Management of hematologic conditions including MDS and acute leukemias are particularly challenging among older adults due to variable coexisting comorbid conditions and functional status which can impact treatment tolerance and benefit. Clinical trials which individualize risk assessment for older patients and capture patient-centric outcomes, such as quality of life, are needed to optimize management for each older adult.

  • Geriatric Assessment Predicts Survival for Older Adults Receiving Induction Chemotherapy for Acute Myelogenous Leukemia: This study published in Blood demonstrated the utility of performing geriatric assessment prior to intensive chemotherapy treatment for older adults with newly diagnosed acute myeloid leukemia. In this study both objectively measured physical performance (tested by walking speed, balance testing, chair stands) and cognitive function were independently associated with overall survival. The results suggest that objectively assessing physical function and cognition adds information to usual care and can help identify patients who are fit versus vulnerable for a given therapy.
  • Hematopoietic Stem Cell Transplantation for Hematologic Malignancies in Older Adults: Geriatric Principles in the Transplant Clinic: Because of the high rate of morbidity from autologous and allogeneic hematopoietic stem cell transplantations, which increases with age, doctors have traditionally not used these treatment strategies with older patients. But in this Journal of the National Comprehensive Cancer Network article, authors propose that the decision to conduct hematopoietic stem cell transplantations should be based on comorbidities and functional status, rather than age alone, and that a comprehensive geriatric assessment can be helpful in this treatment decision process.
Acute Leukemias in Older Adults
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Acute Leukemia in Older Adults