Special considerations for the treatment of multiple myeloma according to advanced age, comorbidities, frailty and organ dysfunction

Muhammad Asad Fraz, Faiza Hassan Warraich, Sami Ullah Warraich, Muhammad Junaid Tariq, Zabih Warraich, Ali Younas Khan, Muhammad Usman, Awais Ijaz, Pavan Tenneti, Adeela Mushtaq, Faisal Akbar, Zaina Shahid, Zeeshan Ali, Hafiz Muhammad Fazeel, Cesar Rodriguez, Aboo Nasar, Ali McBride, Faiz - Anwer

Research output: Contribution to journalReview article

Abstract

Multiple Myeloma (MM) is primarily a disease of old age with a median age of sixty-nine years at diagnosis. The development of novel therapies for induction and use of autologous stem cell transplantation has resulted in improved clinical outcomes and better quality of life for MM patients. Elderly patients, comprising the majority of MM population, have a higher incidence of age-related comorbidities, frailty and organ dysfunction which complicates the coordination of treatment and limits the selection of therapies. Even in the era of multiple chemotherapeutic options, the clinical heterogeneity of the myeloma patients’ demands personalized treatments which often require dose-adjustments or dose delays. The use of reduced-dose regimens and various comorbidity indices has improved clinical outcome and regimen tolerability in MM patients with renal, neurological and bone abnormalities. We focus on advancements in the treatment of multiple myeloma with the goal to guide clinicians towards patient-specific management.

Original languageEnglish (US)
Pages (from-to)18-26
Number of pages9
JournalCritical Reviews in Oncology/Hematology
Volume137
DOIs
StatePublished - May 1 2019

Keywords

  • Comorbidities
  • Dose modifications
  • Dose reduction
  • Elderly
  • Frailty
  • Multiple myeloma
  • Personalized therapy

ASJC Scopus subject areas

  • Hematology
  • Oncology

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  • Cite this

    Fraz, M. A., Warraich, F. H., Warraich, S. U., Tariq, M. J., Warraich, Z., Khan, A. Y., Usman, M., Ijaz, A., Tenneti, P., Mushtaq, A., Akbar, F., Shahid, Z., Ali, Z., Fazeel, H. M., Rodriguez, C., Nasar, A., McBride, A., & Anwer, F. . (2019). Special considerations for the treatment of multiple myeloma according to advanced age, comorbidities, frailty and organ dysfunction. Critical Reviews in Oncology/Hematology, 137, 18-26. https://doi.org/10.1016/j.critrevonc.2019.02.011