Personalized therapy in multiple myeloma according to patient age and vulnerability: a report of the European Myeloma Network (EMN).
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Personalized therapy in multiple myeloma according to patient age and vulnerability: a report of the European Myeloma Network (EMN). / Palumbo, Antonio; Bringhen, Sara; Ludwig, Heinz; Dimopoulos, Meletios A; Bladé, Joan; Mateos, Maria V; Rosiñol, Laura; Boccadoro, Mario; Cavo, Michele; Lokhorst, Henk; Zweegman, Sonja; Terpos, Evangelos; Davies, Faith; Driessen, Christoph; Gimsing, Peter; Gramatzki, Martin; Hàjek, Roman; Johnsen, Hans E; Fernando, Leal Da Costa; Sezer, Orhan; Spencer, Andrew; Beksac, Meral; Morgan, Gareth; Einsele, Hermann; Miguel, San; Jesus, F; Sonneveld, Pieter.
In: BLOOD, Vol. 118, No. 17, 17, 2011, p. 4519-4529.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Personalized therapy in multiple myeloma according to patient age and vulnerability: a report of the European Myeloma Network (EMN).
AU - Palumbo, Antonio
AU - Bringhen, Sara
AU - Ludwig, Heinz
AU - Dimopoulos, Meletios A
AU - Bladé, Joan
AU - Mateos, Maria V
AU - Rosiñol, Laura
AU - Boccadoro, Mario
AU - Cavo, Michele
AU - Lokhorst, Henk
AU - Zweegman, Sonja
AU - Terpos, Evangelos
AU - Davies, Faith
AU - Driessen, Christoph
AU - Gimsing, Peter
AU - Gramatzki, Martin
AU - Hàjek, Roman
AU - Johnsen, Hans E
AU - Fernando, Leal Da Costa
AU - Sezer, Orhan
AU - Spencer, Andrew
AU - Beksac, Meral
AU - Morgan, Gareth
AU - Einsele, Hermann
AU - Miguel, San
AU - Jesus, F
AU - Sonneveld, Pieter
PY - 2011
Y1 - 2011
N2 - Most patients with newly diagnosed multiple myeloma (MM) are aged > 65 years with 30% aged > 75 years. Many elderly patients are also vulnerable because of comorbidities that complicate the management of MM. The prevalence of MM is expected to rise over time because of an aging population. Most elderly patients with MM are ineligible for autologous transplantation, and the standard treatment has, until recently, been melphalan plus prednisone. The introduction of novel agents, such as thalidomide, bortezomib, and lenalidomide, has improved outcomes; however, elderly patients with MM are more susceptible to side effects and are often unable to tolerate full drug doses. For these patients, lower-dose-intensity regimens improve the safety profile and thus optimize treatment outcome. Further research into the best treatment strategies for vulnerable elderly patients is urgently needed. Appropriate screening for vulnerability and an assessment of cardiac, pulmonary, renal, hepatic, and neurologic functions, as well as age > 75 years, at the start of therapy allows treatment strategies to be individualized and drug doses to be tailored to improve tolerability and optimize efficacy. Similarly, occurrence of serious nonhematologic adverse events during treatment should be carefully taken into account to adjust doses and optimize outcomes.
AB - Most patients with newly diagnosed multiple myeloma (MM) are aged > 65 years with 30% aged > 75 years. Many elderly patients are also vulnerable because of comorbidities that complicate the management of MM. The prevalence of MM is expected to rise over time because of an aging population. Most elderly patients with MM are ineligible for autologous transplantation, and the standard treatment has, until recently, been melphalan plus prednisone. The introduction of novel agents, such as thalidomide, bortezomib, and lenalidomide, has improved outcomes; however, elderly patients with MM are more susceptible to side effects and are often unable to tolerate full drug doses. For these patients, lower-dose-intensity regimens improve the safety profile and thus optimize treatment outcome. Further research into the best treatment strategies for vulnerable elderly patients is urgently needed. Appropriate screening for vulnerability and an assessment of cardiac, pulmonary, renal, hepatic, and neurologic functions, as well as age > 75 years, at the start of therapy allows treatment strategies to be individualized and drug doses to be tailored to improve tolerability and optimize efficacy. Similarly, occurrence of serious nonhematologic adverse events during treatment should be carefully taken into account to adjust doses and optimize outcomes.
KW - Humans
KW - Aged
KW - Aged, 80 and over
KW - Europe
KW - Age Factors
KW - Age of Onset
KW - Frail Elderly
KW - Community Networks
KW - Individualized Medicine/methods
KW - Multiple Myeloma/epidemiology/therapy
KW - Vulnerable Populations/statistics & numerical data
KW - Humans
KW - Aged
KW - Aged, 80 and over
KW - Europe
KW - Age Factors
KW - Age of Onset
KW - Frail Elderly
KW - Community Networks
KW - Individualized Medicine/methods
KW - Multiple Myeloma/epidemiology/therapy
KW - Vulnerable Populations/statistics & numerical data
M3 - SCORING: Journal article
VL - 118
SP - 4519
EP - 4529
JO - BLOOD
JF - BLOOD
SN - 0006-4971
IS - 17
M1 - 17
ER -