Fondazione Italiana Linfomi (FIL)

“…This would guide treatment choices better among the increasingly wide range of options and supportive care available for older patients. 19 …”

“…A careful use of supportive care is another important way to improve outcome and quality of life in this group of patients. 16,19,20 Although the reported results come from a large number of octogenarians consecutively treated in specialized centers, this study has some limitations. Patients in very compromised clinical conditions or with very advanced disease may be lost as they are often not referred to secondlevel centers.…”

Ibrutinib, rituximab, and lenalidomide in unfit or frail patients aged 75 years or older with de novo diffuse large B-cell lymphoma: a phase 2, single-arm study

“…4,5 The Comprehensive Geriatric Assessment (CGA), based on age, comorbidities, and functional abilities of daily living, categorises patients into fit, unfit, or frail, for older patients with DLBCL, to choose the best treatment approaches. [6][7][8][9][10][11] Usually, older unfit or frail patients are excluded from large clinical trials and the optimal treatment for this population is still not clear. Rituximab in combination with attenuated cyclophosphamide, doxorubicin, vincristine, and prednisone is the standard of care in patients with DLBCL who are older than 80 years without severe comorbidities and the complete remission rate with this regimen was around 60%, with the 2-year progression-free survival as 47% and 2-year overall survival as 59%.…”

Old age: the crown of life, our play's last act. Question and answers on older patients undergoing allogeneic hematopoietic cell transplantation

“…Investigators from Germany efficiently identified older allogeneic HCT candidates’ frailties through the combination of CGA in conjunction with quality of life (QoL) evaluation through self-reported questionnaires, and assessed their prognostic value on HCT clinical outcomes [42,43]. The incorporation of clinical scores able to effectively capture cognitive and physical impairments of older transplant candidates could be a valuable tool for transplant physicians in the delicate HCT candidacy assessment [44,45 ▪ ].…”