Therapy concepts for elderly patients with multiple myeloma

The variability in biological fitness increases with age necessitating assessment of morbidity, frailty and disability for treatment planning in elderly patients with multiple myeloma. This article presents an evidence-based review of current treatment recommendations. Systematic review of the literature in Pubmed, Medline, a manual search and inclusion of results from consensus conferences. In patients aged a parts per thousand yenaEuro parts per thousand 75 years and in those with significant morbidities, adaptation of both the treatment regimen and dose is recommended while cytogenetic risk factors are of minor importance for treatment selection. Several two and three drug treatment regimens incorporating one or two novel drugs were evaluated in prospective randomized trials and are available for first line therapy. Treatment should be administered for at least 9 months in responding patients. Elderly patients are prone to experience side effects of therapy underlining the importance of skillful use of available prophylactic measures and supportive treatments options. In elderly patients biological fitness should be carefully assessed and considered for treatment selection.