Treatment decisions for elderly patients with haematological malignancies: a dilemma

被引：66

作者：

Peyrade, Frederic ^{[1
]}

Gastaud, Lauris ^{[1
]}

Re, Daniel ^{[1
]}

Pacquelet-Cheli, Sandrine ^{[1
]}

Thyss, Antoine ^{[1
]}

机构：

[1] Comprehens Anticanc Ctr, F-06289 Nice, France

来源：

LANCET ONCOLOGY | 2012年 / 13卷 / 08期

关键词：

ACUTE MYELOID-LEUKEMIA; NON-HODGKINS-LYMPHOMA; B-CELL LYMPHOMA; RISK MYELODYSPLASTIC SYNDROME; ACUTE MYELOGENOUS LEUKEMIA; OLDER-ADULTS; INDUCTION CHEMOTHERAPY; GEMTUZUMAB OZOGAMICIN; RITUXIMAB MAINTENANCE; GERIATRIC ASSESSMENT;

D O I：

10.1016/S1470-2045(12)70234-6

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 [肿瘤学];

摘要：

Over the past decade, haematological malignant diseases have been diagnosed with increasing frequency in patients older than 65 years. The management of these diseases is particularly difficult in elderly patients, as non-tumour-related life expectancy is highly variable and the benefit-to-risk ratio for oncological treatments depends on comorbidities and pharmacological factors. Very few data are available in very old or frail patients, and management decisions are usually based on data obtained in younger patients. Patients might, therefore, be overtreated or undertreated without clear clinical or biological justification. In this Review we discuss the management of haematological malignant diseases in the elderly, with respect to biology or pharmacokinetic and pharmacodynamic features. We focus on acute myeloid leukaemia and aggressive lymphoma. Additionally, we discuss how the implementation of geriatric tools, such as comprehensive geriatric assessment scores, in the clinical management of elderly patients might help to adapt treatment to meet individual patients' needs.

引用

页码：E344 / E352

页数：9

共 84 条

[1]

Age and acute myeloid leukemia [J].

Appelbaum, FR ;

Gundacker, H ;

Head, DR ;

Slovak, ML ;

Willman, CL ;

Godwin, JE ;

Anderson, JE ;

Petersdorf, SH .

BLOOD, 2006, 107 (09) :3481-3485

[2]

Is lymphoma occurring in the elderly the same disease? [J].

Armitage, James O. .

LEUKEMIA & LYMPHOMA, 2008, 49 (01) :14-16

[3]

Non-Hodgkin's lymphoma in patients 80 years of age or older [J].

Bairey, O ;

Benjamini, O ;

Blickstein, D ;

Elis, A ;

Ruchlemer, R .

ANNALS OF ONCOLOGY, 2006, 17 (06) :928-934

[4]

Balducci L, 2006, ONCOLOGY-NY, V20, P135

[5]

Balducci Lodovico, 2010, Expert Rev Hematol, V3, P675, DOI 10.1586/ehm.10.72

[6]

Favorable Prognostic Impact of NPM1 Mutations in Older Patients With Cytogenetically Normal De Novo Acute Myeloid Leukemia and Associated Gene- and MicroRNA-Expression Signatures: A Cancer and Leukemia Group B Study [J].

Becker, Heiko ;

Marcucci, Guido ;

Maharry, Kati ;

Radmacher, Michael D. ;

Mrozek, Krzysztof ;

Margeson, Dean ;

Whitman, Susan P. ;

Wu, Yue-Zhong ;

Schwind, Sebastian ;

Paschka, Peter ;

Powell, Bayard L. ;

Carter, Thomas H. ;

Kolitz, Jonathan E. ;

Wetzler, Meir ;

Carroll, Andrew J. ;

Baer, Maria R. ;

Caligiuri, Michael A. ;

Larson, Richard A. ;

Bloomfield, Clara D. .

JOURNAL OF CLINICAL ONCOLOGY, 2010, 28 (04) :596-604

[7]

Comprehensive geriatric evaluation in elderly patients with lymphoma: Feasibility of a patient-tailored treatment plan [J].

Bernardi, D ;

Milan, I ;

Balzarotti, M ;

Spina, M ;

Santoro, A ;

Tirelli, U .

JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (04) :754-754

[8]

Clinical response and miR-29b predictive significance in older AML patients treated with a 10-day schedule of decitabine [J].

Blum, William ;

Garzon, Ramiro ;

Klisovic, Rebecca B. ;

Schwind, Sebastian ;

Walker, Alison ;

Geyer, Susan ;

Liu, Shujun ;

Havelange, Violaine ;

Becker, Heiko ;

Schaaf, Larry ;

Mickle, Jon ;

Devine, Hollie ;

Kefauver, Cheryl ;

Devine, Steven M. ;

Chan, Kenneth K. ;

Heerema, Nyla A. ;

Bloomfield, Clara D. ;

Grever, Michael R. ;

Byrd, John C. ;

Villalona-Calero, Miguel ;

Croce, Carlo M. ;

Marcucci, Guido .

PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2010, 107 (16) :7473-7478

[9]

Buechner, Thomas ;

Berdel, Wolfgang E. ;

Haferlach, Claudia ;

Haferlach, Torsten ;

Schnittger, Susanne ;

Mueller-Tidow, Carsten ;

Braess, Jan ;

Spiekermann, Karsten ;

Kienast, Joachim ;

Staib, Peter ;

Grueneisen, Andreas ;

Kern, Wolfgang ;

Reichle, Albrecht ;

Maschmeyer, Georg ;

Aul, Carlo ;

Lengfelder, Eva ;

Sauerland, Maria-Cristina ;

Heinecke, Achim ;

Woermann, Bernhard ;

Hiddemann, Wolfgang .

JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (01) :61-69

[10]

A comparison of low-dose cytarabine and hydroxyurea with or without all-trans retinoic acid for acute myeloid leukemia and high-risk myelodysplastic syndrome in patients not considered fit for intensive treatment [J].

Burnett, Alan K. ;

Milligan, Donald ;

Prentice, Archie G. ;

Goldstone, Anthony H. ;

McMullin, Mary F. ;

Hills, Robert K. ;

Wheatley, Keith .

CANCER, 2007, 109 (06) :1114-1124

← 1 2 3 4 5 6 7 8 9 →