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Management of Newly Diagnosed Elderly Multiple Myeloma Patients

  • Geriatric Oncology (AR MacKenzie, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Given the median age at diagnosis of 69, multiple myeloma (MM) is commonly identified among elderly individuals. Over-treatment of the frail may lead to unnecessary morbidity, while under-treatment of fit elderly patients may prevent improvement in organ function; both instances reducing quality of life. Here, we summarize assessments of frailty and include considerations in managing newly diagnosed elderly MM patients.

Recent Findings

Eligibility criteria for studies of anti-myeloma agents have traditionally relied on performance status and comorbidities; however, geriatric and myeloma-specific frailty assessments are beginning to be incorporated for more accurate stratification of patients for treatment. The IMWG and R-MCI scores are validated metrics that predict survival in elderly MM patients. In addition, dose-attenuated induction regimens and conditioning before autologous transplant may decrease morbidity in elderly MM patients.

Summary

Although MM remains incurable, multi-drug regimens have the ability to prolong survival of both untreated and relapsed elderly patients. Older patients require a highly individualized approach since they may have preexisting organ dysfunction, worse frailty scores, and variable goals of care.

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  1. Department of Medicine, Division of Hematology/Oncology, NYU Winthrop Hospital, 120 Mineola Blvd. Suite 500, Mineola, NY, 11501, USA

    Crystal Antoine-Pepeljugoski & Marc Justin Braunstein

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Marc Justin Braunstein has received consulting fees from Celgene, Janssen, AstraZeneca, Amgen, and Takeda.

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Antoine-Pepeljugoski, C., Braunstein, M.J. Management of Newly Diagnosed Elderly Multiple Myeloma Patients. Curr Oncol Rep 21, 64 (2019). https://doi.org/10.1007/s11912-019-0804-4

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